Heavy Drinking, Health and Mental Wellbeing

The link between alcohol consumption and individual health outcomes remains a contentious area of public policy. Whilst a range of medical evidence clearly shows the effect of alcohol on mental and physical functions, there is a large step from this to the public health question of how alcohol consumption choices by individuals influences their health. A body of research has developed in economics that seeks to identify this causal effect on health outcomes. The most credible of these involve using legislative variations in alcohol availability. Most notably, Carpenter and Dobkin (2009) use minimum drinking age laws and use a regression discontinuity design (RDD) to demonstrate a sizeable causal effect of drinking frequency on a range of alcohol related deaths.

Less is known about the causal effect of alcohol consumption for wider age groups. This is of interest as the health effects of alcohol consumption for young people may be quite distinct. This paper contributes to this literature by using variations in on-premise alcohol availability to estimate the effect of alcohol consumption on individual health outcomes. We use the recent extension of bar opening hours from 11am out to 5am in England and Wales in 2005 to examine how greater on-premise drinking influences individual health. This policy change was motivated by a desire to reduce excessive alcohol consumption caused by restrictive opening hours, so called drinking to ‘beat the clock’. The view was that short opening hours were a cause of excessive drinking.  Our initial contribution is to provide the first evidence on effect of this extension of on-premise opening hours on alcohol consumption. We demonstrate that longer hours cause greater alcohol consumption on premise, and provide evidence that this isn’t through substitution for off-premise drinking. Hence, overall consumption appears to increase. This is complementarity to existing research that demonstrates a link between alcohol availability and consumption, either in terms of minimum legal age or restrictions in off-license sales at particular times (see for instance Heaton, 2012 or Carpenter and Eisenberg, 2009, Norstrom and Skog, 2005).  

We then use this for the basis of estimating the effect of drinking, specifically heavy drinking, on individual health outcomes. Heavy drinking seems a natural point of focus as this is where negative health effects are likely to be concentrated. It is, as described later, a form of consumption for which our data is particularly advantageous. Our estimates suggest that increases in heavy drinking have marked negative consequences on both physical and mental health. We use these first stage estimates to compute the implied health to alcohol unit consumption relationship, and demonstrate a marked decrease in both physical and mental health due to increased heavy drinking. The take home message from our paper is that longer on-premise alcohol availability leads to overall increases in alcohol consumption and that this, in turn, has detrimental effects on individual mental and physical health through increased heavy drinking.