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Scotland’s minimum unit alcohol pricing may not be curbing drinking in those most vulnerable

Published:  19 July, 2022

The introduction of minimum unit pricing (MUP) for alcohol may not be curbing drinking habits of those most at risk, according to a new report.

In May 2018, as part of a larger national alcohol strategy, the MUP in Scotland was set at 50p per unit to target cheap, high-strength beverages as a key source of problem drinking.

Prior to the introduction of MUP, NHS Scotland announced that in 2015, an average of 22 people per week died in Scotland due to alcohol-related causes - 54% higher than in England and Wales. 

In 2016, 10.5 litres of pure alcohol were sold per adult in Scotland, the equivalent of 20.2 units per adult per week. This means that enough alcohol was sold in Scotland in 2016 for every adult to exceed the weekly guideline by 44% every week of the year.

Clearly, there was precedence for the MUP in Scotland, the first country to implement the measure. Four years on however, consumption levels remain high across the country.

According to new research published by BMJ Open, consumption increased among the 5% of heaviest drinkers following the introduction of MUP.

The researchers drew on data from the KWP Alcovision survey, an online diary survey of the previous week's alcohol consumption, which annually samples around 30,000 adults in Great Britain.

Respondents provide detailed information on their alcohol consumption over the previous seven days. The researchers compared these figures for Scottish adults with those of English adults before and after the introduction of the MUP.

The final analysis included drink diaries completed by 106,490 respondents (53,347 women and 53,143 men) from England and Scotland between 2015 and 2018. 

The average reported weekly consumption for all respondents was just under 126g for men and just over 71g for women.

Analysis of the survey data showed that compared with residents in England, MUP was associated with a drop in reported weekly total alcohol consumption of just under 6g a week-2.7g in licensed premises and 3.3g elsewhere-representing a fall of just over 6%.

The reductions were larger for women (8.6g a week) than for men (3.3g a week), both when compared with England as a whole and when compared with just Northern England. And they were greater among heavier drinkers than lighter drinkers, except for the 5% of heaviest drinking men, among whom consumption increased by 10%.

Further analyses showed that falls in consumption were greater among older survey respondents and those living in less deprived areas. But MUP wasn't associated with a fall in consumption among younger men (under the age of 32) and those living in the most deprived areas.

The researchers noted: "When the Minister for Public Health, Sport and Wellbeing introduced the 2018 alcohol policy framework, he emphasised that the implementation of the MUP was strongly motivated by an interest in decreasing health inequalities through a reduction in alcohol consumption among the heaviest and most vulnerable drinkers.

"Our results indicate that this goal may not be fully realised: First, we found that women, who are less heavy drinkers in our data and in almost all surveys worldwide to date, reduced their consumption more than men; second, the 5% of heaviest drinking men had an increase in consumption associated with MUP; and, third, younger men and men living in more deprived areas had no decrease in consumption associated with MUP."

The new results go some way to back up the concerns of the Portman Group (the alcohol industry’s self regulatory body) back in 2019 which said there is ‘little evidence’ to back up the recommendations of a report from alcohol health experts, including Alcohol Health Alliance (AHA), health professionals and MPs.