A “buck a beer,” but at what cost to public health?

  • Kevin D. ShieldEmail author
  • Charlotte Probst
  • Jürgen Rehm


Alcohol use leads to a substantial number of hospitalizations, and to increased health and social harms as well as economic costs in Ontario and across Canada. The effects of alcohol price changes on consumption and resulting harms have been firmly established; changes in the minimum price of alcohol have the greatest effect on consumption among people who for reasons of affordability consume low-priced alcoholic beverages, typically adolescents, people with lower socio-economic status, and people with harmful alcohol use. Decreases in inflation-adjusted minimum pricing in British Columbia from 2002 to 2006 have been associated with increases in deaths wholly attributable to alcohol. Furthermore, decreases in alcohol prices have been previously associated with increases in drink-driving, decreases in life expectancy, increases in road traffic injuries, violence, and alcohol poisonings, and long-term increases in deaths from infectious diseases, circulatory diseases, and digestive diseases. Based on the findings of previous studies, lowering the cost of alcohol will negatively impact the health of Ontarians and further strain a healthcare system with limited resources. Accordingly, Ontario should be strengthening alcohol policies to improve public health, including raising the minimum price of alcohol, rather than weakening alcohol policies.


Ethanol Ontario Health policy Economics Mortality 


La consommation d’alcool mène à un nombre important d’hospitalisations, et à une augmentation des méfaits sur la santé et la société, ainsi que des coûts économiques en Ontario et dans l’ensemble du Canada. Les effets des variations du prix de l’alcool sur sa consommation et les méfaits qui en résultent ont été fermement établis; les modifications du prix de vente minimum de l’alcool ont le plus grand effet sur la consommation des personnes qui, pour des raisons d’accessibilité économique, consomment des boissons alcoolisées à bas prix, en général des adolescents, des personnes de statut socio-économique inférieur et des personnes ayant une consommation abusive d’alcool. En Colombie-Britannique, la diminution du prix de vente minimum de l’alcool (en dollars constant) entre 2002 et 2006 a été associée à des augmentations de décès entièrement attribuable à l’alcool. De plus, la diminution du prix de vente minimum de l’alcool est associée à l’ivresse au volant, à la réduction de l’espérance de vie, aux accidents de la circulation, à la violence et l’intoxication alcoolique, et à l’augmentation à long terme des décès causées par des maladies infectieuses, circulatoires et digestives. D’après les conclusions d’autres études, réduire le prix de ventre de l’alcool aura des conséquences néfastes sur la santé de la population ontarienne et mettra à rude épreuve les ressources déjà limitées du système de santé provinciale. En conséquence, l’Ontario devrait renforcer la politique en matière d’alcool afin d’améliorer la santé publique, notamment en augmentant le prix de vente minimum de l’alcool, au lieu de l’affaiblir.


Éthanol Ontario Politique de santé Économie Mortalité 



Dr. Shield has received funding from the CIHR Institute of Population and Public Health (CIHR IPPH) Trailblazer Award.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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Copyright information

© The Canadian Public Health Association 2019

Authors and Affiliations

  1. 1.World Health Organization/Pan American Health Organization Collaborating Centre for Addiction and Mental HealthCentre for Addiction and Mental HealthTorontoCanada
  2. 2.Institute for Mental Health Policy ResearchCentre for Addiction and Mental HealthTorontoCanada
  3. 3.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  4. 4.Institute for Clinical Psychology and PsychotherapyTU DresdenDresdenGermany
  5. 5.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  6. 6.Campbell Family Mental Health Research InstituteCentre for Addiction and Mental HealthTorontoCanada
  7. 7.Department of PsychiatryUniversity of TorontoTorontoCanada

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