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Paying the Tab

Paying the Tab: The Costs and Benefits of Alcohol Control

Philip J. Cook
Copyright Date: 2007
Pages: 278
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  • Book Info
    Paying the Tab
    Book Description:

    What drug provides Americans with the greatest pleasure and the greatest pain? The answer, hands down, is alcohol. The pain comes not only from drunk driving and lost lives but also addiction, family strife, crime, violence, poor health, and squandered human potential. Young and old, drinkers and abstainers alike, all are affected. Every American is paying for alcohol abuse.

    Paying the Tab, the first comprehensive analysis of this complex policy issue, calls for broadening our approach to curbing destructive drinking. Over the last few decades, efforts to reduce the societal costs--curbing youth drinking and cracking down on drunk driving--have been somewhat effective, but woefully incomplete. In fact, American policymakers have ignored the influence of the supply side of the equation. Beer and liquor are far cheaper and more readily available today than in the 1950s and 1960s.

    Philip Cook's well-researched and engaging account chronicles the history of our attempts to "legislate morality," the overlooked lessons from Prohibition, and the rise of Alcoholics Anonymous. He provides a thorough account of the scientific evidence that has accumulated over the last twenty-five years of economic and public-health research, which demonstrates that higher alcohol excise taxes and other supply restrictions are effective and underutilized policy tools that can cut abuse while preserving the pleasures of moderate consumption.Paying the Tabmakes a powerful case for a policy course correction. Alcohol is too cheap, and it's costing all of us.

    eISBN: 978-1-4008-3741-0
    Subjects: Finance, Political Science, Business

Table of Contents

  1. Front Matter
    (pp. iii-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Illustrations
    (pp. ix-x)
  4. Preface
    (pp. xi-xiv)
  5. CHAPTER 1 Introduction
    (pp. 1-10)

    Excess drinking is a problem for millions of Americans and their families. It is also a problem for the communities in which they live, degrading public health and safety and ultimately lowering our standard of living. The public response to this problem has varied over time, but always with some mix of two general approaches. On the one hand are efforts, both public and private, to reduce excess drinking directly—education, persuasion, counseling, treatment, sanctions of various sorts. On the other hand are measures to reduce excess drinking by restricting availability or raising the price—licensing, product and sales regulation,...

  6. Part I Rise and Fall of Alcohol Control

    • CHAPTER 2 A Brief History of the Supply Side
      (pp. 13-33)

      National Prohibition, the Noble Experiment of the 1920s, is the most remarkable feature in the long history of American policy toward alcoholic beverages. It involved two amendments to the U.S. Constitution—the Eighteenth, which mandated national prohibition, and the Twenty-first, which repealed it—both ratified quickly and with broad support. The experience with prohibition has had a powerful influence on public discourse. That it failed, and was destined to fail because it sought to “legislate morality,” are lessons that have become part of the conventional wisdom. People who now seek to reduce alcohol abuse by advocating controls on supply and...

    • CHAPTER 3 The Alcoholism Movement
      (pp. 34-46)

      The temperance movement was grounded in the belief that alcohol is a dangerous drug—a poison—that threatens all who imbibe with physical, social, and moral harms. Hence it made sense to institute broad limits on the availability of alcohol. National Prohibition was the ultimate realization of this approach, and although it was eventually deemed a costly failure by the vast majority of Americans, temperance thinking continued to be influential following Repeal, animating the push for state alcohol-control systems during the 1930s. But an alternative perspective gained great traction during the 1940s and 1950s, namely that the “problem” is alcoholism,...

  7. Part II Evidence of Effectiveness

    • CHAPTER 4 Drinking: A Primer
      (pp. 49-64)

      Quantification is essential to assessing the scope, pattern, and trend of drinking, and to evaluating particular interventions intended to reduce problematic drinking. But not just any data will do—what we need depends on how the “problem” is defined. As we have seen, the temperance reformers of the early twentieth century saw alcohol itself as the problem, and ultimately adopted abstinence as the goal. For them, “success” would be equated with an increasing prevalence of teetotalers and falling sales figures. On the other hand, for advocates in the alcoholism movement, data on overall sales are essentially irrelevant—what’s needed are...

    • CHAPTER 5 Prices and Quantities
      (pp. 65-81)

      The noble experiment of Prohibition was a failure in the sense that it lost popular support. But as we have seen, it was associated with a sharp reduction in alcohol consumption and alcoholism. Although there is some wisdom in the view that “you can’t legislate morality,” legislationcaninfluence prices and availability, and hence the choices people make—regardless of whether those choices are informed by moral considerations as well.

      As it turns out, the evidence on how prices and availability affect drinking is not limited to the unusual circumstances of Prohibition. Economists and others have analyzed the response of...

    • CHAPTER 6 Alcohol Control as Injury Prevention
      (pp. 82-106)

      The public interest in regulating alcohol stems primarily from the consequences of overindulgence, which include the indiscretions and injuries associated with inebriation, and the long-term effects of heavy drinking on organ function and volition. The key question is whether regulations which limit availability and raise the price of alcohol are actually effective policy instruments. Is highway safety enhanced by the minimum age laws, excise taxes, and liability rules for bars? Would there be noticeably fewer gonorrhea cases and unwanted pregnancies if Congress raised the beer excise tax? Does alcohol availability affect rates of criminal violence and suicide? The answer to...

    • CHAPTER 7 Long-Term Effects: Hearts and Minds
      (pp. 107-119)

      The most vivid consequences of intoxication are immediate. The drinker gets into a wreck or a fight, or has unprotected or unwanted sex—or not. If not, then the physical harm is likely to be limited to a hangover the next morning. But that is not the whole story. A particular drinking bout may affect other people’s opinions of the drinker. His behavior while drunk may affect his standing with his family, employer, and friends. Alcohol-fueled antics at fraternity parties may raise his standing among his brothers and make for a fond recollection years later. Or drinking may help an...

    • CHAPTER 8 The Drinker’s Bonus
      (pp. 120-130)

      Does drinking affect the productivity of the labor force? Common sense, backed by a good deal of evidence, says yes. In fact, estimates of alcohol-related social costs are typically dominated by the value of lost productivity (Harwood Fountain, and Livermore 1998). Historically the concern with the quality and quantity of work provided by the labor force was a major factor in nineteenth-century temperance movements in the United States and Europe (Roberts 1984; Rumbarger 1989). Clark Warurton (1932) stated the argument concisely:

      Prohibition, if it actually resulted in the cessation of use of alcoholic beverages, might be expected to affect the...

  8. Part III Assessing Policy Options

    • CHAPTER 9 Evaluating Interventions
      (pp. 133-147)

      In my state, North Carolina, it is commonplace for convenience stores to sell single beers on ice, positioning them in a big barrel located near the cash register. This presentation encourages customers to buy a ready-to-drink beer on impulse. Someday the state legislature may get around to debating a ban on this practice. Predictably, advocacy groups such as Mothers Against Drunk Driving would argue for a ban to make the highways safer by reducing drinking-while-driving. On the other side, representatives of the convenience store owners might make the case that they are simply providing a service to anyone who relishes...

    • CHAPTER 10 Regulating Supply
      (pp. 148-164)

      The states have been in the business of taxing and regulating alcoholic beverages since Repeal. As we have seen (in chapter 3), the systems put in place during the 1930s were guided by the goals of promoting temperance, collecting revenue, and preventing the crime and corruption associated with Prohibition and the infamous pre-Prohibition saloons. In practice the temperance goal never had much sway, and in the post-War period state officials came to view alcohol control as irrelevant to alcohol-abuse prevention (Medicine in the Public Interest 1979; Room 1984). But evidence to the contrary has been accumulating in recent years. As...

    • CHAPTER 11 Taxing the Alcohol Industry
      (pp. 165-178)

      Of all the alcohol-control measures, taxes have unique advantages. They help curtail alcohol abuse and its consequences without a direct restriction on freedom of choice. They can be set high or low or anywhere in between, providing the possibility of a calibrated response to the costs of alcohol-related problems. And rather than competing for resources with other government priorities, alcohol taxes enhance public revenues. As we have seen (chapter 2), it was this last advantage that was the immediate motivation when the first Congress imposed a whiskey excise tax in 1791, and the revenue motive has remained paramount in federal...

    • CHAPTER 12 Youth as a Special Case
      (pp. 179-195)

      My students agree on two things—the transcendent importance of Duke basketball, and the absurdity of campus drinking regulations. On the latter issue they sound much like critics of social policy through the ages, whose arguments, as Albert Hirschman has documented, can be summarized as “futility,” “perversity,” or “jeopardy” (1991). They assert that the effort to ban drinking by underage students is futile, and even perverse in that it pushes the party scene off campus where it is more dangerous and strains town-gown relationships. A deeper criticism is that these control measures jeopardize the effort to create a sense of...

    • CHAPTER 13 Alcohol-Control Policy for the Twenty-first Century
      (pp. 196-202)

      There is no crisis, no epidemic, no dramatic upsurge of alcohol abuse that demands public attention. Average alcohol consumption is well below the peak years circa 1980, and the damage to public health and safety has declined as well. In particular, the DUI problem has dropped thanks not only to the reduction in overall alcohol consumption but also to tougher enforcement and the secular improvement in highway safety. Violent crime has dropped sharply since the peak in 1991, due to an easing of the crack-cocaine epidemic, increased incarceration, and other factors (Cook and Laub 2002; Levitt 2004; Blumstein and Wallman...

  9. Methodological Appendix
    (pp. 203-206)
  10. Notes
    (pp. 207-220)
  11. References
    (pp. 221-248)
  12. Index
    (pp. 249-262)