The role of alcohol control policy on the level of alcohol consumption in member states of the Association of Southeast Asian Nations 2000-2022: identifying trends and country clusters for further analyses.

Background: In his historical studies of current high-income countries, Angus Deaton demonstrated a correlation between a country's prosperity and the health of its population. His conceptual framework has recently been expanded to include the role of alcohol. In this ecological study, we test the key assumptions of the expanded framework and classify countries with respect to both their levels of alcohol consumption and alcohol control policies to economic development. Methods: We explored linear trends from 2000 to 2022 in gross domestic product per capita at purchasing power parity (GDP-PPP per capita), life expectancy, and adult alcohol per capita consumption (APC) in 10 member states of the Association of Southeast Asian Nations (ASEAN), grouping them through cluster analyses based on these three variables. We also scored and ranked the countries based on their alcohol control policies. Lastly, we used generalised least squares models, accounting for temporal autocorrelation, to evaluate the associations between GDP-PPP per capita, life expectancy, and APC. Results: We corroborated Deaton's conclusions that increases in economic wealth were associated with increases in life expectancy, with the largest improvements seen in low-income countries and the smallest in high-income countries. Economic transition was consistently related to increases in the level of alcohol consumption in low-income economies, with the exception of Muslim-majority countries. Following their transition to a lower middle-income status, some ASEAN countries appear to have implemented more effective alcohol control policies that halted further increases in their levels of consumption. In Muslim-majority countries, the level of consumption was low, irrespective of the level of economic development. Conclusions: The implementation of alcohol control policies prevents further increases in alcohol consumption and attributable harm and thus allows countries undergoing economic transition to reap the full health benefits of economic development.