Aims To examine how standard analytical approaches to model mortality outcomes of alcohol use compare to the true results using the impact of the March 2017 alcohol taxation increase in Lithuania on all-cause mortality as an example. Methods Four methodologies were used: two direct methodologies: (a) interrupted time-series on mortality and (b) comparing predictions based on time-series modeling with the real number of deaths for the year following the implementation of the tax increase; and two indirect methodologies: (c) combining a regression-based estimate for the impact of taxation on alcohol consumption with attributable-fraction methodology and (d) using price elasticities from meta-analyses to estimate the impact on alcohol consumption before applying attributable-fraction methodology. Results and Conclusions While all methodologies estimated reductions in all-cause mortality, especially for men, there was substantial variability in the level of mortality reductions predicted. The indirect methodologies had lower predictions as the meta-analyses on elasticities and risk relations seem to underestimate the true values for Lithuania. Directly estimated effects of taxation based on the actual mortalities seem to best represent the true reductions in alcohol-attributable mortality. A significant increase in alcohol excise taxation had a marked impact on all-cause mortality in Lithuania.

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预测酒税增加对死亡率的影响——不同估计技术的比较

目的 以立陶宛 2017 年 3 月酒精税增加对全因死亡率的影响为例，检验酒精使用死亡率结果模型的标准分析方法与真实结果的比较。方法 使用了四种方法：两种直接方法：(a) 死亡率的间断时间序列和 (b) 将基于时间序列模型的预测与实施增税后一年的实际死亡人数进行比较；和两种间接方法：(c) 将基于回归的估计税收对酒精消费的影响与归因分数方法相结合，以及 (d) 在应用归因分数之前使用荟萃分析的价格弹性来估计对酒精消费的影响方法。结果和结论 虽然所有方法都估计了全因死亡率的降低，尤其是男性，但预测的死亡率降低水平存在很大差异。间接方法的预测较低，因为对弹性和风险关系的元分析似乎低估了立陶宛的真实价值。基于实际死亡率直接估计的税收影响似乎最能代表酒精导致的死亡率的真实下降。酒精消费税的显着增加对立陶宛的全因死亡率产生了显着影响。间接方法的预测较低，因为对弹性和风险关系的元分析似乎低估了立陶宛的真实价值。基于实际死亡率直接估计的税收影响似乎最能代表酒精导致的死亡率的真实下降。酒精消费税的显着增加对立陶宛的全因死亡率产生了显着影响。间接方法的预测较低，因为对弹性和风险关系的元分析似乎低估了立陶宛的真实价值。基于实际死亡率直接估计的税收影响似乎最能代表酒精导致的死亡率的真实下降。酒精消费税的显着增加对立陶宛的全因死亡率产生了显着影响。