Minimum pricing needs to be part of a larger scale plan to improve addiction services and social conditions, but that does not make it useless in and of itself.
Every week, 22 people in Scotland die from an alcohol-related disease - 54% more than in England and Wales. Alcohol abuse is estimated to cost us £3.6 billion annually, equal to £900 for each Scottish adult. Clearly, then, the country has a significant drinking problem that hasn’t been solved by years of restricted sale times or educational campaigns. It is time for a novel solution.
In 2016, the Sheffield Alcohol Research Group studied how people from different socioeconomic groups would change their drinking habits if a minimum price of 45p/unit was introduced. Those who drink excessively from the lowest income group (the bottom 20%) were projected to reduce their drinking by 300 units a year. Moderate drinkers in this income group reduced their consumption by 3.8 units (less than 2 pints of beer) per year, with an increase in annual spending of just 4p, allaying fears that responsible drinkers on low incomes would be penalised. The proposed minimum price in Scotland is 5p higher than this, but the study demonstrates that minimum unit pricing effectively targets the right people.
The Alcohol (Minimum Pricing) (Scotland) Act was passed by Holyrood five years ago. It has taken this long to come into force not because public health experts doubted its efficacy, but because the Scotch Whisky Association has fought tooth and nail in court to stop it. The drinks industry knows that problem drinking is a massive financial boon, and fights any regulation on their products not to protect our rights but to protect their profits. Significantly, no major public health board or think tank has spoken out against this Act, and almost the entirety of the opposition comes from the alcohol industry.
This same industry actively coerces vulnerable people into drinking though pricing strategies. In the last month, several pubs on Victoria Road in the deprived area of Govanhill displayed big new banners advertising Carling at £2.60 a pint. No claim is made about the taste or quality, only cheapness. The same strategy can be seen in off-licences and supermarkets across the country, but especially in deprived areas, on ciders and lagers with cheap prices pre-printed on the label. The industry is clearly aware of the huge influence price has on alcohol consumption, and runs it’s advertising accordingly. Minimum pricing is one way of balancing the books against the industry’s aggressive pricing campaigns.
A criticism of the plan is that alcohol abuse spans all of society, and that middle and upper class people with equally harmful drinking habits will be unaffected by minimum pricing. However, an NHS report last year showed that the most deprived areas of Scotland had six times higher rates of alcohol-related deaths than in the least deprived areas, and a nine times higher rate of alcohol-related hospital stays. Minimum pricing may fail to reduce harm from alcohol in more affluent groups, but it does target those most at risk.
It is also often argued that increasing the cost of alcohol is taking away one of the few pleasures of life for the most deprived in our society. I imagine those pushing this view have never seen the misery of end stage liver disease or heart failure resulting from years of alcohol abuse. If people in a society have lives so hard their only respite is the bottle, surely we should strive to improve the conditions of the society instead of enabling the self destruction of the least fortunate within it. Minimum pricing needs to be part of a larger scale plan to improve addiction services and social conditions, but that does not make it useless in and of itself.
Paying 50p a unit isn’t going to convert any alcoholics to teetotallers. But the goal of public health policy is to reduce suffering from ill health and help people to live healthier, happier lives. The evidence we have so far suggests minimum pricing will do just that.