Minimum unit price for alcohol is planned for England and WalesBMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2295 (Published 23 March 2012) Cite this as: BMJ 2012;344:e2295
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The proposed introduction of minimum unit pricing for alcohol outlined in the Coalition Government's recently published Alcohol Strategy may go some way to reducing the burden of harms caused by excessive drinking. While a potential welcome step in addressing the rising tide of alcohol related injury, disease and crime,the details of how the planned intervention will be implemented are as yet unclear.
If minimum unit pricing of alcohol is to work, the underpinning legislation will need to have substantial 'teeth' and will have to be enforced robustly. How feasible will it be to achieve these ends in practice? There are considerable challenges to be overcome, for example:
How will retail sites be policed to ensure that alcohol is not sold below the unit price floor and who will do it? Will the Government need to employ thousands of inspectors or rely on the honesty of retailers? What will be the sanction if the law is breached?
Unless these issues are clearly thought out and addressed, the legislation may end up moldering on the statute book achieving little. Unfortunately, there are precedents for such an outcome. It has been illegal to serve or buy alcohol to someone who is already intoxicated for many years (Sections 172 - 173 and 141 - 142 of the Licencing Acts 1964 and 2003 respectively) and yet these are rarely enforced. The Government's Alcohol Strategy notes that only 3 successful prosecutions were made in 2010 for serving alcohol to a drunk person attracting a maximum fine of £1000 (level 3 on the standard scale). For the health of the nation let's hope minimum unit pricing works rather better than these examples.
HM Government, The Government's Alcohol Strategy. 2012. Available at: http://www.homeoffice.gov.uk/publications/alcohol-drugs/alcohol/alcohol-... [Accessed 31/03/2012]
HM Government, Licensing Act 2003. Part 7 - Offences. Available at: http://www.legislation.gov.uk/ukpga/2003/17/contents [Accessed 31/03/2012]
HM Government, Licensing Act 1964. Chapter 26. Available at: http://www.legislation.gov.uk/ukpga/1964/26[Accessed 31/03/2012]
HM Government, Criminal Justice Act 1982. The standard scale of fines for summary offences. Available at: http://www.legislation.gov.uk/ukpga/1982/48/part/III/crossheading/introd... [Accessed 31/03/2012]
Competing interests: No competing interests
While England and Wales are planning to bring in minimum unit prices for alcohol , the value of raising alcohol excise tax should not be forgotten. There is little doubt that minimum pricing will help reduce alcohol consumption and alcohol-related problems, given the review work by NICE , and studies from where it has been used e.g., Canada . But higher alcohol excise tax is likely to be more effective since it will have an impact on the whole spectrum of binge and heavy drinkers (i.e., not just those who are purchasing in the lowest price bracket). Indeed, raising alcohol excise tax is clearly a very effective , and very cost-effective , public health intervention.
Furthermore, excise tax raises revenue for the government which can then be used for funding ways to better prevent alcohol-related harm or to pay for health services. Using these arguments can improve public acceptability for raising the tax (as seems the case for tobacco taxes ), whereas minimum pricing does not generate revenue for the government that can be used for the tax-payer’s benefit. The strongest argument for introducing minimum pricing is that this prevents (large) retailers selling alcohol below cost and absorbing any increases in excise tax – but this is also so for introducing both policies together (minimum pricing and an increased excise).
Since all alcohol control measures engender media and public controversy, the issue is infrequently tackled by politicians. Hence when the opportunity to make progress arises, politicians should focus on the full range of cost-effective interventions, and not waste this current political opportunity.
1. Kmietowicz Z. Minimum unit price for alcohol is planned for England and Wales. BMJ 2012, 344:e2295.
2. NICE (National Institute for Health and Clinical Excellence). Alcohol use disorders: Preventing the development of hazardous and harmful drinking. NICE Public Health Guidance 24. London: NICE; 2010.
3. Stockwell T, Auld MC, Zhao J, Martin G. Does minimum pricing reduce alcohol consumption? The experience of a Canadian province. Addiction 2011, [E-publication 16 December].
4. Wagenaar AC, Tobler AL, Komro KA. Effects of alcohol tax and price policies on morbidity and mortality: a systematic review. Am J Public Health 2010;100:2270-2278.
5. Chisholm D, Rehm J, Van Ommeren M, Monteiro M. Reducing the global burden of hazardous alcohol use: a comparative cost-effectiveness analysis. J Stud Alcohol 2004;65:782-793.
6. Anderson P, Chisholm D, Fuhr DC/ Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet 2009;373:2234-2246.
7. Wilson N, Weerasekera D, Edwards R, et al. Characteristics of smoker support for increasing a dedicated tobacco tax: National survey data from New Zealand. Nicotine Tob Res 2010; 12:168-173.
Competing interests: No competing interests