For some quality life years...

Alcohol’s deleterious effects not just pose a health and social burden but also impact the economics of the country, writes Rashikkha Ra Iyer

In moments of economic crises, alcohol always precedes the queue in terms of priority. As of 2023, the economy of alcohol consumption remains comfortably ensconced in this very incongruous dichotomy. Whilst the moral overtones of alcohol policies are poignant, its proximate to a source of revenue remains constant. In 2020, alcohol taxes generated a revenue of Rs 2.25 trillion spread nationally making a good case in point. Alcohol’s deleterious effects not just pose a health and social burden, but also a huge economic burden. This is often glossed over. In the year 2018, a report by the World Health Organisation indicated that alcohol use resulted in 132.6 million Disability-adjusted life years (DALYs) which is basically 5.1% of all DALYs in that year. Alcohol was the 7th leading risk factor for both deaths and DALYs.

The trajectory of economic burden through alcohol is often through health effects and consequent health system costs, out-of-pocket (OOP) expenditure for treatment of co-morbidities precipitated by alcohol consumption, dwindling productivity, and reduction in life span/ premature mortality due to related health conditions. Most of these studies have dedicated their sole focus to developed countries, whilst only meagre studies have investigated this phenomenon in developing countries like that of India. The socioeconomic milieu, and cultural factors that steer drinking patterns in India are distinct from those in Western countries. Thus, the findings for economic burden related to alcohol from developed countries cannot be applied to India. One such pilot study was conducted by Gaurav Jyani et al., to exclusively investigate India with an aim to inform policy and legislation formulation. This study successfully yielded a quantitative testimony that established the correlation between alcohol consumption and consequent economic burden in India. This analysis showed that between the years of 2011 and 2050, alcohol-attributable deaths would lead to a loss of 258 million life years. This accounts for the loss of 75.60 days of life (discounted) per capita by the year 2050. If alcohol consumption is streamlined and regulated and consequently eliminated, India would gain 552 million quality-adjusted life years (discounted).

Being the world’s fourth-largest producer of alcohol, the key benefit for state governments in India stems from the excise revenue on alcohol taxes. In most states, apart from where state laws-driven prohibitions exist, alcohol continues to remain in the second or third position in terms of contribution to the national exchequer. However, a noteworthy observation would be to identify that these revenues are only sourced from licensed, registered producers of liquor. Indigenised alcoholic beverages produced within the home and cottage industry such as arrack, and toddy, fall into the unorganised sector, and thus make no contributions to the excise collection.

As an effective response, policymakers should thus identify the dearth of India-specific alcohol-economy-related data. More commissioned research projects coupled with holistic, comprehensive cost-benefit analysis must be conducted both at the state and national levels. Whilst looking into the prevalence of alcohol consumption in India, the representative digits of consumption among the adolescent population is often imprecise. This must be streamlined and coupled with further focus on other marginalised and vulnerable groups who often do not make up the sample population. Many studies intermittently also miss the intangible cost-effects of alcohol such as family distress, household distress, and consequent economic burden. This in turn often serves as a significant perpetrator of many crimes, committed as a result of poverty or to fund the habit of addiction. In comparison to developed countries such as the US and the UK that garner quite a billion from alcohol excise duties, India’s dependence on it is inordinate. This in turn explains the hurried resumption of alcohol sales, especially when the country was just rolling out from the national lockdown during Covid-19. For instance, Tamil Nadu witnessed 150 crores worth of liquor sales on day 1 of re-opening post-lockdown. This eloquently speaks of alcohol serving as the economic rescue for India in terms of government finances.

In the long run, alcohol is execrable for the Indian economy and makes a significant part of a poor financial strategy.

This thus substantiates the need for sound policy-making with a robust evaluation of cost-benefit analysis in trying to tackle the harms associated with alcohol consumption.

(The author is a multidisciplinary professional who works in the UK.)