Minimum unit pricing for alcohol: Scotland the brave

On 1 May 2018, Scotland courageously (after years of legal challenge by alcohol companies) implemented a world first: a national minimum unit pricing (MUP) policy with a mandatory lowest retail price per unit of alcohol.123 O’Donnell and colleagues provide encouraging evidence that this policy is effective, with weekly purchases reduced by 9.5 g of alcohol per adult per household.1 In the linked editorial, Mooney and Carlin argue that the rest of the UK should follow suit.2

O’Donnell and colleagues’ article is a helpful immediate assessment of Scotland’s MUP policy—comprehensive impact assessment will follow. NHS Health Scotland will undertake an independent multicomponent assessment of the impact of MUP on a range of outcomes, reporting their complete results in 2023.4

Meanwhile in Russia the World Health Organization reports that total per capita alcohol consumption dropped by 43% from 2003 to 2016.56 The report provides a timeline of alcohol policies mapped to changes in mortality rates (table 2, figure 14).6 MUP for vodka was introduced in 2003, followed by MUP for other alcoholic beverages. Russia doesn’t have MUP for all alcoholic beverages and its long term strategy was abandoned for a period, but evidence based measures—including MUP and mainly targeting availability and affordability—have coincided with reductions in mortality rates, particularly in those of working age.6

I agree with Mooney and Carlin2 that the rest of the UK should follow Scotland’s lead. Mounting evidence shows that MUP is effective1789 and cost effective, particularly when combined with tax increases.8

Although alcohol consumption remains high in Russia—total per capita alcohol consumption was11.7 L of pure ethanol in 2016, compared with the WHO European average of 9.8 L6—we can learn from its success to date.56

For more information on Scotland’s MUP policy, see the 14th research and policy briefing from Scottish Health Action on Alcohol Problems.3