White ciders and 'super strength' drinks have been a regular feature in alcohol policy debates over the years. This month a letter published in Clinical Medicine reminded readers of research that found all cheap strong cider drinkers in Scotland are 'dependent, and possibly ill' - or 'alcoholics' as some of the media seemed to prefer.
The existence of such drinks are therefore highly contested and interplay with key alcohol policy areas including price, availability and industry led 'responsibility' action. In 2011 a report released by Alcohol Concern called for action to stop 'irresponsible profiteering from the high-alcohol low-cost drinks' whillst the Observer ran a feature 'White cider is becoming like heroin among alcoholics'.
Price and taxation: time for change?
An Alcohol Research UK comment piece responding to the recent letter highlighted Scotland's minimum unit pricing (MUP) legal battle is currently going through the final stages, with a decision expected soon - albeit likely to be subject to further legal appeal. However the precise impact of MUP on white cider drinkers is unknown. Whilst some arguments have been made that MUP is an 'almost perfect policy' precisely because it will force the heaviest drinkers to cut down, questions over what alternative drinks might be sought instead by the most severely dependent, and the possible impact on others, have also been raised.
MUP though would also impact a much wider range of 'harmful' drinkers given the volume of off-trade units that are sold below 50 pence a unit, and as such public health epidemiologists might counter that smaller reductions in a larger group are more significant in terms of the intended gains. It is often cited that '40% of all alcohol is consumed by 10% of the drinkers', yet only a small proportion will access treatment services or seek formal help.
Tax has also been much discussed as an issue, though under the current system unrealistic tax hikes would be required to see the equivalent price effects of MUP. Added complications include how some producers might absorb tax rises on certain drinks, price shift onto different products, or the effects on groups such as the craft cider industry. The Institute for Fiscal Studies' repeated calls for the re-structuring alcohol taxation have support from some health groups as an additional measure to MUP, and may be more likely following Brexit.
RIP Responsibility Deal?
What of industry-led action? The greatest claimed success of the now expired responsibility deal was to have removed more than a billion units from the market, though subsequently questioned. However public health groups are unlikely to be concerned that there appear to be no signs of revitalising the former alcohol pledges.
Despite this, there may be scope for further pressure on producers to reduce strength, serving sizes or even de-list 'super strength' products. In 2009 White Lightening was de-listed by its owners Heineken to 'reinforce its stance on responsible drinking', but what value was such a move if other products such as Frosty Jacks have merely filled the gap in the market?
More recently, local 'reducing the strength' type initiatives appeared to have risen in popularity. Some positive impacts have been reported, but opposition from some industry groups and questions over sustainability and actual impact may warrant further attention.
For Scotland, an eventual MUP victory would certainly be celebrated by many health groups, and cheap ciders could be the most obvious scalp from the off-trade shop floor. To what extent wider 'harmful drinking' population effects would mitigate possible potential negative impacts on those at the heavier end of the spectrum would be closely monitored by supporters and opponents alike.