One of the most effective and cost-effective ways for society to minimise the damage from alcohol consumption is by regulating the price of alcohol.
The price of alcohol matters because when the price of alcohol goes down, consumption of alcohol goes up. The more affordable alcohol becomes, the more people use it, and the more harm we experience because of it.
Alcohol Minimum Unit Pricing (MUP)
Aim of Minimum Unit Pricing (MUP)
To reduce the consumption of alcohol, particularly among hazardous and harmful drinkers, leading to reduction in alcohol-related harm.
SHAAP was the first organisation to call for MUP, when we published the report, ‘Price, Policy and Public Health’ in 2007.
What does MUP do?
It sets a minimum price of 50p per unit of alcohol below which no alcohol in Scotland may be sold.
1 unit = 10mls/8g of alcohol
ITEM – volume + strength
Whisky, 70cl, 40% abv
Vodka 70cl, 37.5% abv
Lager, 400ml, 4% abv
Wine, 75cl, 12.5% abv
Cider, 1L, 5% abv
Strong (‘white’) cider, 3L, 7.5% abv
Benefits of minimum pricing
1. According to Sheffield University Modelling (2015), it will save lives - in the first year alone:
- 60 fewer alcohol-related deaths,
- 1,600 hospital admissions
- 3,500 crimes.* (figures from University of Sheffield modelling)
- MUP targets the cheapest, strongest drinks like white cider, own-brand spirits and super-strength lager. These are bought mostly by the heaviest drinkers, so it will reduce harm in this group where premature deaths and hospitalisations are highest. Moderate drinkers won’t be affected.
- MUP only affects shops and supermarkets where alcohol is cheapest: drinks in pubs and restaurants already cost more than 50p per unit.
- MUP is widely supported by the public, politicians, doctors, police, homelessness services, children's charities and parts of the licensed trade.
- MUP is legal - passed in the Scottish Parliament in May 2012, tested in Europe, approved by the Scottish courts twice and finally by the UK Supreme Court in November 2017.
- MUP will save money - £1bn to the public purse over 10 years.
Why is MUP needed?
- Alcohol is much cheaper to buy now than 2 generations ago: it is 60% more affordable today compared with 1980 -> higher consumption per head across society
- Drinking habits have changed: people drink less in pubs/restaurants (on-sales) and more at home, as it is much cheaper to buy alcohol in supermarkets/shops (off-trade) -> higher consumption
- 1,265 wholly-alcohol attributable deaths were registered in Scotland in 2016, an increase of 115 (10%) compared with 2015 – from National Records of Scotland
- In addition, alcohol was a contributory factor in 3,705 deaths in Scotland in 2015 – from NHS Health Scotland
- One in four alcohol deaths (1,048) was from cancer, 544 deaths were from heart conditions and strokes, and 357 deaths were from unintentional injuries eg falls.
- At least 41,161 patients were admitted to hospital due to alcohol in 2015, including 11,068 due to unintentional injuries, 8,509 due to mental ill health and behavioural disorders and 4,291 due to liver disease and pancreatitis.
Evidence that MUP works from British Columbia, Canada
A series of studies by Stockwell et al in British Columbia between 2002-2009, when there were three increases in minimum prices for beer & four for spirits, found that, in the first year, a 10% increase in average minimum price was associated with a 9% reduction alcohol-related hospital admissions and a 32% reduction in wholly alcohol related deaths.
What happens now?
MUP was implemented in Scotland on 1st May 2018. Over the following five years, its effects will be evaluated by a process being managed by NHS Health Scotland to assess impacts on:
- public health, crime and disorder, public safety, public nuisance, and protecting children and young people from harm
- Impact on producers and licence holders
- Impacts by gender, age, socio-economic status and drinking status, where possible.
The findings from the evaluation will be considered by the Scottish Parliament after 5 years; the legislation contains a ‘sunset clause’, meaning MUP can be discontinued if it is felt the results are not positive; if they are, another vote will be required to continue minimum unit pricing thereafter.
MUP one year on
- Alcohol Sales
In June 2019 NHS Health Scotland published its first-year MESAS report on alcohol sales: http://www.healthscotland.scot/media/2587/mesas-monitoring-report-2019.pdf (Giles L, Robinson M. Monitoring and Evaluating Scotland’s Alcohol Strategy: Monitoring Report 2019. Edinburgh: NHS Health Scotland; 2019). This showed that:
- The average Scottish adult bought 19 units of alcohol per week (CMO limit: 14 units a week for men and women).
- The annual volume of "pure alcohol" in drinks sold in Scotland was 9.9 litres per adult, down about 3% from 10.2 litres in 2017.
- The volume of alcohol sold per adult in Scotland in 2018 has fallen to its lowest level in 25 years
- The volume of alcohol is 9% higher than in England and Wales (9.1 litres) – but is the smallest difference since 2003
- Since 2010 the volume of pure alcohol sold per adult through supermarkets and off-licences has fallen by 9% in Scotland but has risen by 3% in England and Wales over the same period.
Data on alcohol sales is recorded by calendar year, so the 1st year report also includes the four months of January to April before MUP took effect on 1st May 2018. And whilst the data on alcohol sales appear to show a broadly positive trend, It should be noted that the MESAS report does not look at data on harm caused by drinking, which is only available for 2017 before MUP was introduced.
In August 2019 NHS Health Scotland published its report on compliance with MUP: http://www.healthscotland.scot/publications/minimum-unit-pricing-evaluation-compliance-study
This found that compliance in licensed premises had generally been high and the transition to minimum unit pricing had been implemented smoothly, while police and licensing authority officials reported no significant increase in illegal and unlicensed activity.
- Impacts on the alcoholic drinks industry
Read the report from Frontier Economics published by NHS Health Scotland 02 Oct 2019
Further reports to be published in 2019 include: impacts on children & young people’s drinking; sales-based analysis of first full year of MUP.
Priorities for the future
The entire medical profession are confident the evaluations will show positive effects of MUP, and clinicians, who see the damage alcohol does to their patients on a daily basis, have a vital role to play in raising awareness about the harms of alcohol.
Nobody has ever suggested that MUP alone will resolve alcohol problems in Scotland. MUP will make a vitally important contribution to reduce alcohol-related harms, especially among our most vulnerable populations, affecting people who drink and those around them. There also needs to be more investment in evidence-based services to provide the care and support for recovery that people need, and to reduce stigma that prevents people accessing help.
SHAAP will also continue to advocate for other evidence-based measures, including actions to reduce availability and marketing of alcohol, including exposure of young people to the latter.
Read more about the campaign to achieve Minimum Unit Pricing in Scotland in our new Briefing: The MUP Issue