Alcohol use is weaved into much of our cultural and social fabric. For some people, it can be harmless, and alcohol spaces (such as pubs) provide many people with many of their social connections. But the harm often linked to alcohol is clear, and may be experienced by individuals, families, communities, and the wider society. It’s this harm that leads governments to develop public health alcohol policies, aimed at reducing harmful alcohol consumption.
October 2022 |
10 minutes
Wulf Livingston from Wrexham Glyndŵr University looks at what research into minimum unit pricing (MUP) can tell us so far.
Price policies work on the logic that increasing alcohol prices relative to people’s spending power leads to less alcohol consumption, which in turn leads to reduced harms.
There are multiple approaches to this – such as restrictions on marketing (advertising) and availability (licensing and retail) – but a major focus of public policy on alcohol in recent years has been on managing price. To be strictly accurate, it’s not price that matters so much as affordability. Price policies work on the logic that increasing alcohol prices relative to people’s spending power leads to less alcohol consumption, which in turn leads to reduced harms. That means that price policies need to keep up with inflation (or wage inflation) and we’ll come onto that in a bit.
Some governments have targeted specific alcohol products but the approach taken in the Republic of Ireland (since January 2022), Wales (since March 2020), and Scotland (since May 2018) has been to set a minimum price for a given amount of pure alcohol, regardless of what kind of drink it’s in.
In Scotland and Wales, alcohol cannot be sold for less than a minimum price of 50p per 10ml unit of pure alcohol. So, a 75cl bottle of wine at 14% ABV, which will contain 10.5 units, will not be found on sale for less than £5.25. In England, where no such policy is in place, similar products can be found on sale for less than £4.00.
The biggest impact of MUP has not been on supermarket wines ... The biggest changes have been seen in the strongest, cheapest products, like white cider, previously sold for as little as 20p per unit.
The biggest impact of MUP, however, has not been on supermarket wines (although it has reduced the scope for multiple purchase discounts such as 25% off six bottles of wine). The biggest changes have been seen in the strongest, cheapest products, like white cider, previously sold for as little as 20p per unit.
The big question now is: does it work? There are substantial evaluations of MUP underway in Scotland and Wales, with teams of researchers trying to make sense of what these policies are doing at ground-level. Researchers are using a range of approaches including analysing big data; surveys of consumers and retailers; and more bespoke interviewing. The Scottish Government will publish the first full synthesis of these evaluations in 2023, and the Welsh Government has also begun to publish early and interim reports with more on the way.
It’s worth saying at the start that any evaluation of MUP involves being in a messy space. There are a range of other possible contributory factors that may explain some of the changes we have observed: the rollout of Universal Credit has hit some people’s spending power; the Covid-19 pandemic disrupted patterns of drinking and adversely affected many people’s income; and there is the current cost of living crisis. All of these have affected and/or are affecting alcohol consumption and affordability.
So, what can we say so far, on the basis of the facts in the public domain by now? The first thing is that MUP has been implemented smoothly in Scotland and Wales, with good levels of compliance and observable price changes on specific products – most notably on strong ciders, which have either had a huge price increase or have disappeared from the shops. There have been more modest increases in the prices of some other products to get them up to the 50p per unit threshold. The alcohol industry has also responded by lowering the ABV of certain products and/or making smaller container sizes more readily available, e.g. the move to a 50cl spirit bottle, which allows it to be sold for less than £10 (a more attractive price than £13.13 for a 70cl bottle).
Secondly, most people that researchers have surveyed – drinkers, retailers, and alcohol treatment providers – appear to broadly agree with MUP and its aspirations, although this is often accompanied by expressions of concern about the impacts on drinkers with high levels of alcohol dependency and/or low incomes.
In terms of the impacts on drinking behaviours in the real world, people drinking at modest levels – who tend to buy products whose price has been unaffected by MUP – are likely to have felt no obvious effects on their consumption and purchasing behaviour. Amongst people who are drinking more heavily, two interesting themes have emerged in the early data. One is more use of local shops, since there are fewer alcohol discounts to attract people to travel to larger supermarkets. The other is drinkers switching from strong ciders to wine or spirits. MUP applies to all drinks types, and so there is no way to sidestep it and get more “bangs for your bucks” – more units for your money. It may be that some drinkers believe that, if they have to pay 50p per unit, they may as well buy a more palatable drink like wine; or one that gets them drunk more quickly, like spirits.
For people struggling financially, researchers have found some evidence of the extension of existing coping strategies, notably prioritising alcohol purchases over food and other household costs. There have also been limited reports of some of the feared negative consequences of MUP, such as switching to other drugs, or increases in criminal activity. This is not necessarily an argument against the policy. What is does show is that the policy on its own is not enough: that people need other support and treatment interventions to help them manage the other challenges and obstacles they face in life.
We mentioned earlier that price policies are really affordability policies, and so have to keep up with inflation to keep being effective. Much of the commentary on MUP in Scotland and Wales so far has noted that the policy in both territories has been based on a 50p unit price – a figure that reflects pre-2010 modelling and which has been eroded by inflation during the lengthy delay in implementation following alcohol industry legal challenges. There are some who advocate that 50p in 2009 is equivalent to 65p today, and a shift to a 65p MUP would certainly significantly increase the effects of the policy.
The detail of any impact of MUP is nuanced and we should be cautious about making bold claims. But we know that very cheap alcohol contributes to alcohol harms, and we have some evidence that minimum alcohol pricing policy can effectively address this.
In conclusion, it is too early to say a great deal for certain; and there have been so many other factors at play, such as the pandemic and the rising cost of living. The detail of any impact of MUP is nuanced and we should be cautious about making bold claims. But we know that very cheap alcohol contributes to alcohol harms, and we have some evidence that minimum alcohol pricing policy can effectively address this. As the evaluations proceed in Scotland and Wales, and gather more information, we’ll know more and more about how MUP works and what more we can to do alongside it to reduce alcohol harm.
