Minimum Unit Pricing for alcohol – would it stillwork?   Scotland’sminimum pricing policy for alcohol, to be fixed at 50 pence a unit, will comeinto force on 1 May 2018. This note examines correlation between Minimum UnitPricing (MUP), alcohol consumption, and alcohol related harm, considersevidence for the effectiveness of MUP, and outlines major vectors for efficientevidence-based policymaking.   BackgroundThere is anumber of people in the UK experience harm from irresponsible drinking.  Alcohol misuse is a significant riskfactor attributable to early mortality, ill health, and disability. Excessivealcohol consumption can also increasethe risk of unemployment, thelikelihood of suicidal ideation or criminal behavior.

Irresponsible alcoholconsumption has significant impact on both health and social wellbeing andnational economics.Today alcohol is 60% moreaffordable in the UK than it was in 1980. In England and Wales, there has been a ban onalcohol being sold at below cost since May 2014; the first conviction forselling alcohol below the level took place in 2016. In 2012 legislation to havea minimum price of £0.50 per unit was passed in Scotland. On 15 November 2017,the UK Supreme Court confirmed that the legislation is lawful. The policy ofMUP in Scotland aims to decrease alcohol related deaths by about 120 per yearand reduce the number of hospital admissions of 2,000 per year by year twentyof the policy.   (Annual figures for England show over 1million alcohol-related hospital admissions in 2013-2014 and 6500alcohol-related deaths in 2013.

These figures have dramatically increasedcompared with a decade previously of 115% and 10%, respectively – diagram) KeyfindingsThe reviewexamined the effect of price interventions on alcohol consumption,alcohol-related morbidity and mortality, and wider harms in several countriesincluding The UK, Ireland, Australia, Canada, Poland, Finland, Russia, etc. from1970 to nowadays. The results can be summarized in few thesis. Strongassociation between pricing and alcohol consumption  In 16/26studies published in peer-reviewed journals, correlation between pricing andalcohol consumption or alcohol-related harm was evident. Inverse associations havebeen documented in Europe, North America and Australia.

For example, studies inCanada showed that 10% increases in minimum prices are associated withreductions in alcohol consumption of 3.4–8.4%, reductions in alcohol-relatedhospital admissions of 9% and reductions in mortality caused by drinking of32%.

Studies where price changes preceded changes in alcohol consumption orharm have also been conducted in Russia, Poland, and Finland.Pricingmatters more for heavier drinkers It isevident that the higher the MUP the greater the reductions in alcoholconsumption or alcohol-related harms. Thus, a thorough examining of MUP in thecontext of average personal income and inflation should be hold to use analcohol price as an economic mechanism to influence consumption in the mosteffective way.

The review outlines that MUP has different impact depending onalcohol consumption patterns. Statistically significant associations betweencheaper alcohol and heavier drinking were found in the UK, Australia, Ireland,and the USA. Reviews report that the reduction in consumption amongharmful drinkers is considerablyhigher than among moderate drinkers as they are more likely to pay less than a proposed MUP (??????? ??????)MUP is notan exclusive factor to influence alcohol consumptionAlthoughMUP policy demonstrates a significant impact on alcohol consumption, there is awide range of factors that are also important. Except for price(affordability), the two key drivers are availability (how easy it is topurchase) and acceptability (social norms).

This also includes the minimumprice level chosen and other governmental regulations like taxation which isoften considered alongside with minimum pricing. A tax increase can leadto improvements in overallnational health; there is evidence that doubling tax rates decreasesalcohol-related mortality by an average of 35%, with further reductions inviolence, crime, road fatalities, and sexually transmitted infections. (??????? ? ????????????????)Adjustablefactors influencing alcohol consumptionTaxationand price regulation (MUP and taxes)Regulatingmarketing (advertising abilities including sponsorship)Regulatingavailability (points of sales, age of customers, time limitations )Providinginformation and education (raising awareness of hazards)Managing thedrinking environment (regulations on serving alcohol to intoxicated customers,replacing glasswear with plastic alternatives, public drinking regulations)Preventingdrink-driving (high fines and lower drink-drive limits)Briefinterventions and treatment (examining drinking patterns and offering advice) Conclusionand recommendationsIt is highlyprobable that introducing MUP for alcohol would reduce alcohol consumption andalcohol-related harms. Heavy drinkers who are most likely to causealcohol-related harm will be influenced by MUP more than moderate responsibledrinkers that can possibly bring significant economic benefits. It is essentialto examine the MUP fixed at 50p a unit and consider its potential increase asthe policy is designed for a five-year time. Implementation of a wide range ofmeasures preventing the misuse of alcohol can lead to the enhancement of MUPpolicy efficiency. Combining alcohol polices may create a critical masseffect, changing social norms around drinking to increase the impact onalcohol-related harm. Thechallenge for policy makers is to implement the most effective andcost-effective set of policies for the Scottish context.

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