The implementation of minimum unit pricing (MUP) legislation for alcohol is linked with a 13 per cent reduction in deaths from alcohol consumption in Scotland, suggests a new study published in The Lancet. This was observed in the most socio-economically deprived areas of the country.
According to the study, the 13 per cent reduction in alcohol-specific deaths is equivalent to avoiding around 150 deaths per year.
What is minimum unit pricing for alcohol?
The Scottish government, in May 2018, introduced legislation to implement a minimum price of 50 pence per unit of alcohol, which is equal to 10 mL (millilitres) or eight grams of pure alcohol, in order to impact low-cost high-strength alcohol and reduce alcohol consumption in the heaviest drinkers. The minimum unit pricing legislation was also intended to save lives, reduce hospital admissions and have positive impacts across the whole health system in Scotland.
How is minimum unit pricing for alcohol beneficial?
According to the Scottish government, minimum unit pricing sets a floor price for a unit of alcohol, which means that alcohol cannot be legally sold for below 50 pence per unit. The higher the alcohol content in a drink, the stronger it is, and the higher the minimum unit price will be. Minimum unit price is a targeted way of ensuring alcohol is sold at a sensible price.
How the study was conducted.
Researchers conducted an analysis over the two years and eight months following policy implementation, as part of the study. They made an estimate of the deaths that would have occurred had the legislation not been implemented, using data from England, and found that there was a 13 per cent reduction in alcohol-specific deaths after the implementation of the minimum unit pricing legislation.
The introduction of the policy reduced alcohol sales by three per cent, previous studies indicate. Research has suggested that the greatest reductions were in households that purchased the most alcohol before the policy.
While previous studies have looked at reductions in alcohol sales, none had looked at if the minimum unit pricing policy has led to reductions in alcohol-specific deaths and hospitalisations at the Scottish National level.
Ahead of the parliamentary vote on the future of minimum unit pricing in Scotland in 2024, members of the Scottish Parliament will be given wider evidence on the extent to which minimum unit pricing has had an impact in Scotland.
In a statement released by The Lancet, Dr Grant Wyper, Public Health Intelligence Adviser at Public Health Scotland, said Scotland has the highest rate of death due to alcohol consumption in the United Kingdom, with those living in the most socio-economically deprived areas in Scotland experiencing death rates more than five times higher compared to those living in the least deprived areas.
Wyper also said the minimum unit pricing policy aims to tackle the inequality by reducing alcohol consumption, and therefore harms caused to health, in the heaviest drinkers who tend to buy the least expensive alcohol.
Wyper explained that the findings indicate the policy is having a positive impact on public health, because its implementation is linked with fewer alcohol-specific deaths in men and those living in the 40 per cent most deprived areas of Scotland who are disproportionately dying of alcohol-related harms.
How the study was conducted
The study authors obtained data from Scotland and England on alcohol-specific deaths and hospitalisations prior to the introduction of the minimum unit pricing legislation, from January 2012 to April 2018, and data over two years and eight months after the implementation of the policy, from May 2018 to December 2020.
The authors used the data from England to form a control group as part of the United Kingdom where the legislation was not implemented, and compared the change in deaths and hospitalisations in the two periods across the two countries.
The researchers also accounted for various other factors such as the level of government restrictions during the Covid-19 pandemic.
Decrease in hospitalisations and deaths due to alcohol consumption
The study found that the policy was linked with a 13.4 per cent decrease in deaths due to alcohol consumption, in the two years and eight months following the implementation of the policy, compared to an estimate of the number of deaths that would have occurred in the absence of the minimum unit pricing legislation.
The authors found statistically significant reductions in alcohol-specific deaths associated with minimum unit pricing in those living in the most socio-economically deprived 40 per cent of Scotland.
The implementation of the policy was linked with a 4.1 per cent decrease in hospitalisations due to alcohol consumption.
Decrease in deaths from long-term conditions caused by alcohol consumption
The study found a significant decrease in deaths from long-term conditions caused by alcohol consumption.
The implementation of the minimum unit pricing legislation was linked with a 11.7 per cent reduction in deaths due to alcohol liver disease, and a 23 per cent reduction in deaths from alcohol dependence syndrome.
Why did short-term conditions caused by alcohol consumption increase after the policy’s implementation?
However, the implementation of the minimum unit pricing legislation was linked with an increase in the rate of deaths and hospitalisations due to short-term conditions caused by alcohol consumption, which contribute to around five per cent of alcohol-specific deaths in Scotland. Short-term conditions caused by alcohol consumption include alcohol poisoning.
According to the study, there are some potential mechanisms that could result in faster intoxication, and thus, explain why short-term conditions caused by alcohol consumption increased following the implementation of the policy. These mechanisms include the substitution of food intake for alcohol, due to the financial pressures of the policy.
The authors noted that the study highlights the importance of ensuring timely, accessible services for those dependent on alcohol.
The impact of the policy on long-term conditions offsets the impact on short-term conditions, and hence, the policy has an overall benefit to the health of the Scottish public, the study said.
The authors noted some limitations to the study, including the fact that there was an impact on hospital capacity and attendance during the Covid-19 pandemic, which increases the uncertainty of the findings related to hospitalisations.