Background: While specific taxation has been found to be effective in reducing alcohol
consumption and its related harms in High-Income Countries, it theoretically encourages
drinking initiation in Low- and Middle-Income Countries (LMIC) with a high prevalence of
lifetime abstainers. This dissertation aims to systematically review the existing evidence of the
effects of taxation in LMIC on alcohol consumption, alcohol-related harms, and the rate of
drinker initiation, and to examine how changes in Thailand’s Two Chosen One (2C1) taxation
rates affect alcohol consumption, related harms and drinking initiation.
Method: (1) A systematic review and meta-analysis that examines the effects of taxation policy
on alcohol consumption, alcohol-related harms and the rate of drinker initiation in LMIC. (2) A
quasi-experimental study using interrupted time-series analysis that examines the effects of
alcohol taxation increases in Thailand on alcohol consumption and traffic fatalities. (3) An
analysis of four consecutive national surveys on alcohol consumption behaviours to examine the
effect of alcohol tax increases on drinking initiation prevalence in Thailand.Result: There were only 10 published studies that quantitatively examined the effect of alcohol
taxation policy on consumption in LMIC. In LMIC the price elasticity of demand was -0.64 for
all alcohol consumption, -0.50 for beer consumption, and -0.79 for consumption of other alcohol.
No studies were found that examined the effects of taxation policy on alcohol-related harms and
drinking initiation in LMIC. Thailand’s alcohol taxation increase in 2009 was associated with a
reduction in alcohol consumption (tax elasticity of -1.95) and in traffic fatalities (tax elasticity of
-1.90). Increased taxation prevented drinking initiation among young people 15 – 24 years of age
during 2001-2011 in Thailand (tax elasticity of -0.40).
Conclusion: Increases in taxation under the 2C1 taxation method were associated with decreases
in alcohol consumption, alcohol-related harms and drinking initiation.