A policy of minimum unit pricing (MUP) on alcohol introduced in Scotland last year appears to have cut spending on alcohol in shops and supermarkets in the country and possibly consumption, suggests a study* published by The BMJ today.
The effects were greatest in households which bought the most alcohol, suggesting that the policy had achieved its ambition to make relatively cheap and strong alcohol less affordable thus improving public health.
In May 2018, Scotland became the first country in the world to introduce a national minimum pricing policy (MUP), setting a limit of 50p per unit below which alcohol cannot be sold. In the rest of the UK, only Wales is considering a similar move from next year.
In the UK, one unit contains 10ml/8g of alcohol and is about equal to half a pint of ordinary strength beer or cider, or a small pub measure (25ml) of spirits. A small (125ml) glass of wine contains around 1.5 units (15ml/12g) alcohol.
To test whether the policy was having an effect, researchers led by Peter Anderson at Newcastle University set out to assess the impact of MUP on alcohol purchases in Scotland in the eight months immediately after implementation.
Their findings were based on shopping data for 2015-18 from 5,325 Scottish households, compared with 54,807 English households as controls, and 10,040 households in northern England to control for potential cross border effects.
The researchers found that after adjusting for number of adults in each household, the introduction of MUP was followed by a price increase of 5.1p per UK unit (or 7.9%) and a reduction of 7.6% (or 1.2 UK units) in weekly ‘off-trade’ (shop) purchases of alcohol per adult per household.
Reductions were most notable for beer, spirits, and cider, including the own-brand spirits and high strength ciders that the policy was designed to target.
In addition, the price increases were greatest in households that bought the largest amount of alcohol (just under £3 per adult per week) and among the lower income groups, which supports the idea that MUP effectively targets those most at risk of harm from alcohol with a minimal impact on household budgets.
This was an observational study so could not establish cause and analyses were restricted to off-trade sales. The authors pointed out that heavier drinkers were more likely to buy alcohol from shops than ‘on-trade’ in bars and restaurants.
Nevertheless, they said: “Our analyses indicate that MUP “is an effective policy option to reduce alcohol purchases, particularly affecting higher purchasers, and with no evidence of a significant differential negative impact on expenditure by lower income groups.”
They concluded: “Our data supports the introduction of MUP as an effective policy option in other jurisdictions.”
The view was supported by public health experts in a linked editorial.**
John Mooney from the University of Sunderland and Eric Carlin from the Royal College of Physicians of Edinburgh, said: “In an age when complex public health issues such as harm from alcohol require whole system approaches, no single policy lever should be seen as a panacea, and MUP is still regarded in Scotland as one component of the overall strategy.”
Nevertheless, they added: “The observed reductions of up to 7.6% in purchases were more than double the modelling based estimates, confirming the authors’ conservative assumptions and highlighting that health benefits could be substantially greater.
“Surely it is time to follow Scotland’s lead and implement MUP across the rest of the UK.”
* O’Donnell A, Anderson P, Jané-Llopis E, et al. Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18. BMJ 2019;366:l5274. DOI:10.1136/bmj.l5274
** Mooney, JD and Carlin E. Minimum unit pricing for alcohol in Scotland Editorial. BMJ 2019;366:l5603. DOI:10.1136/bmj.l5603