Reducing harm caused by alcohol

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Alcohol sales and MUP

Before minimum unit pricing was introduced in Scotland in May 2018 you could drink more than the recommended alcohol limit for a whole week for the price of one cup of coffee. These pocket money prices encouraged people to drink more with damaging consequences: 1,200 Scots lost their lives, and more than 35,000 admitted to hospital due to drink in 2017.  Something needed to be done and the Scottish government - with the backing of the Scottish Parliament – was prepared to take on the might of global alcohol corporations and put Scotland’s health first.   

Since the introduction of MUP we have been hearing anecdotal evidence of positive effects on alcohol consumption.  For example, frontline workers have reported that people are switching drinks, moving away from cheap, high strength white cider, an expected outcome of MUP.  If those people are spending the same amount of money on other types of drinks they will likely be consuming fewer units of alcohol overall.  The retailers have also reported that people are buying smaller sizes of cans and bottles.

The initial figures from the MESAS Monitoring Report 2019 , on the amount of alcohol sold per adult – the first since minimum unit price (MUP) was introduced are hugely encouraging and suggest the policy is having a real impact on the way we drink in Scotland.  A reduction of 3% in average consumption in 2018 is great news for Scotland’s health and is in contrast to England and Wales, who don’t have MUP, where consumption has increased by 2%.  The figures are particularly encouraging given that MUP was only introduced on 1 May, four months into the year, and the fact that last summer was an extraordinary one which according to the trade press pushed up alcohol sales across the UK.   

The world has been watching to see how this ground-breaking policy takes shape and what the outcomes will be. It is right that the MESAS programme - a robust and thorough evaluation - has been put in place to help look at the wider impact of minimum pricing over the next five years, not least because the effect of MUP is expected to build over time.  But these initial figures on alcohol sales should encourage those in Wales, Ireland and Australia who are following in our footsteps and hopefully embolden others such as the UK Government to take action.

 As well as the consumption figures for 2018, we have also seen the publication by National Records of Scotland (NRS) of the alcohol-specific death figures for last year.  Whilst these show a 1% increase in deaths in 2018 these figures are well within the range of the year-to-year fluctuations that have been seen in previous years. We would expect a lag between falling consumption and falling harms, particularly for acute conditions.  It’s also worth being aware that the NRS definition of alcohol-specific deaths only captures about one third of all deaths due to alcohol in Scotland (consequently only a third of the lives expected to be saved by MUP would be expected to show up in the NRS data).  Deaths due to alcohol-related cancers, for example, are not included in the NRS data.  Cancers are responsible for around one third of all deaths due to alcohol in Scotland according to Scottish Public Health Observatory estimates.

There is still every reason to remain confident that, as with the smoking ban, this progressive policy will significantly improve our health and the well-being of our families and our communities.  But, as with tobacco control, one measure alone will not be sufficient. Given the very high levels of consumption and harm in Scotland we need to build on minimum pricing with action to control availability and restrict marketing if we are to change Scotland’s relationship with alcohol for good. 

Alison Douglas, chief executive, Alcohol Focus Scotland.