Research Article: The costs of negative affect attributable to alcohol consumption in later life: A within-between random longitudinal econometric model using UK Biobank

Date Published: February 13, 2019

Publisher: Public Library of Science

Author(s): Chenlu Li, Simon C. Moore, Jesse Smith, Sarah Bauermeister, John Gallacher, Geilson Lima Santana.


Research demonstrates a negative relationship between alcohol use and affect, but the value of deprecation is unknown and thus cannot be included in estimates of the cost of alcohol to society. This paper aims to examine this relationship and develop econometric techniques to value the loss in affect attributable to alcohol consumption.

Cross-sectional (n = 129,437) and longitudinal (n = 11,352) analyses of alcohol consumers in UK Biobank data were undertaken, with depression and neuroticism as proxies of negative affect. The cross-sectional relationship between household income, negative affect and alcohol consumption were analysed using regression models, controlling for confounding variables, and using within-between random models that are robust to unobserved heterogeneity. The differential in household income required to offset alcohol’s detriment to affect was derived.

A consistent relationship between depression and alcohol consumption (β = 0.001, z = 7.64) and neuroticism and alcohol consumption (β = 0.001, z = 9.24) was observed in cross-sectional analyses, replicated in within-between models (depression β = 0.001, z = 2.32; neuroticism β = 0.001, z = 2.33). Significant associations were found between household income and depression (cross sectional β = -0.157, z = -23.86, within-between β = -0.146, z = -9.51) and household income and neuroticism (cross sectional β = -0.166, z = -32.02, within-between β = -0.158, z = -7.44). The value of reducing alcohol consumption by one gram/day was pooled and estimated to be £209.06 (95% CI £171.84 to £246.27).

There was a robust relationship between alcohol consumption and negative affect. Econometric methods can value the intangible effects of alcohol use and may, therefore, facilitate the fiscal determination of benefit.

Partial Text

The potential benefits of light alcohol consumption has long been described in terms of greater happiness, reduced anxiety and positive changes in other affective states [1]. The pursuit of happiness is an unalienable right in some jurisdictions [2] and the UK Government explicitly referenced the presumed positive effect of alcohol on well-being in the 2012 Alcohol Strategy [3]. However, there is a reliable and consistent relationship between greater alcohol use and negative affect [3]. Initiatives that reduce alcohol consumption should, therefore, be expected to elicit improvements to a population’s affective state.

There were several notable findings from the present investigation. First, consistent with previous cross-sectional and longitudinal research, a robust relationship between alcohol consumption and affect was observed, and between income and affective state. Second, using the relationship between household income and negative affect, the shadow price for alcohol consumption per gram consumed was calculated, with broadly consistent results: for cross-sectional analyses, £204 (depression) and £231 (neuroticism), and for the within-between random model, £178.04 for depression and £222.03 for neuroticism. Averaging across these values yields a cost per gram of alcohol per day of £209.06 (95% CI £171.84 to £246.26) on annual household income. For those interested in the cost-effectiveness of alcohol policy, this estimate captures the intangible effects of alcohol and might be used to inform estimates of the societal costs of alcohol consumption [20].

The findings presented here are consistent with the research evidence suggesting that greater alcohol use is detrimental to consumers’ affective state and that policies that reduce alcohol consumption improve public well-being. Shadow pricing methods were used to assign value to the affective and intangible consequences of alcohol consumption. The affective benefit of reducing alcohol consumption by one bottle of wine (75g ethanol per 750ml) each week is equivalent to an increase in annual household income of £2,389 whereas reducing consumption by one pint of beer (20.45g ethanol per 568ml) each week is equivalent to an increase in annual household income of £610.69, and in addition to the purchase price of alcohol.




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