Impact of Alcohol Policies on Suicidal Behavior: A Systematic Literature Review

Abstract

Alcohol consumption has been found to be related to suicidal behavior at the individual and population level, but there is lack of literature reviews on the effect of alcohol policies on suicidal behavior. Therefore, the aim of the current study is to conduct a systematic literature review of the impact of alcohol policies at the population level on suicidal behavior and ideation. We searched the Cochrane CENTRAL, Cochrane DARE, EMBASE, Medline, ProQuest, PsycINFO, PubMed, SCOPUS, and Web of Science electronic databases in March 2019. Papers analyzing alcohol policies limiting alcohol use and studying suicidal behaviors as an outcome measure were included; we identified 19 papers. Although the methods and effect sizes varied substantially in the studies, reducing alcohol often led to reduction in suicidal behavior. Ecological-level studies predominantly investigated the effect of restrictions on alcohol availability and increased cost of alcohol, and the majority presented a reduction in suicides across Western and Eastern Europe, as well as the US. The majority of studies were rated as unclear risk of bias for a number of domains due to a lack of clear reporting. Policies targeting harmful alcohol consumption may contribute towards a reduction in suicidal behavior at the population level.

Police-reported suicides during the first 16 months of the COVID-19 pandemic in Ecuador: A time-series analysis of trends and risk factors until June 2021

“…Our findings are consistent with other data showing alcohol regulations are associated with falls in suicide. 29 Therefore (re)-implementation of laws and regulations, such as taxation, and sales restrictions on certain hours or days may be a cost-effective public health policy to reduce suicide as well as other alcohol-related mortality. 30 …”

A qualitative exploration of young people’s experiences of attempted suicide in the context of alcohol and substance use

“…The young people in this study spoke about the accessibility and normalisation of alcohol use and the impact that this has on their suicidal ideation and attempts. A recent systematic review of international literature [ 29 ] found that by changing policies related to accessibility and cost of alcohol there was a decrease in suicide rates. The results highlight the importance of including assessment and formulation of alcohol and substance use when working with young people with suicidal ideation.…”

Suicidal ideation and associated factors among school-going adolescents in rural Ghana

“…Beyond these possibilities, the evidence underscores the need for government to strengthen the enforcement of the country's alcohol policy to prevent access and sale of alcoholic beverages to underage persons (Ministry of Health Ghana, 2016). A recent systematic review suggests that strengthening policies targeted at reducing harmful alcohol consumption could contribute to reducing suicidal behaviours (Kõlves et al, 2020).…”