Exactly a year after minimum alcohol pricing was supposed to have been introduced in Scotland, this week a group of public health professionals including myself registered a protest against the fact that it is still not in place.
The legislation that was passed by the Scottish Parliament in 2012 to introduce minimum pricing remains stalled. An initial case by the Scotch Whisky Association (SWA) challenging the law was rejected in a Court of Session judgement in May 2013. But the SWA’s decision to appeal is still delaying implementation.
My colleagues and I have signed an open letter to the SWA, drafted by Alcohol Focus Scotland. It called on the SWA to drop its legal action and let the measure proceed as part of ongoing efforts to reduce the harm that alcohol causes to heavy drinkers, their families and communities.
The point of minimum pricing
What would minimum unit pricing (MUP) achieve? The planned Scottish MUP of 50p would not affect alcohol sold in pubs and restaurants, nor would it affect most products sold in shops and supermarkets. It would increase the price of the cheapest alcohol, which can cost as little as 18p a unit – drinks such as strong white ciders and supermarket own brand spirits.
Modelling conducted by colleagues at the University of Sheffield estimated that in the first year following introduction, MUP would result in 60 fewer deaths, 1600 fewer hospital admissions and 3500 fewer crimes in Scotland.
These estimates are supported by the experience in Canada. For more than a decade I’ve regularly visited relatives in British Columbia, one of a number of Canadian provinces that has had a MUP schedule in place for a number of years. Alcohol does not appear noticeably more expensive overall, while they don’t have the very cheapest drinks that we do.
Professor Tim Stockwell and his team at the University of Victoria have assessed the impact of this policy.
Between 1989 and 2010, there was a 10% increase in the minimum price of an alcoholic drink, which reduced its consumption by 16%. Wine consumption fell by 8.9%, ciders by 19.9% and beer by 1.5%. More importantly, there was a 32% drop in wholly alcohol attributable deaths.
Despite this evidence, fears remain in Scotland that MUP will increase the price of all drinks and punish moderate drinkers. This misunderstands the policy. MUP focuses on those who suffer the greatest harm from alcohol. We explained this in a report last year that set out an independent strategy on alcohol for the UK.
The report argued that very cheap alcohol undermines other policies designed to address alcohol problems. An MUP of 50p would increase moderate drinkers’ costs (assuming their consumption remained the same) but only by a very small amount – an average of 29p per week.
The English compromise
In England there is currently little prospect of MUP being introduced after the government abandoned the policy last year. A different price policy, involving a “below cost ban”, will come into effect next week instead. It will prevent the sale of alcohol below the rate of duty including VAT.
The Westminster government has argued this will address the sale of cheap alcohol but research suggests that its impact on reducing alcohol harms will be negligible. It is estimated that the 45p level of MUP initially discussed in England would have a 40 to 50 times larger effect on consumption than the below-cost ban that is being introduced.
John Holmes from the University of Sheffield outlined the differences between the two policies for The Conversation earlier this year.
So in Scotland we wait for a policy that should go some way to addressing the fact that alcohol is 48% more affordable than it was in 1980, with all the harm to drinkers and those around them that this entails. Let’s hope we won’t have much longer to wait.