• Robert A Tessler, Stephen J Mooney, D Alex Quistberg, Ali Rowhani-Rahbar, Monica S Vavilala, and Frederick P Rivara.
• Harborview Injury Prevention and Research Center, Seattle, Washington; Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: tesslerra@upmc.edu.
• Am J Prev Med. 2019 May 1; 56 (5): 708-715.

IntroductionThis study sought to determine the association between changes in state-level beer excise tax and firearm homicide rates among individuals aged 15-34years.MethodsA time series analysis with synthetic controls was conducted for the years 2003-2015. Exposed states changed the beer excise tax during the study period. Synthetic controls were weighted mimics that combined portions of unexposed states using state-year specific demographic and firearm covariates. Average annual incidence rate differences were calculated between each exposed state and its synthetic control. Alcohol taxes were available through the National Institute of Alcohol Abuse and Alcoholism and firearm homicide rates were obtained from theCenters for Disease Control and Prevention. States that changed the beer excise tax but forwhich <2years of pre-exposure data were available were excluded. Data were collected in 2017 and analyzedin 2018.ResultsFive states met inclusion criteria, and all raised the beer excise tax: Illinois (2009), New York (2009), North Carolina (2009), Connecticut (2011), and Rhode Island (2013). The percentage increase in beer excise tax ranged from 10% to 27%. Differences in pre-exposure firearm homicide rates between exposed states and synthetic controls were minimal. The increase in beer excise tax was associated with a lower average annual firearm homicide rate in all states except Illinois (Rhode Island: incidence rate difference= -2.48, Connecticut: incidence rate difference= -2.57, New York: incidence rate difference= -1.45, North Carolina: incidence rate difference= -0.45, and Illinois: incidence rate difference=1.54 per 100,000 population).ConclusionsAmong individuals aged 15-34years, price-sensitive consumption of beer may representone feasible tool for policymakers seeking to reduce rates of firearm homicide.Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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