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Minimum alcohol pricing delivers health benefits without penalising moderate drinkers, finds analysis

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2939 (Published 07 May 2013) Cite this as: BMJ 2013;346:f2939
  1. Owen Dyer
  1. 1Montreal

Placing a minimum price on a unit of alcohol delivers health benefits much greater than those predicted by the UK government’s theoretical model, concludes a new report by the independent UK Institute of Alcohol Studies, which used empirical data from Canada, where minimum pricing has been in place for decades.1

Most Canadian provinces have long exercised some form of government control over the distribution of alcohol through a mixture of government owned and privately owned outlets. Most provinces set minimum prices on a litre of wine, beer, and spirits. One province, Saskatchewan, adjusts minimum prices within drink categories according to alcohol content, a policy very similar to the UK proposal.

The UK government has used the Sheffield alcohol policy model to predict effects of minimum unit pricing on consumption, health, and public revenue. It has been adapted to Canada, but its predictions of health benefits seemed conservative when compared with results of studies of the actual effects of minimum unit pricing.

In British Columbia the Sheffield model estimated that a minimum price per unit of $C1.50 (£1; €1.1; $US1.5) for all alcoholic drinks would reduce the number of wholly alcohol caused deaths (a category that includes alcohol poisoning but not cirrhosis) by 39 and the number of hospitalisations by 244 in the first year, with additional health benefits 10 years later. But the Institute of Alcohol Studies’ report cites studies published in Addiction and the American Journal of Public Health which found that a $C1.45 minimum price resulted in an estimated reduction of 92 wholly alcohol caused deaths and 1212 hospitalisations in the first year, with additional health benefits in chronic disease seen two years later.2 3

These analyses concluded that a 10% rise in average minimum alcohol prices was associated with reductions of 32% in wholly alcohol caused deaths, 9% in chronic and acute hospitalisations, and 3.4% in total consumption. A separate analysis showed that Saskatchewan’s policy of raising the minimum price for products of higher alcohol content within a particular class of beverage brought a shift in consumption towards less strong beers and wines.4

The institute’s report cites evidence that heavy and problem drinkers are far more likely to seek out cheap alcohol and thus to be affected by a minimum price. Katherine Brown, the institute’s director of policy, said that the report would “give policy makers confidence that fulfilling the commitment to introduce this measure in the UK will deliver significant health and social benefits without unfairly penalising moderate drinkers or those on low incomes.”

The report comes as Scotland’s Court of Session struck down a challenge by the Scotch Whisky Association to the Alcohol (Minimum Pricing) (Scotland) Act 2012, which sets a 50p minimum price on a unit of alcohol.5 But the law will have to survive at least one UK appeal and a possible case in the European Court of Justice.

In England and Wales the government announced a commitment to minimum unit pricing last year,6 but, with opposition from senior cabinet members, all mention of the project has been dropped from the upcoming Queen’s speech. The Home Office web page that declared “we will introduce a minimum unit price for alcohol” has also been removed.

A Home Office spokesperson said, “The government has recently consulted on minimum unit pricing. We received a large number of consultation responses and are carefully considering the views received. We will announce our decisions when this evaluation is completed.”

Notes

Cite this as: BMJ 2013;346:f2939

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