Effect of Maryland's 2011 Alcohol Sales Tax Increase on Alcohol-Positive Driving

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Introduction—The 2011 Maryland alcohol sales tax increase from 6% to 9% provided an opportunity to evaluate the impact on rates of alcohol-positive drivers involved in injury crashes. Methods—Maryland police crash reports from 2001 to 2013 were analyzed using an interrupted time series design and a multivariable analysis employing generalized estimating equations models with a negative binomial distribution. Data were analyzed in 2014–2015. Results—There was a significant gradual annual reduction of 6% in the population-based rate of all alcohol-positive drivers (p < 0.03), and a 12% reduction for drivers aged 15–20 years (p < 0.007), and 21–34 years (p < 0.001) following the alcohol sales tax increase. There were no significant changes in rates of alcohol-positive drivers aged 35–54 years (rate ratio, 0.98; 95% CI = 0.89, 1.09). Drivers aged ≥ 55 years had a significant immediate 10% increase in the rate of alcohol-positive drivers (rate ratio, 1.10; 95% CI = 1.04, 1.16) and a gradual increase of 4.8% per year after the intervention. Models using different denominators and controlling for multiple factors including a proxy for unmeasured factors found similar results overall. Conclusions—The 2011 Maryland alcohol sales tax increase led to a significant reduction in the rate of all alcohol-positive drivers involved in injury crashes especially among drivers aged 15–34 years. This is the first study to examine the impact of alcohol sales taxes on crashes; previous research focused on excise tax. Increasing alcohol taxes is an important but often neglected intervention to reduce alcohol-impaired driving