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This paper evaluates production and consumption of alcohol from an economic point of view. The economic rationale for public policies towards alcohol in a market system is discussed at the outset. Economic costs and benefits of alcohol consumption are then assessed. Three alternatives for taxing alcohol with a special excise tax are presented. The main results of a cost-benefit study of the treatment of chronic alcoholics in Switzerland are reported. Finally, some conclusions are drawn regarding public policy in this field.

For the purposes of an analysis of the hospital capacities of the canton of Basel-Stadt, a one-day census was conducted on April 20, 1983. On that day, the physicians in charge identified every fifth patient out of 2920 hospitalized patients as misplaced. "Misplaced" means that, from a medical point of view, mostly elderly patients could be treated and cared for as well (and cheaper) in other institutions (e.g., nursing homes) or in community settings if adequate home care services were available.

The quantitative impact of smoking on mortality and longevity in Switzerland is investigated. The calculations are based on mortality ratios between smokers and nonsmokers reported in prospective epidemiologic studies, the prevalence of smoking in Switzerland, cause-specific mortality rates and the lifetable. The results imply that in 1976 roughly 3800 premature deaths were attributable to smoking, more than 90% involving males. Thus, smoking appears to be the leading preventable cause of death in Switzerland. The results of lifetable methods used to estimate the impact of smoking on longevity imply that smoking reduces male life expectancy by 12 to 16 months, and that eradication of smoking would increase life expectancy accordingly. Combining the above results suggests that, in 1976, between 52 000 and 54 000 life years were lost as a consequence of the smokers' premature mortality.

"The social costs of energy production and consumption in terms of increased mortality and morbidity are estimated for Switzerland using recent empirical studies on air pollution and health in the United States. These costs were between 100 and 300 million Swiss francs 1980 and occurred mainly as externalities. The paper illustrates how these externalities could be corrected via a Pigou tax. However, there is uncertainty about the epidemiological basis and the imputed values for health and mortality reductions making the imposition of such a tax infeasible until better cost estimates are available." (summary in ENG, FRE), (excerpt)