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There was a sharp drop in alcohol-related deaths when booze became more expensive, researchers reported.

In an 8-year study in the Canadian province of British Columbia, a 10% increase in the minimum price of alcoholic beverages led to nearly a 32% drop in deaths that were wholly attributable to alcohol, such as poisoning and alcoholic cardiomyopathy, according to Tim Stockwell, PhD, of the University of Victoria in Victoria, British Columbia, and colleagues reported online in Addiction.

"This study adds to the scientific evidence that, despite popular opinion to the contrary, even the heaviest drinkers reduce their consumption when minimum alcohol prices increase," Stockwell said in a statement.

"It is hard otherwise to explain the significant changes in alcohol-related deaths observed in British Columbia," he said.

However, the price increases were introduced at the same time as a partial privatization of alcohol sales, allowing sales in outlets other than government liquor stores, and Stockwell and colleagues reported that a 10% increase in the number of private liquor stores was associated with increases from 1.99% to 2.45% in alcohol mortality rates.

The researchers studied changes in death rates over time, using three categories of death associated with alcohol -- wholly alcohol attributable, acute, and chronic.

So-called wholly alcohol attributable deaths included those caused by such things as alcohol poisoning, alcoholic psychoses, alcoholic cardiomyopathy, and alcoholic gastritis.

Acute deaths were mainly those caused by alcohol-related injuries, while chronic deaths were those caused by such things as liver cirrhosis and some cancers.

All told, over the 32 annual quarters of the study from 2002 through 2009, there were 3,642 acute deaths and 5,842 chronic deaths, including 1,388 that were "wholly" attributable to alcohol.

Over the study period, the British Columbia government increased minimum per liter prices for spirits and for beer, while leaving those for liqueurs, wines, and alcoholic coolers unchanged.

A multivariate analysis showed:

• A 10% increase in average minimum prices was significantly associated with a 31.72% reduction in wholly alcohol attributable deaths per 100,000 people.
• Significant decreases in chronic and total deaths attributable to alcohol were seen between 2 and 3 years after price increases.
• A 10% increase in private liquor stores per 100,000 people 15 or older was associated with immediate 2.45%, 2.36%, and 1.99% increases in acute, chronic, and total mortality rates, respectively.

One possible reason for the drop in mortality, Stockwell and colleagues noted, is that increasing the price of cheaper drinks may reduce their consumption by heavier drinkers who prefer them.

The researchers cautioned that they could not tease out which groups are most affected by minimum pricing and changes in the density of alcohol outlets.

They also noted that the analysis was an ecological study, in which the data are measures averaged over individuals and "may not reflect individual level associations."

However, "the results of the present study, while mixed, are interpreted as indicating public health benefits from minimum alcohol prices," they concluded.

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