Minimum unit price for alcohol is planned for England and Wales

BMJ 2012; 344 doi: (Published 23 March 2012) Cite this as: BMJ 2012;344:e2295
  1. Zosia Kmietowicz
  1. 1London

The Government is to introduce a minimum price for a unit of alcohol as soon as it has consulted on what that price should be, it says in its new national alcohol strategy for England and Wales. The price is likely to be around 40p per unit.

The strategy has been billed as “a radical approach to turn the tide against irresponsible drinking, which costs the UK £21bn [€25.1bn; $33.3bn] a year,” and aims to end the scenario of beer for sale at prices cheaper than water. The strategy is also being promoted as a means of reducing the 1.2 million alcohol related hospital admissions in 2011.

Minimum price policies are already being considered in Scotland and Northern Ireland.

As part of the strategy, the government is also considering giving more powers to hospital accident and emergency departments and pubs to refuse to deal with people who are drunk; banning multibuy promotions such as buy one, get one free; and a late night levy to make pubs and clubs help pay for policing.

Prime Minister David Cameron said, “Binge drinking isn’t some fringe issue, it accounts for half of all alcohol consumed in this country. The crime and violence it causes drains resources in our hospitals, generates mayhem on our streets, and spreads fear in our communities.”

For an average drinker a 40p minimum unit price would cost an extra £21-23 a year, and for harmful drinkers (more than 50 units a week for men and 35 for women) an extra £105-135 a year, says the strategy.

The unit price rise will lead to 170 fewer alcohol related deaths in the first year of the strategy, rising to 900 a year over 10 years (7.7% fewer alcohol related deaths). There will be 50 600 fewer crimes a year, including 12 900 fewer violent crimes. More than £80m will be saved in health and crime costs in the first year, rising to over £140m in the tenth year.

Ian Gilmore, of the Royal College of Physicians and the Alcohol Health Alliance UK, welcomed the strategy, saying the evidence that imposing a minimum unit price on alcohol affected consumption was “irrefutable.”

He added, “Health care workers who struggle every day to cope with the impact of our nation’s unhealthy drinking will welcome tough new policies in areas such as price and licensing that are based on evidence and should bring about real benefits.”

Vivienne Nathanson, head of science and ethics at the BMA, said, “The decision to tackle the affordability of cheap alcohol and the availability of multibuy discount deals is a step in the right direction. It is also important that the drinks industry takes greater responsibility by funding extra policing at night and making sure they do not serve individuals who are already drunk.

“We are, though, disappointed that the strategy does not appear to address late night licensing or alcohol advertising. Both help to fuel the UK’s unhealthy relationship with alcohol and must be addressed if we are to truly get a grip on the problem.”

Eric Appleby, chief executive of Alcohol Concern, which campaigns for effective alcohol strategy, said, “This is a victory for common sense. We cannot carry on with a situation where it’s cheaper to buy cans of lager than a can of Coke. All the research shows there is a link between price and consumption and we know that lives can be saved if a minimum price is introduced.”

However, drinks retailers said that increasing prices would not reduce consumption by problem drinkers.

Henry Ashworth, chief executive of the Portman Group, said, “For this strategy to be successful, it must not penalise the vast majority who drink responsibly, or unfairly burden businesses that are helping government tackle alcohol misuse through the responsibility deal partnership—it is vital that these proposals do not undermine this partnership and the good progress that is being made.”

Just before the strategy was launched, the health secretary Andrew Lansley, who has opposed a minimum unit price for alcohol, announced plans to increase the availability of lower strength beers and wines.

The Department of Health announced on 23 March that 34 companies were working towards removing a billion units of alcohol from sales of alcohol in a decade, a move it says would result in almost 1000 fewer alcohol related deaths a year, and thousands fewer hospital admissions and alcohol related crimes.

However, a spokesman for Alcohol Concern, said the figures were, “a leap of faith.” He added, “We don’t quite believe [the increased availability of low alcohol drinks] will lead to the grand claims [the Department of Health] is making.”

The initiative to reduce units of alcohol is part of the responsibility deal that is at the centre of the coalition government’s health strategy. The responsibility deal involves partnerships between public health, commercial, and voluntary organisations to improve public health without legislation (BMJ 2011;342:d1702, doi:10.1136/bmj.d1702).

Under the plan, 34 companies have committed to produce a wider range of lighter alcohol products, in response to market research that suggests more people are looking for lower strength wines. The department says that in the last year demand for low and non-alcohol beer has increased by 40%.

Mark Bellis, spokesperson on alcohol for the Faculty of Public Health, said, “A typical bottle of wine sold 20 years ago would be considered low alcohol by today’s standards. Over recent decades, a bottle of wine has gained the equivalent alcohol of adding between a double and triple vodka. Beers have been through a similar transformation.

“It’s not been difficult to move people’s tastes towards stronger alcoholic drinks. Selling more lower alcohol wine and beer is part of the commitment industry have made today, but the more important part for public health is selling less of the stronger beers and wines we now consider as normal.”


Cite this as: BMJ 2012;344:e2295