Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004.

AIMS To review the consequences of the changes in Finnish alcohol policy in 2004, when quotas for travellers' tax-free imports of alcoholic beverages from other European Union (EU) countries were abolished, Estonia joined the EU and excise duties on alcoholic beverages were reduced in Finland by one-third, on average. DESIGN A review of published research and routinely available data. SETTING Finland. MEASUREMENTS Prices of alcoholic beverages, recorded and unrecorded alcohol consumption, data on criminality and other police statistics, alcohol-related deaths and hospitalizations, service use. FINDINGS Alcohol consumption increased 10% in 2004, clearly more than in the early 2000s. With few exceptions, alcohol-related harms increased. Alcohol-induced liver disease deaths increased the most, by 46% in 2004-06 compared to 2001-03, which indicates a strong effect on pre-2004 heavy drinkers. Consumption and harms increased most among middle-aged and older segments of the population, and harms in the worst-off parts of the population in particular. CONCLUSIONS Alcohol taxation and alcohol prices affect consumption and related harms, and heavy drinkers are responsive to price. In Finland in 2004, the worst-off parts of the population paid the highest price in terms of health for cuts in alcohol prices. The removal of travellers' import quotas, which was an inherent part of creating the single European market, had serious public health consequences in Finland.