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Minimum alcohol pricing goes ahead in Scotland after drinks industry loses legal battle

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j5302 (Published 15 November 2017) Cite this as: BMJ 2017;359:j5302

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Re: Minimum alcohol pricing goes ahead in Scotland after drinks industry loses legal battle

Years ago, the All Party Parliamentary Group on alcohol debated a minimum price for alcohol extensively (with valuable input from Scottish policy-makers). A clear consensus was reached that this intervention was likely to reduce death and disease from sales in shops of "cheap booze", at little cost to taxpayers, and without disrupting licensed sales from rural pubs that can play a social, community role. The news that Scotland can now proceed with minimum pricing is good news indeed.

However, in terms of Population Health, the actual amount of harm prevented needs to measured reliably, so that future roll-out of this intervention can have a credible evidence base. For a baseline in England, we need to make the wisest use of the Local Alcohol Profiles [1] so that any subsequent impact of introducing a minimum price for English drinkers can be accurately monitored. At present, deaths from liver disease are rising steadily here, and I really hope could will be reversed. In the short term, given the social gradient for health related to alcohol, I think we may also see a rapid reduction in suicides among men in the most deprived neighbourhoods. [2] Adult male suicide has also been increasing, in just the areas where rates of unemployment or insecure employment are high. Most men faced with a personal crisis who kill themselves, are drunk at the time.

Right now in 2017 is the time to start appropriate baseline measures, assuming that the passage and implementation of any new alcohol legislation will need about 2 years.

[1] Local Alcohol Profiles for England: November 2017. London: Public Health England (https://www.gov.uk/government/uploads/system/uploads/attachment_data/fil... )

[2] Caan W. Unemployment and suicide: is alcohol the missing link? Lancet 2009; 374: 1241-1242.

Competing interests: Co-Chair, Alcohol special interest group, Faculty of Public Health, and member British Society for Population Studies.

15 November 2017
Woody Caan
Editor, Journal of Public Mental Health
Duxford, Cambridge