We need to continue long-term focus on alcohol

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We need to continue long-term focus on alcohol

Among the many profound changes to our lives in 2020, the way in which we access and consume alcohol is also significantly changing. In recent weeks we have seen the closure of pubs, bars and restaurants. Meanwhile, rising sales of alcohol in supermarkets, off-licences and online show that many of us are drinking at home. Recent polling from Alcohol Focus Scotland and Alcohol Change UK has shown that it is those of us who were drinking more to begin with who have increased our intake during lockdown.

Scotland already had an alcohol problem. That’s why we took the bold step to introduce minimum unit pricing (MUP) two years ago, to improve our health and that of our children. While the full effect of minimum unit pricing won’t be seen for 20 years, we should be proud of this global first. The evidence we are seeing already gives us cause for optimism that minimum unit pricing appears to be having an effect on how much we drink and this should translate into improvements in health and well-being.

That gives hope that, in future, fewer families will have to suffer the devastating loss of a loved one due to alcohol in future.

The most encouraging signs so far are the decrease in consumption and off-sales. The annual Monitoring and Evaluation of Scotland’s Alcohol Strategy (MESAS) report in 2019 showed the biggest drop in consumption in 25 years. Figures from a study looking at sales-based consumption in the first year of MUP show that Scotland bought 3.6% less alcohol from off-sales than in the previous year. This was in contrast to England and Wales, who didn’t have MUP, where off-sales purchases went up by 3.2% (Wales has since introduced minimum pricing, in March 2020). This comparison with England and Wales is really important as it provides a control. When you look at data from before the introduction of MUP, Scotland has consistently bought more alcohol per person than England and Wales. Such a big change suggests that minimum unit pricing is having an impact.

The most encouraging signs so far are the decrease in consumption and off-sales.

Beneath the headline sales figures there are also some interesting shifts happening in what people are buying which suggest that MUP is having the expected effects. People are buying less high-strength cider, which prior to MUP retailed for as little as 18p per unit, leading some stores to stop stocking some products. Producers have reduced pack sizes or reduced the strength of some products, suggesting that they know consumers are price sensitive and that they are looking for products at certain price points. Both of these are positive from a policy perspective as they suggest that MUP is changing both supply and demand. We would like to see those companies who profit from the sale of alcohol be required to provide data on their sales, to provide a fuller picture of what is sold and where, instead of taxpayers’ money having to be spent to purchase this information from market research companies.

The “theory of change” behind minimum pricing, is that an increase in price will reduce consumption, which, in turn, will lead to reductions in harm. The main measures of harm are alcohol specific deaths and alcohol-related hospital admissions. While we haven’t yet seen any change in the rate of deaths from alcohol following minimum unit pricing (MUP), this is not overly concerning as it seems reasonable to assume that the effect on deaths would lag behind the reduction in consumption. Interestingly, although overall hospital admissions have not gone down, there are some positive signs that the number of people admitted due to alcoholic liver disease has decreased since MUP was introduced – particularly amongst people living in our poorer communities. This is important because people in our more deprived communities suffer the greatest harm – they are eight times more likely to be hospitalised as a result of drinking.

Young people were one group we thought might be price-sensitive and be impacted by minimum unit pricing. However, a study of around 50 young people who were drinking prior to MUP found that, for them, price was not a major consideration. Many of the products they favoured were already being sold above 50p per unit before MUP was introduced and they did not report changes in how much they were drinking or the products they chose to drink. The main influences on their alcohol use were friends, parents and carers. It’s important to note that the study was designed to help understand the lived experience of the 50 or so young people who took part and is not generalisable to all young people in Scotland. More widely across Scotland we have seen a reduction in how much young people are drinking since the early 2000s.

Contrary to arguments from the alcohol industry, an initial study into the impact on the producers, retailers and wholesalers has shown that they are reporting little change. The Scottish Government estimated that MUP would increase off-trade revenue by over £40m per annum. So far retailers and producers have not reported this type of windfall, however, an independent assessment needs to be made. Any additional profits as a result of MUP should be used to help offset the significant costs faced by our NHS, police and local authorities in dealing with alcohol-related harm.

Any additional profits as a result of MUP should be used to help offset the significant costs faced by our NHS, police and local authorities in dealing with alcohol-related harm.

It also worth noting that some of the negative consequences which some in the industry had claimed would result from the introduction of MUP - such as thousands of Scots driving to England to buy their alcohol, a substantial increase in illicit alcohol sales and the levying of punitive tariffs on Scotch by other countries - have not come to pass. Meanwhile slowly but surely other countries are following Scotland with Wales and the Northern Territories of Australia have already implemented it and the Republic of Ireland having passed legislation on it.

There are many more specific studies to come over the next few years. These will look at a range of impacts including on crime and public safety, on people already drinking heavily before MUP, the children and young people affected by parent or carer drinking, further investigations into the effect on retailers and the economy. There will also be several more years of routine data to come on consumption, deaths and hospital admissions.

It remains to be seen what impact social distancing will have and what new challenges it will throw up. But it seems unlikely that Scotland’s unhealthy relationship with alcohol will be changed for the better. The Scottish government has a strong track record in tackling alcohol harm and it will be important that they continue to prioritise the nation’s health and wellbeing as part of our longer-term recovery.

Alison Douglas, Chief Executive

Find out more about why minimum unit pricing was introduced in Scotland and the evaulation and evidence so far.