Evaluation of Alcohol Taxes as a Public Health Opportunity to Reduce Liver Transplant Listings for Alcohol-Related Liver Disease.

BACKGROUND Alcohol-related liver disease (ALD) is a leading indication for liver transplantation. METHODS State consumption of spirits, wine, and beer was determined from published sources. Excise and ad valorem alcohol taxes of spirits, wine, and beer were calculated following standard practices and correlated using multiple logistic regression models to 2002-2015 ALD transplant listing data from the United Network for Organ Sharing (UNOS) database. RESULTS 21.22% (29,161/137,440) of transplant listings were for ALD. Increased consumption of spirits was associated with increased ALD transplant listings (Odds Ratio (OR) 1.67, 95% CI 1.12-2.49, P=0.01) but wine and beer consumption did not have a statistically significant association with ALD transplant listings. Spirits excise taxes on- and off-premise were inversely associated with ALD transplant listing (OR 0.79 and 0.82 respectively, both P<0.02). Beer and wine taxes were not significantly associated with ALD transplant listings. CONCLUSIONS Transplant listings for ALD are directly associated with spirit consumption and inversely associated with spirits excise taxes. These findings suggest a possible public health benefit of increasing excise taxes for spirits.