Two further pieces of evidence have been released indicating the early stage effects of minimum pricing in Scotland, including an analysis on consumer purchasing data and an NHS Health Scotland evaluation of the impact on alcohol retailers and purchasers.
Published in the BMJ, an analysis of the immediate impact on alcohol purchases in Scotland utilised samples of household purchasing data including England as a control group. Amongst the findings, a fall in the purchasing of alcohol in Scotland was found such that it concluded MUP led to a 7.6% reduction in off-trade purchases in Scotland, equivalent to drop of 328 g (41 UK units) per adult per household per year. This may be seen as broadly in line with early MUP market research sales data released earlier this year by NHS Scotland showing a fall in consumption against a rise in England.
A Twitter thread by Colin Angus summarised the BMJ analysis, highlighting key findings including the greatest effects have been seen amongst the heaviest drinkers and lowest income households, broadly consistent with prior modelling predictions. The data indicates only the 20% of households that bought the most alcohol saw a significant reduction and only the lowest 60% of households in terms of income. Prior to MUP, the average panel member in Scotland bought 2.5 more units than in England, but post MUP this difference dropped to 1.2 units. The data set also found that prior to MUP, off-trade prices were on average 1.2p lower in Scotland, but were 4p unit more expensive post-MUP.
The BBC reported the study as MUP 'cuts drinking by half a pint a week', with Scottish public health minister Joe Fitzpatrick describing the findings as "very encouraging". However, certain MUP opponents attacked the study, including the IEA's Christopher Snowden, who pointed to IRI sales figures (a different data set) showing a rise in off-trade purchasing following MUP. IRI data however does not include Lidl and Aldi sales - important retailers in the context of MUP - and does not appear to compare results with England in a period where a World Cup and heatwave likely boosted drinking significantly. Nonetheless, academics and NHS Scotland acknowledge that there are limitations to all the available data sources, and in terms of the effects of MUP, these are still very early days.
The economic impact of MUP on retailers and producers
As part of the NHS Health Scotland's comprehensive MUP evaluation plan, an assessment on the economic impact of MUP across the alcoholic drinks industry in Scotland has been released (see Colin Angus Twitter summary here). Based on case studies of alcohol retailers and producers, a small negative effect on profits was reported due to decrease in volume sales, although this was off-set to a large degree by an increase in margins. However, there were no reports of job losses, store closures or reduced investment in the industry, and no effect on the level of visits to on-trade premises such as pubs was found.
Consumer responses to MUP were mainly reported as less purchasing, switching to smaller containers or switching to 'better quality' products including some non-alcoholic drinks. However, pre-existing trends towards 'premiumisation', low and no alcohol drinks or other consumer behaviours make separating out the exact effects of MUP on purchasing behaviour difficult. Some evidence of producer and retailer responses were apparent, including cases of product reformulation, changes to pack sizes and some products being de-listed, though these effects were considered modest in the context of the broader drinks market.
The Guardian chose to focus on reports of a rise in sales just south of the border as its headline, though acknowledged three of the five interviewed supermarkets near the border reported no change in their sales, and there was no evidence of a substantial fall in sales for Scottish shops near the border.
A growing case for pricing controls?
Public health advocates will likely regard the findings as further evidence that the overall impact of MUP is having a positive effect on Scotland's heavier drinking populations, broadly in line with modelled predictions and therefore strengthening the case for the use of pricing controls as a public health measure. Whilst Wales and Ireland are currently in the process of implementing MUP, England's policy makers have insisted on waiting to see what happens north of the border following the infamous 2013 U-turn on the policy.
Further evidence supporting the role of control policies was also recently released by the World Health Organization (WHO) in a report highlighting alcohol consumption in Russia has dropped by 43% since 2003, resulting in significant falls in mortality and improvements in life expectancy. The improvements followed a series of measures including restrictions on alcohol sales, pricing levers and the legal categorisation of beer as an alcoholic drink in 2013. The Guardian reported that although Gorbachev had adopted partial prohibition which led to a decline in consumption from the mid-1980s until 1990, alcohol consumption exploded after the collapse of the Soviet and continued to rise until the early 2000s until the new control policies began to be adopted.
For many, the conclusions that national level alcohol control levers result in reductions in alcohol consumption and harms will come as no surprise, even though questions about the exact impact in the context of a wide range of determinants are important. Others though will focus on the question of what role evidence should and does play in the formulation of policy - a question often highlighted in the context of politics, lobbying and evidence concerning alcohol pricing. Whilst UK domestic policy may be largely overwhelmed by Brexit, some may hope it can only be a matter of time before politicians accept the case for MUP - and indeed higher duties - in England. Meanwhile, further evidence on the effect of MUP, and crucially its impact on health outcomes, will continue to be topics of close scrutiny.
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