The estimates varied by state while trends for each beverage type were consistent across states

This increase was driven by the brand Steel Reserve, with a %ABV of 8.1%, as the top-selling brand in the malt beer category from 2006 onwards. Also between 2005 and 2006 the market share of malt beer increased by about 29%, although it still only comprised less than 3% of the market share in 2006. The decline in the national mean %ABV of beer between 2006 and 2010 was explained by the continued decline in market shares of premium beer, which lost 20% of its market shares over this period. The marked increase in the national mean %ABV of beer from 2010 to 2016 was driven by the increase in mean %ABV and market shares of flavored malt beverages and of craft beer. The mean %ABV of FMBs increased from 5.9% to 6.5%, and of craft beer from 4.9% to 5.3% between 2011 and 2016. Over the same period FMBs increased its market share by approximately 56%, while craft beer increased by approximately 85%. It is also important to note that light beer, which had a stable %ABV over time of about 4.3%, showed a steady decline in market shares from a high of 52.9% in 2010 to 44.5% in 2016. The increase in the mean %ABV of wine between 2007 and 2010 was driven by increases in the sales-weighted mean %ABV of table wine. Table wines increased from 11.7 in 2007 to 12.4 %ABV in 2010 when the %ABV peaked and changed little thereafter. Table wines comprised the vast majority of wine sales nationally with a market share consistently around 90%. This market share changed little over the entire 2003-2016 period from 90.2% to 90.7%, and was highest in 2010 at 91.8%. The slight decline in the mean %ABV of wine between 2010 and 2011 was attributable to the decline in the mean %ABV of dessert and fortified wine from 15.0% to 14.1%, which also lost market shares by approximately 16% between 2010 and 2011, although comprised only 3% of the market in 2010. Spirits showed a steady increase in mean %ABV over the 2003 to 2016 period,microgreen rack for sale reflecting a gradual increase in the market shares of higher %ABV spirits and a gradual decrease in lower %ABV spirits.

Vodka, with a mean 40% ABV throughout the study period, showed the largest rise in market shares from 26.2% in 2003 to 33.6% in 2016. Similarly, market shares of tequila, also with a mean 40% ABV, increased market shares from 4.8% to 7.2%. Straight whiskey also increased its market shares from 8.4% to 9.5% between 2003 and 2016, and had a slight increase in mean %ABV from 41.1% to 41.9%. There were limited changes in the mean %ABV of spirits sub-types, with the exception of cordials & liqueurs and prepared cocktails. Cordials & liqueurs showed an increase of mean %ABV from 23.7% to 28.4%, and prepared cocktails from 9.7% to 11.9%. National beverage-specific and total per capita alcohol consumption estimates. The new national variant %ABV-based PCC estimates for beer, wine, and spirits, and for total consumption, with comparisons to AEDS estimates are presented in Figure 2. Overall, our new estimates showed that consumption of pure alcohol from beer was somewhat higher for every year and that consumption of alcohol from wine, spirits, and total PCC was lower in every year compared to AEDS estimates. Our PCC estimates from beer decreased from 4.8 to 4.4 liters per capita between 2003 and 2016 and showed a similar trend over time compared to AEDS estimates. However, the percent difference between the AEDS and our estimates increased between 2011 and 2016 from 3.2% to 5.1% showing that the trends diverge slightly. Our PCC estimates from wine increased from 1.2 to 1.6 liters per capita between 2003 and 2016. The trend is similar to AEDS estimates, although there is a notable convergence between our estimates and the AEDS estimates, where the percent difference decreased from 9.7% in 2003 to 5.0% in 2016. Our estimates of PCC from spirits increased between 2003 and 2016 from 2.31 to 2.98 liters per capita and followed a very similar trend to the AEDS estimates, remaining mostly parallel over the study period. A slight convergence was observed as the percent difference between our estimate and the AEDS estimate was 10.3% in 2003, 7.9% in 2015 and 6.8% in 2016. Our total PCC estimates followed a similar pattern over the 2003 to 2016 period to that of the AEDS estimates . However, there are important differences. Overall, our total PCC estimates were lower than the AEDS estimates.

Further, the trend for our estimate converged with the AEDS estimate trend. The difference between our estimates declined from 0.24 liters of alcohol per person in 2003 to a difference of just 0.08 liters in 2016. Importantly, the percent change between 2003 and 2016 for the AEDS estimates was 5.8% compared to a 7.9% change in our estimates over the same period. This 7.9% change represents 0.66 liters, which is a mean of approximately 37 drinks per person per year. In contrast, a 5.8% change represents 0.48 liters, which is a mean of approximately 27 drinks per person per year. State %ABV estimates for beer, wine, and spirits. The estimates of the mean %ABV of beer, wine,cannabis grow facility layout and spirits for each state and the District of Columbia for selected years are presented in Table 3. The mean %ABV of each beverage type are seen to vary by state in each year, reflecting the variation in preferences and mean %ABV for each beverage sub-type across states and time. All states and the District of Columbia showed an increase in the mean %ABV of beer between 2003 and 2016, and most states followed the national trend. The states with the least amount of change over the 2003-2016 period were North Dakota, Virginia, and Iowa with percent increases of 1.2%, 1.1%, and 0.9%, respectively, while New Mexico, Montana, and Maine experienced the greatest percent increases of 4.9%, 4.4%, and 4.3%, respectively. For wine, all states showed an increase in mean %ABV and followed the national trend. The states with the greatest increases between 2003-2016 were Idaho, Virginia, and Tennessee with increases of 6.8%, 6.8%, and 6.7%, respectively. The states with the lowest percent change were Illinois, North Carolina, and Mississippi with increases of 3.1%, 3.0%, and 2.9%, respectively. For spirits, 45 states and the District of Columbia showed increases in the mean %ABV of spirits, and of these the vast majority followed the national trend. Ohio, Rhode Island, and Nebraska had the largest percent increases at 10.5%, 7.9%,and 6.6%, respectively, while West Virginia, Mississippi, and Alabama had the largest decreases in %ABV for spirits of 0.4%, 0.5%, and 1.8%, respectively. State mean %ABVs and market shares for beverage sub-types. The change in the mean %ABV of beer, wine, and spirits was driven by changes in beverage sub-type mean %ABVs and preferences, and these %ABVs and preferences varied by state. To describe these state-level beverage sub-type %ABV and preference changes in relation to state-level changes in mean beverage-specific %ABV, we present data for the states with the largest change in mean %ABV for each beverage type.

The increase in %ABV of beer for New Mexico, which had the largest percent increase of 4.9%, is attributable to a decline in the market shares of beer with relatively low mean %ABV and an increase of relatively higher mean %ABV beer sub-types. Between 2006 and 2016 the market shares of light beer declined from 51.5% to 37.6%. The market shares of the super premium, micro/specialty, and FMBs sub-type category increased from 6.8% in 2006 to 11.9% in 2010, and between 2011 and 2016 the market shares of craft beer increased from 8.2% to 14.9%. Similar to the national trends in the mean %ABV of wine, state-level trends were driven by the increase in the mean %ABV and the market shares of table wine. Idaho, which had the largest percent change in mean %ABV of wine of 6.8%, had the largest market share of table wine for most years between 2003 and 2016, where market shares of table wine were 97.3% in 2003 and 97.4% in 2016. Comparable to national trends in the mean %ABV of spirits, state level trends were driven by declines in the market shares of low %ABV spirit sub-types and increases in high %ABV spirit sub-types. Between 2003 and 2016, Ohio had the largest increase in mean spirits %ABV of 10.5%. Unlike the national trend, it showed a marked increase between 2012 and 2014 after which it leveled off. The increase in %ABV between 2012 and 2014 was driven by a decline in the market shares of prepared cocktails from 9.3% in 2012 to 0.2% in 2014 and a concomitant increase in the market shares of cordials and liqueurs, straight whiskey, tequila, and brandy & cognac. State beverage-specific and total per capita alcohol consumption estimates. The new beverage-specific %ABV-variant PCC estimates for selected years for each state are presented in Table 3.The total PCC estimates for each state with comparisons to AEDS estimates for 2003 and 2016 are presented in Table 4. The estimates varied by state in each year, representing the range in total PCC by state. Table 4 also shows the percent change in total PCC for each state for both our new estimates and the AEDS estimates. The ranking by percent change varies by the new and AEDS estimates. North Dakota has the largest percent change in total PCC according to both estimates, however, the new estimates rank Vermont second followed by Idaho while the AEDS estimate rank Idaho second followed by Vermont. The vast majority of states showed an increase in total PCC, although 2 more states, Nebraska and Illinois, showed a decline according to AEDS estimates than did according to our new estimates. For all beverage types, our mean %ABV estimates increased nationally and for all but five states. These increases were driven by an increase in national and state preferences for beverages with a higher and increasing %ABV and a decrease in preferences for lower %ABV beverages. The estimates of PCC from wine and spirits utilizing variable %ABV conversion factors were lower than AEDS estimates, while consumption from beer was higher. While our total PCC estimates were also lower than AEDS estimates, the trends in PCC showed a more dramatic increase in pure alcohol volume than those using ABV-invariant methods. Researchers have used PCC estimates to try to understand the observed increases in alcohol-related morbidity and mortality in the U.S. over the first part of the 21st century. For example, White et al noted an increase of 1.7% in PCC and concluded that it did not appear to be related to the 47% increase in the rate of alcohol-related ED visits from 2006 to 2014 . Using our ABV variant method, PCC between 2006 and 2014 increased by 3.6%, over double the increase using the ABV invariant method. This difference and the absolute increase using the ABV variant method may not alone explain the increase in the rate of alcohol-related ED visits. However, because the change in PCC was likely underestimated, it suggests PCC should not be dismissed and may be one of many factors driving the increase in alcohol-related emergency room visits. This example also highlights the importance of the rate of change in PCC trends, and is consistent with findings from an Australian study that similarly showed the value of including time-varying ABV values to ensure precision in PCC estimates so change over time can be accurately measured . It is important to note that cohort and lag effects may also be drivers of the disparity between changes in alcohol-related morbidity and mortality and changes in PCC. Cohort effects may be related in that previous generations may have been drinking at high levels that resulted in death from alcohol-related diseases so that their alcohol consumption would not be included in current PCC estimates . Lag effects may contribute because the time from changes in PCC to the time to first effect for some alcohol-attributable diseases, such as alcohol-related cancers, is at least 10 years .

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