Impact of government monopoly alcohol shop systems on alcohol consumption in high-income countries.

Government monopoly alcohol shop systems have existed for around 100 years in five well-developed and high-income countries. These countries have a monopoly to sell alcohol above a specified alcohol concentration and apply higher levels of taxation to these sales. The aim of this study is to compare population drinking levels in OECD high-income countries with and without these monopoly shop systems for the period 1973–2015. The study employs a panel regression design. Annual alcohol consumption (liters per capita aged 15+ years) in these countries is the outcome variable. While there were changes in the monopoly shop operations and their operational contexts, their core public health-oriented goals did not change. There is a significant negative association between whether foundational and early joiner OECD member countries have monopoly shop systems and level of alcohol consumption across the whole study period. Second, results were similar for the two subperiods 1985–2000 and 2005–2015 for foundational OECD member countries and all joiners together. Some caution should be exercised in drawing conclusions from this historical data. However the results suggest that countries with monopoly shop systems were overall successful in protecting their population’s public health through restricting access to alcohol.