Do alcohol tax changes reduce pre-pregnancy and pregnancy alcohol consumption? Evidence from the PRAMS

• In Event: From Taxes to Treatment: Policy Approaches to Substance Use and Maternal and Child Health

Abstract

Studying alcohol consumption among pregnant women is particularly important because of the substantial, lifelong health consequences to the child of being exposed to a teratogen in utero. However, many policies aimed directly at reducing alcohol consumption during pregnancy have been unsuccessful or even counterproductive – for instance, by causing women to avoid health care professionals out of fear of being scolded or even reported (e.g., Atkins and Durrance 2020).  Alcohol taxes, in contrast, are broad-based and do not target pregnant women in particular.  This kind of policy, if successful, could be considered an element of the broader web of supportive alcohol policy that can generate improvements in maternal and fetal health without stigmatizing women (Wolfson and Poole, 2023). 

I examine the relationship between alcohol taxes and prenatal alcohol exposure using data on state-level alcohol taxes from the Tax Policy Center and Tax Foundation linked to births documented in the Pregnancy Risk Assessment and Monitoring System (PRAMS) for the years 2000-2022.  While PRAMS is a voluntary survey, during this time period there are 30 states that ask women about their alcohol consumption during the last 3 months prior to pregnancy and (in most state-years) their alcohol consumption during the last 3 months of pregnancy. During this time, about 1/3 of these states made discrete changes to their alcohol taxes.  I use a basic fixed-effects model followed by a local event study model to predict changes in consumption levels (on both the intensive and extensive margin) as identified by these policy changes.  Preliminary estimates suggest that there is a response to alcohol taxes during the third trimester of pregnancy (but not in the three months prior to pregnancy).  The largest effects seem to be from changes in wine and liquor taxes. The probability of drinking any alcohol in the third trimester is predicted to fall by 15 percent upon increasing alcohol taxes.  The next stage of estimation will incorporate other substance use and will further investigate potential effects on birth outcomes.

Author

• Sarah Hamersma, Syracuse University
  Presenting Author