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BMJ 2010; 340 doi: (Published 29 March 2010) Cite this as: BMJ 2010;340:c1735

Alcohol policies that cut consumption, save money, and save lives

The UK’s NHS spends £2.7bn (€3bn; $4bn) a year treating ill health caused by alcohol, and the government is under increasing pressure to regulate the price of alcohol in pubs, clubs, off licences, and supermarkets. Minimum pricing looked like one of the best options in a study commissioned by the Department of Health. The authors estimate that a legal threshold of 50 pence a unit would cut consumption by close to 7%, save 2930 lives a year, and accrue £6.2bn of health economic benefits over 10 years. Minimum pricing had its biggest effect on problem drinkers in this model, making it an attractive policy option for legislators keen to avoid penalising responsible drinkers.

A 10% increase in overall prices cut alcohol consumption (by 4.4%) and saved lives (1460 a year), but had no preferential effect on harmful drinkers. Banning all discounting by supermarkets and off licences was also effective.

Policy makers in England and Scotland are already looking seriously at a minimum price for alcohol, says a linked comment (doi:10.1016/S0140-6736(10)60276-0). This study shows what might be achieved, and why politicians must fight and win through inevitable challenges from commercial interests and possibly also from European competition laws. Public health comes first, it says, and we could all do more to encourage political will in that direction.

Truncated trials overestimate benefits

Stopping trials early is controversial. Results tend to fluctuate in the early stages of trials, and interim analyses can truncate trials at a random high point that overestimates the benefits of the treatment under study. One team of researchers recently compared trials stopped early because the treatment seemed to work with completed trials on the same research question. Most truncated trials reported lower relative risks (greater benefits) than their matched completed trials. The overall ratio of relative risks across 63 different …

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