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Unless Scottish Government takes action to reduce alcohol consumption and prevent population harm, it is undermining its own ambition on prevention.

Prevention was one of the much-hyped themes of this Programme for Government.

With an ageing population and a growing prevalence of long-term conditions, our increasing need for the NHS has become unsustainable. The calls for action outlined in the Christie Commission fifteen years ago have become even louder – without a pivot to preventative action and early intervention, our public services will struggle to keep up.  

While alcohol is a major cause of disease, and linked to seven kinds of cancer, its harms are extremely preventable. Alcohol related harm affects people who drink heavily, and even those who drink within recommended limits. Surely, an ideal focus for prevention initiatives, reducing the prevalence of disease, giving us a healthier population and a more resilient NHS?  

Programme for Government – warm words with no specifics 

Sadly, not this time. For all its talk on prevention, there were no specific commitments in the Programme for Government on preventing alcohol harm.  A commitment to “building on our public heath approach to alcohol harm, improving prevention and early intervention” was the only mention of alcohol harm prevention, with no details or time frame given. There was a much welcome commitment to expanding Alcohol Care Teams, but nothing to reduce how much we drink as a country, or prevent people from needing Alcohol Care Teams in the first place.  

This is particularly frustrating, given that Scottish Government knows what action is needed to prevent and reduce alcohol harm. A significant body of international evidence, and the World Health Organization, says that the best and most cost effective ways to prevent alcohol harm at a population level are by limiting the exposure to alcohol marketing, changing the price of the product, and restrictions on the availability of alcohol. The Scottish Government even announced, prior to the election, that it would bring forward an Alcohol Harm Prevention Plan, with future steps to reduce the affordability, availability and attractiveness of alcohol. Not to see this reflected in the Programme for Government is disappointing, and we will continue to call for this plan to be developed as a priority for this parliamentary term.  

Alcohol deserves its own focus 

The Programme for Government also perpetuates a narrative we saw in the National Mission - conflating alcohol and drug harms into a single problem. Most mentions of alcohol in the PfG are of ‘drug misuse and alcohol harm’, said in a single breath.  Unfortunately this narrative has real consequences. Audit Scotland reported in 2024 that tacking on alcohol to the National Mission on Drugs led to work to alcohol deaths being overshadowed by a greater focus on drug deaths.  

There are fundamental differences between drug and alcohol use. 80 per cent of Scots drink alcohol- it is legal, widely available and heavily promoted.   Furthermore, 20 per cent of us regularly drink enough to harm our health. Many people who die from alcohol specific causes are not dependent drinkers, but those who have drunk heavily throughout their lives. If we limit our policy focus to those who drink enough that they require treatment or support, then we overlook a significant number of people at increased risk of cancer, heart disease and liver disease. Alcohol use is a population health issue, and it deserves to be recognised as such.  

Significantly more people die from alcohol-related deaths than from drugs – and combining them in the same approach benefits no one. Drinking in Scotland is a big enough problem that it deserves its own focus. 

Scottish Government fails to get the balance right 

Alongside the disappointment we feel at the lack of clear action in this Programme for Government, some of what has been included gives us pause.  

The Government’s plan features an image of John Swinney standing in a warehouse full of whisky casks, alongside commitments to reduce business regulation. Immediately before the PfG was announced, the First Minister agreed to speak to the Treasury about cuts to alcohol duty for Scotch whisky. Business interests are a strong theme for this plan. 

To be clear - it is possible to balance Scotland’s economic interests on the global stage with action on public health at home.  Indeed, no one would expect the First Minister not to represent the interests of Scottish businesses. But right now, that balance is not being struck. No amount of financial benefit justifies harming public health. The Scottish Government is capable of balancing the health of the people of Scotland with the interests of Scottish businesses – it must show that it will.  

What we need 

This Programme for Government says it understands drug and alcohol ‘misuse’ as a public health emergency – but there is no real commitment to action to reduce alcohol consumption and reduce harm undermining its own ambition on prevention.  

There are clear steps that Scottish Government can take quickly. Introducing automatic uprating for Minimum Unit Pricing, which we called for in our election manifesto, would ensure that alcohol does not become more affordable over time. The Scottish Parliament voted to increase MUP to 65p per unit from 30 September 2024. We now need a mechanism for regular automatic uprating, to ensure that inflation does not erode the impact of MUP, which would lead to a relative reduction in the price of alcohol and in turn, increased alcohol consumption and harm.  

We also need to see an Alcohol Harm Prevention Plan, outlining the next steps Scotland will take with the next steps to reduce the attractiveness, affordability and availability of alcohol. Restrictions on how alcohol is marketed and where it is promoted or sold, particularly in shops, could significantly reduce population harm.  

We know what needs to be done, and so does Scottish Government. It’s time for alcohol harm prevention to be a priority. 

Sophie Bridger, Policy Manager, Alcohol Focus Scotland