As Massachusetts lawmakers debate new taxes on marijuana of anywhere from 8 to 28 percent, public health advocates say there’s another drug that needs a tax hike: alcohol.
Drinkers in Massachusetts pay just pennies per glass in state taxes, one of the lowest rates in the country, despite reams of research showing that higher alcohol prices lead to fewer car crashes and other harms.
Advocates concerned about alcohol’s toll see a renewed opportunity to press for tougher regulations and higher taxes, as a task force formed by state Treasurer Deborah B. Goldberg conducts a soup-to-nuts review of alcohol laws and regulations.
“Alcohol has caused a terrible burden for a very long time,” said Dr. Timothy S. Naimi, a specialist in alcohol policy at Boston University and Boston Medical Center. “Massachusetts has suffered under that burden even more, relative to most other states. I feel like it’s sort of been forgotten.”
The effort comes as binge drinking and heavy drinking are on the rise, especially among women, in Massachusetts and around the country. At the same time, industry campaigns combined with changing attitudes toward drinking have led many states to update legislation first drafted after the 1933 repeal of Prohibition.
In Massachusetts, representatives of the alcohol industry are pleading to overhaul laws to remove what they see as nonsensical barriers — such as limits on small producers’ ability to let visitors taste their wares — that can harm businesses that play a vital role in the state’s economy.
But public health advocates caution that loosening the rules can have unintended consequences.
About 1,500 Massachusetts residents die each year from events attributed to alcohol, such as car crashes, homicides, suicides, and chronic illness, Naimi said. Among working-age adults, ages 20 to 64, about 10 percent of all deaths can be blamed on alcohol.
In comparison, 2,000 people died of opioid overdoses in the state last year, a record high. But, Naimi noted, “we’ve been having an alcohol-death epidemic going on each and every year for quite a long time.”
Alcohol is ingrained in American culture, and most people who drink do so responsibly. But the proportion of drinkers who consume excessive amounts is growing, and these people do a lot of harm to themselves and others.
According to a recent analysis of data from 2005 to 2012, the number of drinkers held steady, but heavy drinking (an average of more than one drink a day for women, two for men) soared by 17.2 percent, and binge drinking (four drinks on a single occasion for women, five for men) went up 8.9 percent.
Limits on the availability of alcohol, especially the number of licenses and the hours of operation, make a critical difference, Naimi said. Advocates said they will oppose any proposals to lift the state’s cap on liquor licenses or extend hours. They also want to roll back the ability of small breweries and distilleries to serve drinks on the premises, to the dismay of producers whose taprooms and tasting rooms have become a major source of income.
Enforcement of laws prohibiting sales to minors significantly lowers underage drinking.
Alcohol excise taxes in Massachusetts remain among the lowest in the country.
But Massachusetts has only 15 investigators to check on 24,000 licensees, the fifth-lowest ratio in the nation. State and municipal police also help enforce drunken-driving and underage-drinking laws.
But the most potent tool, advocates say, is taxes. Numerousstudies have shown that when alcohol taxes go up, excessive drinking and alcohol-related troubles go down, including motor vehicle crashes, violence, cirrhosis deaths, and possibly even sexually transmitted diseases.
Yet, alcohol excise taxes in Massachusetts remain among the lowest in the country. The excise tax on beer is 11 cents a gallon, compared with $1.29 per gallon in the highest-taxing state, Tennessee, according to 2016 data from the Tax Foundation, a nonprofit concerned with tax policy.
The foundation’s data also show: The Massachusetts tax on wine is 55 cents per gallon, while in highest-taxing Kentucky the rate is $3.30; distilled spirits are taxed at $4.05 per gallon compared with $33.54 in Washington, by far the highest tax rate on hard liquor.
The tax is a flat amount based on volume, rather than a percentage based on price. Because of inflation, the Massachusetts tax has lost about half of its value since it was last changed in 1978, according to Naimi.
By contrast, Massachusetts has the nation’s fourth-highest cigarette tax, at $3.51 per pack.
Any talk of raising alcohol taxes in Massachusetts is likely to face pushback from businesses, which succeeded in repealing a short-lived sales tax on alcohol in 2010 through a ballot question heavily promoted by package store owners and beer distributors. The 6.25 percent tax had been on the books only one year. Now Massachusetts remains one of five states that do not apply the sales tax to alcohol.
Frank Anzalotti, executive director of the Massachusetts Package Stores Association, said higher taxes would simply send customers across the border to New Hampshire, putting many stores out of business.
And higher taxes would needlessly throw sand in the gears of the booming craft brewery business, said Rob Burns, president of the Massachusetts Brewers Guild. “It’s a really growing part of the economy and bringing back manufacturing to Massachusetts,” he said.
Craft brewers also point out that their high-priced specialty products are not the drinks of choice for those who overindulge.
But recent experience in another state shows the positive effects of higher taxes. When Maryland raised the sales tax on alcohol to 9 percent from 6 percent in 2011, it brought swift results. The number of alcohol-related motor vehicle crashes in which people were killed or hurt fell 6 percent each year.
Among people ages 15 to 34, crashes declined by 12 percent a year.
The state of Washington experienced the opposite when it liberalized its alcohol laws in 2012, leading to four times as many outlets selling liquor, sometimes until 2 a.m.
In the 24 months after the change, single-vehicle nighttime crashes, typically attributed to alcohol, went up significantly among people under 21, as did emergency department visits associated with alcohol use, according to Julia A. Dilley, a research scientist with the Multnomah County Health Department in Oregon. But the effects would have been even worse, Dilley said, if it were not for a key mitigating factor: New taxes led to higher prices.
Steven L. Schmidt, senior vice president of public policy and communications at the National Alcohol Beverage Control Association, a confederation of the states that operate their own liquor stores, said three factors have converged to prompt a regulatory overhaul in many states: Big box chains such as Walmart, Target, and Costco seeking the right to sell alcoholic drinks with fewer restrictions; online sales creating a need for new types of regulation; and the growing craft brewery industry bristling at requirements intended for bigger companies.
Total Wine & More, a chain operating in Massachusetts and 16 other states, is the most active retailer working to loosen state laws, Schmidt said. In Massachusetts, Total Wine is campaigning for the right to offer coupons and other discounts, which are currently illegal.
But alcohol is not orange juice, and advocates say that higher costs and inconvenience are necessary to prevent excessive use.
“This is a product that is very unique — a product that can cause significant harm when not used appropriately,” Schmidt said. “It holds a unique place in the economy and the culture.”