Dear Editor,
Minimum unit pricing (MUP) was introduced in Scotland in May 2018, which set a floor price per unit of alcohol at 50 pence.[1] Public Health Scotland has led a comprehensive evaluation of MUP as part of its Monitoring and Evaluating Scotland’s Alcohol Strategy (MESAS) programme.[2]
As reported in The BMJ,[3] a recent MESAS report found a net reduction in alcohol sales in Scotland of 3% in the first three years of MUP’s implementation, when controlling for alcohol sales in England & Wales and adjusting for potential confounders.[4] This reduction was driven by a fall in off-trade sales (supermarkets and other shops), with no observed impact for on-trade sales (bars and restaurants).[4] This robust study demonstrates sustained population-level success of MUP, consistent with earlier MESAS[5] and non-MESAS studies.[6,7]
Considering inflation and the pandemic’s impact particularly on alcohol-specific deaths in Scotland, there is substantial support for MUP to be uprated to 65 pence.[8] The Scottish Government will reportedly complete their review of MUP’s floor price in late 2023, with any new price coming into effect in May 2024.[9]
Scotland’s MUP legislation contains a ‘sunset clause’: MUP will expire in April 2024 unless the Scottish Parliament votes for it to continue, with this vote informed by MESAS and other evaluations.[10] When considering the strong evidence for MUP, including support from the World Health Organization,[11] Parliamentarians should secure MUP’s future in Scotland. Ideally this would include future-proofing MUP, such as by linking the floor price to inflation.[8]
England, where in 2020 consumers could reach the weekly low-risk drinking guideline of 14 units of alcohol for under £3,[12] is now the only part of the UK without recent progress on MUP. In 2020, Wales introduced MUP at 50 pence,[13] which has seen similar early reductions in alcohol sales to Scotland,[7] and Northern Ireland consulted on MUP this year.[14]
If England implemented MUP at 50 pence, this is estimated to save society £5.9-8.4 billion over 20 years.[15] England should urgently implement MUP as part of a comprehensive and coherent alcohol strategy.[16] In November 2022, the Alcohol Health Alliance and Dan Carden MP, who has spoken openly in Parliament about his personal experience of alcohol addiction, coordinated an open letter to the Prime Minister calling for an independent review on alcohol harm to inform such a strategy.[17]
Footnote: Views expressed are the author’s own and do not necessarily reflect those of the University of Manchester or the Royal College of Physicians of Edinburgh.
References
1. Scottish Government. Minimum unit pricing. 2018. https://www.gov.scot/policies/alcohol-and-drugs/minimum-unit-pricing/
2. Public Health Scotland. Outcome areas and studies of evaluation of MUP. 2022. https://www.healthscotland.scot/health-topics/alcohol/evaluation-of-mini…
3. Iacobucci G. Minimum unit pricing has led to drop in alcohol sales in Scotland, data show. BMJ 2022; 379: o2815 https://doi.org/10.1136/bmj.o2815
4. Giles L, Mackay D, Richardson E, Lewsey J, Beeston C, Robinson M. Evaluating the impact of minimum unit pricing on sales-based alcohol consumption in Scotland at three years post-implementation. Public Health Scotland. 2022. https://www.publichealthscotland.scot/publications/evaluating-the-impact…
5. Robinson M, Mackay D, Giles L, Lewsey J, Beeston C. Evaluating the impact of minimum unit pricing (MUP) on sales-based alcohol consumption in Scotland: Controlled interrupted time series analyses. Public Health Scotland. 2020. https://publichealthscotland.scot/publications/evaluating-the-impact-of-…
6. O’Donnell A, Anderson P, Jané-Llopis E, Manthey J, Kaner E, Rehm J. Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18. BMJ 2019; 366: l5274. https://doi.org/10.1136/bmj.l5274
7. Anderson P, O’Donnell A, Kaner E, Llopis EJ, Manthey J, Rehm J. Impact of minimum unit pricing on alcohol purchases in Scotland and Wales: controlled interrupted time series analyses. Lancet Public Health 2021; 6(8): e557-e565. https://doi.org/10.1016/S2468-2667(21)00052-9
8. Scottish Health Action on Alcohol Problems. SHAAP and Alcohol Focus Scotland call for MUP Review. 2021. https://shaap.org.uk/news/354-call-for-mup-review.html
9. Brawn S. Scottish Government review of minimum unit pricing for alcohol now underway. The National. 28 June 2022. https://www.thenational.scot/news/20240583.review-minimum-unit-pricing-a…
10. Public Health Scotland. Overview of evaluation of MUP: Why we are evaluating MUP. 2022. https://www.healthscotland.scot/health-topics/alcohol/evaluation-of-mini…
11. WHO Regional Office for Europe. No place for cheap alcohol: the potential value of minimum pricing for protecting lives. 2022. https://www.who.int/europe/publications/i/item/9789289058094
12. Alcohol Health Alliance. Small change: alcohol at pocket money prices – AHA pricing survey 2020. 2020. https://ahauk.org/resource/small-change-alcohol-at-pocket-money-prices-a…
13. Welsh Government. Minimum Unit Pricing for alcohol. 2019. https://gov.wales/minimum-unit-pricing-alcohol
14. Department of Health, Northern Ireland. Consultation on Minimum Unit Pricing of Alcohol in NI. 2022. https://www.health-ni.gov.uk/mup-consultation
15. Angus C. Gillespie D, Ally A, Brennan A. Modelling the impact of Minimum Unit Price and Identification and Brief Advice policies using the Sheffield Alcohol Policy Model Version 3. ScHARR, University of Sheffield. 2015 (updated 2018). https://www.sheffield.ac.uk/media/13079/download
16. Commission on Alcohol Harm. ‘It’s everywhere’ – alcohol’s public face and private harm. 2020. Available from: https://ahauk.org/resource/commission-on-alcohol-harm-report/
17. Alcohol Health Alliance. MPs, Lords and over 50 organisations and experts write to the Prime Minister calling for an independent review on alcohol harm. 2022. https://ahauk.org/news/independent-review-on-alcohol/
Next steps for minimum unit pricing in Scotland, and England?