Reducing harm caused by alcohol

News Four years of MUP

News

Four years of minimum unit pricing

Four years ago, on 1 May 2018, Scotland became the first country in the world to implement a minimum price per unit of alcohol, set at 50p per unit.

Introduced to address the overwhelming level of harm from alcohol in Scotland, minimum unit pricing (MUP) was expected to reduce deaths, hospital admissions and crime from alcohol. While it will take 20 years to see the full effect of this ground-breaking policy, we are starting to see some encouraging results.

What has the impact been so far?

In the first full year of introducing minimum unit pricing, there was a 3.5% reduction in off-trade sales per adult,[i] reduced household alcohol expenditure,[ii], [iii] the lowest level of consumption in 26 years,[iv] and 10% fewer alcohol-specific deaths.[v] At the end of the first two years, we also saw a small reduction in hospital admissions from liver disease.[vi]

It’s important to note too, that the introduction of MUP has not resulted in any of the unintended consequences the alcohol industry was concerned about. There have been no significant negative impacts on alcohol producers or sellers,[vii] and MUP has had minimal impact on cross-border purchases.[viii]

Modelling for MUP was done on the basis of all else being equal. Of course, nothing can remain exactly the same, but no one could have anticipated the challenge of the Covid-19 pandemic and associated restrictions.

Tragically in 2020 we saw a 17% increase in alcohol-specific deaths on the previous year, resulting in 1,190 lost lives directly because of alcohol.[ix] The full impact of the pandemic on people’s drinking habits and alcohol-related health problems is not yet known, and may not be for some time. However, data shows that many of those drinking most heavily before the pandemic increased their drinking.[x], [xi] The move towards home drinking may also increase risks as it is a cheaper and less-regulated environment.[xii]

What next?

We need to ensure that our recovery from Covid-19 not only returns the nation to pre-pandemic health but improves our health and quality of life. By focusing on policies which deliver at a population level we’ll see benefits across society, but these will be felt most by those who currently experience the greatest burden of alcohol harm – those in our poorest communities.

Alcohol Focus Scotland and 29 other health and children’s charities along with medical Royal Colleges, support uprating MUP to 65p per unit.[xiii] This would take account of inflation over the last nine years since Parliament approved MUP, and increase its impact, saving more lives.

The Sheffield modelling from 2016 found that a minimum unit price of 60p would save twice the number of lives and reduce hospital admissions by twice the level of 50p per unit, while 70p per unit would have three times the effect.[xiv]

Minimum unit pricing is also subject to a ‘sunset clause’, meaning that the Scottish Parliament must vote for the policy to continue. In about a year’s time, the evidence from the extensive independent evaluation will be scrutinised in the Scottish Parliament before MSPs are asked to vote. Alcohol Focus Scotland believes there is a great deal of evidence to support that this life-saving policy is having the expected and desirable impact. Over 70% of the public are either in favour of or neutral in their views on MUP, with support for the policy having grown over time.[xv] Alone MUP is not a silver bullet, but it is one of the best tools we have in tackling the high levels of harm we experience in Scotland.

We urge the Scottish Government to uprate MUP and link it with inflation, safeguarding it from eroding year on year, and, when the times comes, for MSPs to vote to maintain the policy past its sunset clause ensuring it is given the opportunity to deliver its full potential to reduce harm and save lives.

Alison Douglas, chief executive of Alcohol Focus Scotland


[i] Giles, L., Richardson, E. & Beeston, C. (2021). Using alcohol retail sales data to estimate population alcohol consumption in Scotland: an update of previously published estimates. Edinburgh: Public Health Scotland. Available at: https://publichealthscotland.scot/media/2994/using-alcohol-retail-sales-data-to-estimate-population-alcohol-consumption-inscotland-an-update-of-previously-published-estimates.pdf

[ii] Anderson, P. et al. (2021). Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses. The Lancet Public Health. doi.org/10.1016/S2468-2667(21)00052-9

[iii] O’Donnell, A. et al. (2019). Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18. BMJ, 366:l5274. doi.org/10.1136/bmj.l5274

[iv] Giles, L., & Richardson, E. (2021). Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2021. Edinburgh: Public Health Scotland. Available at: https://www.publichealthscotland.scot/media/8090/mesas-monitoring-report-2021.pdf

[v] National Records of Scotland (2020). Alcohol-specific deaths (new National Statistics definition) registered in Scotland, 1979 to 2019. Edinburgh: National Records of Scotland. Available at: https://www.nrscotland.gov.uk/statistics-and-data/statistics/statisticsby-theme/vital-events/deaths/alcohol-deaths

[vi] Public Health Scotland (2020). Alcohol related hospital statistics. Available at: https://beta.isdscotland.org/find-publications-anddata/lifestyle-and-behaviours/substance-use/alcohol-related-hospital-statistics/

[vii] Frontier Economics (2019). Minimum Unit Alcohol Pricing. Evaluating the impacts on the alcoholic drinks industry in Scotland: baseline evidence and initial impacts. Frontier Economics. Available at: http://www.healthscotland.scot/media/2810/frontiereconomics-mup-evaluating-the-impacts-on-the-alcoholic-drinks-industry-in-scotland.pdf

[viii] Public Health Scotland (2022). Evaluating the impact of Minimum Unit Pricing (MUP) of alcohol in Scotland on cross-border purchasing. https://publichealthscotland.scot/media/12040/evaluating-the-impact-of-minimum-unit-pricing-mup-of-alcohol-in-scotland-on-cross-border-purchasing.pdf

[ix] National Records of Scotland. (2021). Alcohol-specific deaths: 2020: https://www.nrscotland.gov.uk/files//statistics/alcoholdeaths/2020/alcohol-specific-deaths-20-report.pdf

[x] Richardson, Elizabeth, Mackay, Daniel, Giles, Lucie, Lewsey, James, Beeston, Clare. (2021). The impact of COVID-19 and related restrictions on population-level alcohol sales in Scotland and England & Wales, March-July 2020. Public Health Scotland

[xi] Stevely, Abigail K., Sasso, Alessandro, Hernández Alava, Mónica, Holmes, John. (2021). Changes in alcohol consumption in Scotland during the early stages of the COVID-19 pandemic: Descriptive analysis of repeat cross-sectional survey data. Public Health Scotland 18 Alcohol Focus Scotland (2020) Scots report changing drinking patterns during coronavirus lockdown. www.alcohol-focusscotland.org.uk/news/scots-report-changing-drinking-patterns-during-coronavirus-lockdown/

[xii] Cf. Foster, John H., Ferguson, Colin s. (2012). Home Drinking in the UK: Trends and Causes. Alcohol and Alcoholism, Vol 47, Issue 3, May/June 2012, pp.355-358

[xiii] Alcohol Focus Scotland and Scottish Health Action on Alcohol Problems (2021). Minimum Unit Price: Time to uprate. /media/440101/joint-afs-shaap-mup-briefing-update-dec-21.pdf

[xiv] Angus, C., Holmes, J., Pryce, R., Meier, P. & Brennan, P. (2016). Model-based appraisal of the comparative impact of Minimum Unit Pricing and taxation policies in Scotland. An adaptation of the Sheffield Alcohol Policy Model version 3. ScHARR, University of Sheffield. Available at: https://www.sheffield.ac.uk/polopoly_fs/1.565373!/file/Scotland_report_2016.pdf

[xv] Ferguson, K., Beeston, C. & Giles, L. (2020). Public attitudes to Minimum Unit Pricing (MUP) for alcohol in Scotland. Edinburgh: Public Health Scotland. Available at: http://www.healthscotland.scot/media/3198/public-attitudes-to-minimum-unit-pricing-mupfor-alcohol-in-scotland.pdf