New public health agency backs calls for minimum price on alcohol

BMJ 2013; 346 doi: (Published 26 March 2013) Cite this as: BMJ 2013;346:f2018
  1. Gareth Iacobucci
  1. 1BMJ

The new national agency in charge of public health in England has backed proposals to establish a minimum price on a unit of alcohol to try to curb the harmful effects of drinking.

Public Health England, which is set to take on national responsibility for tackling public health challenges from 1 April, said that the available evidence supported the introduction of a minimum price per unit of alcohol and urged the government to use this evidence as its guide, as ministers weigh up whether to implement the measure.

Earlier this month the prime minister, David Cameron, told MPs in the House of Commons that the government was still examining the results of its consultation on whether to set a minimum price of 45p (€0.55; $0.72) a unit in England and Wales, amid rumours of a division among members of the cabinet on the issue.1 2 Scotland has gone further by proposing a minimum price of 50p per unit of alcohol.

Public Health England will operate as an arm’s length agency of the Department of Health in England, working with the national government, the NHS, and local authorities—which will assume legal responsibility for improving the health of their communities from 1 April—to formulate public health policies.

Public Health England said that it would base its advice to the government on the evidence available and would not be swayed by politics.

“We do recognise that it’s a political decision, and we are not a political organisation,” said John Newton, its chief knowledge officer.

“Our role is to describe the evidence. We are clear that the evidence would support minimum pricing for alcohol. It’s not that the evidence is necessarily conclusive, but what we have to say is, ‘Is there sufficient evidence to recommend an intervention?’”

Newton added, “Introducing the policy . . . is what we would like to see. It would be useful to see what happened with 45p, and then you could judge whether that was the right level or not. You could do the same with 50p. I don’t think the level is crucial.”

Kevin Fenton, director of health and wellbeing at Public Health England, added, “While we wait for the government to make a decision [on minimum pricing], it’s really important for us to ensure that other effective tools [for tackling the harmful effects of drinking] are implemented.

But he added, “The evidence for MUP [minimum unit price] is clear. Therefore our recommendation would be for the government to base their decision on the best evidence.”

A Canadian study published in the journal Addiction in February reported that a 10% rise in the average minimum price of alcohol was associated with a 32% reduction in wholly alcohol attributable deaths.3

In addition to its support for minimum pricing on alcohol, Public Health England said that it supported a “range of measures” for tobacco control, including the introduction of plain packaging of cigarettes.

Duncan Selbie, chief executive of Public Health England, explained, “We know that the majority of smokers get addicted when they’re very young. With plain packaging, we do think this is a contribution. Anything that contributes to making that less likely is a good thing.”

More broadly the new body will focus its energies on five key priorities to improve the public’s health and to reduce health inequalities, including reducing preventable deaths from conditions such as heart disease, stroke, cancer, and liver disease and tackling conditions that place a burden on people’s lives, such as anxiety, depression, and back pain.

Its remit will also stretch to protecting the population from infectious diseases and environmental hazards; helping families to give children the best start in life through various programmes; and helping employers to facilitate and encourage good health choices among their staff.

Selbie added, “Ultimately, in order to really make a difference in improving our nation’s health, concerted action will be required, with individuals, families, local communities, local councils, the NHS, and government all taking responsibility and working together towards a healthier population.”


Cite this as: BMJ 2013;346:f2018