Reducing harm caused by alcohol


MUP reduces deaths and hospital admissions

Today, Tuesday 21 March 2023, Public Health Scotland (PHS) and The Lancet published new evidence showing that minimum unit pricing (MUP) has reduced deaths and hospital admissions caused by alcohol consumption.

The study estimated a 13.4% reduction in deaths, and a 4.1% reduction in hospital admissions, wholly attributable to alcohol consumption following the implementation of MUP. This means that 156 alcohol-specific deaths were prevented and that 411 alcohol-specific hospital admissions averted each year since the policy was introduced. The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

Alison Douglas, chief executive of Alcohol Focus Scotland welcomed the news. She said, “The whole point of minimum unit pricing is to save and improve lives; this research shows it is doing just that. The reduction in deaths of more than 150 per year is great news and significantly higher than was hoped for based on the Sheffield University modelling.

“It shows the Scottish Government and Scottish Parliament were right to pursue this path-breaking policy in the face of fierce industry opposition. Today fewer families are grieving the heart-breaking loss of loved ones as a result.

“It is particularly heartening to see the positive impact is greatest for people living in our most deprived communities who for too long have suffered the most. Taking bold public health action has paid off and shown that population-level action can stem the tide of alcohol harm.

“The Scottish Government must now renew and uprate the minimum unit price. And it must act on alcohol marketing which also drives consumption and harm.”

Dr Grant Wyper, Public Health Intelligence Adviser at PHS, said: “Our study estimates that, following more than two and a half years of implementation, around 150 deaths, and around 400 hospital admissions, wholly attributable to alcohol consumption, were averted each year due to MUP. The greatest reductions were seen for chronic alcohol health harms, in particular alcoholic liver disease, which were slightly offset with less certain evidence of increases in acute alcohol health harms. The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

“We know that those living in the most socioeconomically deprived areas in Scotland experience alcohol-specific death rates more than five times higher compared to those living in the least deprived areas. The results published today are therefore very encouraging in addressing this inequality, and the overall scale of preventable harm which affects far too many people.”

Professor Daniel Mackay, Professor of Public Health Informatics at the School of Health and Wellbeing, University of Glasgow, said: “The methods we’ve used in this study allow us to be confident that the reduction in alcohol health harms we’ve shown is due to the introduction of MUP, rather than some other factor. This was important as the COVID-19 pandemic occurred towards the end of our study period and may have had an impact on alcohol-related health harms that was unrelated to MUP. Our main findings for the whole study period were consistent with findings from an additional analysis that focused on the pre-pandemic period only.

“In fact, we tested our main finding across a range of different scenarios and found the results to be largely consistent with our main finding, strengthening our conclusion that MUP has been effective at reducing the harm to health caused by alcohol.”

This latest report, which covers the period from 2018 when MUP was introduced to the end of 2020, shows that MUP has achieved more than what was expected. The original modelling from the University of Sheffield estimated that in the first year of MUP, 60 lives would be saved taking 20 years to build to maximum effect where 121 lives being saved each year.

The original modelling also estimated that a higher price would deliver greater benefits. The University of Sheffield found that a MUP of 60p would save twice the number of lives and reduce hospital admissions compared to a MUP of 50p, which MUP is currently set at. As the effect of MUP has been constantly eroded through the years due to inflation, we believe MUP should be index-linked to an automatic uprating system. This will ensure that it keeps pace with inflation and that its effectiveness is maintained.

As MUP is subject to a ‘sunset clause’ where unless the Parliament vote to retain it the policy will expire, it is one of the most thoroughly evaluated policies ever in Scotland. PHS is leading a comprehensive independent evaluation of the policy which will provide evidence to inform Members of the Scottish Parliament ahead of the parliamentary vote on the future of MUP in Scotland in 2024. A final report is due to be published by PHS in June 2023.