Scotland’s  Alcohol Minimum Unit Pricing (MUP) legislation has had a positive impact on health outcomes, including addressing alcohol-related health inequalities.

“Public Health Scotland is confident that MUP is an effective mechanism to reduce alcohol-related harm in Scotland and we support the continuation of MUP beyond April 2024.” – Dr Nick Phin, Director of Public Health Science, Public Health Scotland 

It has reduced deaths directly caused by alcohol consumption by an estimated 13.4% and hospital admissions by 4.1%, with the largest reductions seen in men and those living in the 40% most deprived areas.

The final report on the impact of MUP has been published by Public Health Scotland: Evaluating the impact of minimum unit pricing for alcohol in Scotland: A synthesis of the evidence

Alcohol sales in shops dropped by 3% particularly in cider and spirits.

The evaluation reports that the greatest reductions were amongst those households purchasing the most alcohol, with little impact on households purchasing at lower levels.

However, for those people with alcohol dependence there was limited evidence of any reduction in consumption and there is some evidence of consequences for those with established alcohol dependence on low incomes, that led them to prioritise spending on alcohol over food.

At a population level, the report suggests that there is no clear evidence of substantial negative impacts on social harms such as alcohol-related crime or illicit drug use.

MUP did not have a negative impact on drinks producers in Scotland which was one of the issues raised by objectors to the scheme.

Minimum Unit Pricing came into force on 1^st May 2018 and requires all licensed premises in Scotland to set a floor price of 50 pence per unit of alcohol, below which alcohol cannot be sold. The Alcohol (Minimum Pricing) (Scotland) Act 2012 has a sunset clause that requires the Scottish Parliament to vote before 1^st May 2024 on whether or not MUP will continue.

Overall, the evidence supports that MUP has had a positive impact on health outcomes, namely a reduction in alcohol-attributable deaths and hospital admissions, particularly in men and those living in the most deprived areas, and therefore contributes to addressing alcohol-related health inequalities. There was no clear evidence of substantial negative impacts on the alcoholic drinks industry, or of social harms at the population level. Evaluating the Impact of Minimum Unit Pricing for Alcohol in Scotland: Final Report

Clare Beeston, Lead for the evaluation of MUP, Public Health Scotland said:

“We have seen reductions in deaths and hospital admissions directly caused by sustained, high levels of alcohol consumption, and this is further evidence that those drinking at harmful and hazardous levels have reduced their consumption. MUP alone is not enough to address the specific and complex needs of those with alcohol dependence who will often prioritise alcohol over other needs, and it is important to continue to provide services and any wider support that addresses the root cause of their dependence.

“Those living in the most socioeconomically deprived areas in Scotland experience alcohol-specific death rates at least five times greater than those living in the least deprived areas. Alcohol-related disorders are a leading contributor to health inequalities in Scotland.

“Overall, the evidence shows that MUP has had a positive impact on improving health outcomes, including alcohol-related health inequalities, and can play a part in addressing the preventable harm that affect far too many people, families and communities.”

Key Findings to questions posed by the Scottish Government

To what extent has implementing MUP in Scotland contributed to reducing alcohol-related health and social harms?

• There is strong evidence that MUP reduced deaths directly caused by alcohol consumption (wholly attributable) in Scotland compared to what would have happened in the absence of MUP. The overall reduction was driven by reductions in deaths due to chronic causes, such as alcoholic liver disease. There was some indication of a small increase in deaths from acute causes, such as alcohol intoxication, but there is considerable uncertainty around this finding in part due to the relatively small number of deaths due to acute causes.
• There is strong evidence that MUP reduced wholly attributable hospital admissions due to chronic causes. There is some evidence of an increase in wholly attributable admissions due to acute causes. Overall, it is likely that MUP has reduced wholly attributable hospital admissions in Scotland compared to what would have happened in the absence of MUP.
• There is no consistent evidence that MUP impacted on other alcohol-related health outcomes such as ambulance callouts, emergency department attendances and prescribing of medication for alcohol dependence.
• There is no consistent evidence of either positive or negative impacts on social outcomes, such as alcohol-related crime or illicit drug use, at a population level.
• There is some qualitative evidence of negative health and social consequences at an individual level, particularly for those with alcohol dependence who are financially vulnerable.
  

Are some people and businesses more affected (positively or negatively) than others?

• The observed reductions in wholly attributable deaths and hospital admissions were greatest among men and those living in the most deprived areas of Scotland.
• There is strong and consistent evidence of a reduction in alcohol consumption following MUP implementation. Total alcohol sales reduced by 3% driven entirely by a reduction in sales through the off-trade (supermarkets and other shops). Those households that purchased the most alcohol prior to MUP also reduced their purchasing the most after implementation.
• MUP impacted on the price of some products more than others, particularly some ciders and spirits. This was reflected in alcohol sales, with the greatest reductions in sales observed among these products.
• Retailers found that loss in sales was generally offset by an increase in price; the impact on profits overall is not clear.
• Overall, there is no consistent evidence that MUP impacted either positively or negatively on the alcoholic drinks industry as a whole

Fiona Grahame