Alcohol Sales Taxes Are Associated With Reduced Preterm Birth and Low Birthweight in the United States: Journal of Studies on Alcohol and Drugs: Vol 87, No 5
Objective: Historically, alcohol taxation has been one of the best strategies to reduce drinking and related harms in the general population, and prior analyses support that increased alcohol taxes are associated with fewer harms related to drinking during pregnancy. Here, we examine how alcohol taxes are related to preterm and low birthweight births. Method: Birth certificate data for 101,191,080 births conceived between January 1993 and March 2019 come from the U.S. National Vital Statistics System. Outcomes were preterm birth (<37 weeks) and low birthweight (<2,500 g). Time-varying state-level alcohol tax policies were beverage-specific volume-based, sales, and ad valorem taxes. Final regression models adjusted for individual and state covariates, state trends, and clustered standard errors by state. Results: Only sales taxes were consistently related to birth outcomes. Having a beer sales tax was significantly related to lower odds of preterm birth (odds ratio [OR] = 0.94, 95% CI [0.90, 0.98]) and lower odds of low birthweight (OR = 0.98, 95% CI [0.96, 0.99]). Similarly, having a wine sales tax was significantly related to lower odds of preterm birth (OR = 0.94, 95% CI [0.90, 0.98]) and lower odds of low birthweight (OR = 0.97, 95% CI [0.95, 0.99]). Finally, having a spirits sales tax was also significantly related to lower odds of preterm birth (OR = 0.95, 95% CI [0.91, 0.98]) and lower odds of low birthweight (OR = 0.97, 95% CI [0.95, 0.99]). Conclusions: State-level beverage-specific sales taxes are associated with fewer adverse birth outcomes. This study provides additional evidence that increased alcohol taxes may be relevant for reducing adverse effects related to pregnant people's alcohol consumption. Public health significance statement: Policies related to alcohol use during pregnancy in the United States are related to more harms than benefits. Broader alcohol policies that affect the general public—and not just pregnant people—might be better for reducing harms related to drinking during pregnancy. Increased alcohol taxes are linked to better birth outcomes and are one example of broader alcohol policies that may reduce harms from alcohol use during pregnancy.
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