Minimum Unit Pricing in Scotland: What we know so far about its effects on consumption and health harms

Background

Minimum unit pricing (MUP) for alcohol was introduced in Scotland on 1 May 2018. MUP sets a floor price per unit, currently 50p, below which it is illegal to sell alcohol. This
specifically targets the cheapest, strongest drinks favoured by harmful drinkers – those who regularly drink more than the lower risk guidelines. By lowering alcohol consumption in this group, the policy is intended to “save lives, reduce hospital admissions and, ultimately, have a positive impact across the whole health system in Scotland and for wider society”. The legislation introducing MUP requires the Scottish Government to
conduct a formal evaluation of the policy’s impact five years after it comes into force,
following which the Scottish Parliament will vote on whether to retain MUP.

Several analyses of MUP’s effect on consumption – of varying robustness – have been published

While we await the results of this official evaluation, a number of different sources have
published data exploring the initial impact of MUP on sales and consumption. Media
reports have been mixed, with some claiming the policy has been a success and others
claiming it has been a failure. This briefing attempts to summarise this evidence to draw
conclusions about the impact of MUP based on what we know so far.

When assessing the impact of MUP, one of the most important indicators to measure is alcohol consumption. This is because evidence shows that rates of consumption are directly linked to rates of alcohol harms such as deaths, hospital admissions and crime. Alcohol sales data are often used as a proxy to measure consumption rates and a number of analyses – of varying robustness – have been published using sales data to assess the impact of MUP so far. When evaluating these different sources of evidence, we should consider the following:

• How were alcohol sales measured? The best measure to evaluate the impact of MUP on consumption is the number of units of alcohol sold per adult, rather than ‘natural volumes’ or ‘stock-keeping units’.
• How were the data collected? Alcohol sales data can come from retailer till scans or home consumer panels, each with their own strengths and limitations.
• How were the data analysed and/or published? Data published in official reports and academic journals are more in-depth and transparent than data published solely in newspaper articles and blogs.
• What was the time period covered? Some data relate to the first few weeks or months of MUP, other sources to the full first year.
• What comparison or counterfactual was used? When evaluating a policy, it is important to have a counterfactual or comparison to establish the policy’s causal impact. For MUP, researchers tend to favour comparing Scotland with other parts of the UK, such as England and Wales. However, some studies only compare postMUP figures to data from the year before. The latter assumes that consumption would not have changed year-on-year, despite changing circumstances (such as a particularly hot summer or the football World Cup, which both occurred in 2018).

The available evidence so far strongly suggests MUP has reduced alcohol consumption in Scotland

Two reliable analyses both report a drop in alcohol sales (of around 4-6%) in Scotland
following MUP. While other sources suggest alcohol sales may have been flat year-on-year, every published source shows a greater rise in England and Wales than in Scotland.
The most robust available evidence suggests MUP has reduced per adult alcohol
consumption by 7-8%. Moreover, this reduction in consumption appears to be greatest
among the heaviest drinkers. An overview of published data on alcohol sales in Scotland
following MUP can be found in the appendix.

The evidence on health harms so far is less conclusive

Data related to alcohol health harms will also provide an indication of the impact of MUP.
The official evaluation will assess changes in alcohol-related death rates and hospital
admissions, using robust statistical analysis. However, this briefing presents early
descriptive data on health harms.

Alcohol-specific deaths fell 7% in Scotland in the eight months following MUP, but they fell by the same amount in England. Hospitalisations due to alcohol were flat in the first 12 months of MUP in Scotland, but they appear to have risen in England. More data and robust analysis are needed to accurately distinguish the causal effect of MUP on health harms from random fluctuations, a process which may take years.