91̽��

It’s no secret that too much alcohol can have painful ramifications, and not just a crippling hangover. Ending up in hospital for everything from a drunken fall to a decade of liver abuse contributes to a huge strain on the NHS, costing £2.8 billion each year. Not to mention the cost of alcohol induced crime in society. The vast majority of the UK’s population, around 78% of people, report drinking within the current guidelines of 0-14 units per week. However, the impact of heavy drinking on healthcare and crime can’t be ignored. But how do you introduce change in the face of powerful opposition from industry? 

(SARG) work on the design, development and adaptation of alcohol related policies. And Senior Research Fellow Colin Angus is a key part of this team. He’s spent the last 10 years producing and studying economic models to assess the most effective way to reduce drinking in heavy drinkers without ‘unfairly’ penalising moderate drinkers. What began as a review for the Department Of Health has evolved into policy changes in Scotland and Wales which is expected to improve the lives of thousands of people over the next few years.

Colin and his team use three definitions when talking about drinking: 1) moderate drinkers are people who do not regularly exceed 14 units a week (approximately 78% of people), 2) increasing risk drinkers are men drinking between 14 and 50 units a week and women drinking between 14 and 35 units a week, 3) high risk drinkers who are men drinking over 50 units a week and women drinking more than 35 units a week. Heavy drinkers can come from both the increasing and high risk groups. But heavy drinkers aren’t always dependent drinkers (who it’s estimated make up 1.4 per cent of the UK population). 

The short term health risks of increasing and high risk drinking include alcohol poisoning, accidental injuries from things like falls, and vehicle crashes. But there are also long term health implications like cancer and heart and liver disease. Alcohol-attributable liver disease alone costs the NHS an estimated £176 million each year. The combined impact of this is a strain on healthcare and its economic resources. 

Alcohol’s implications in crime are also a cause for concern, it’s estimated to contribute to 39% of violent crime in England. This cost can be broken down. Physical costs are anything that’s stolen or damaged for example. As well as the cost of services to catch and incarcerate the offender. But what about the social and productivity costs? If the criminal is in prison they’re not contributing to the economy for example.

There are various guidelines and campaigns to encourage people to drink responsibly. Yet, sometimes, as is the case with heavy drinkers, this isn’t enough. If you want to reduce harmful drinking the evidence is clear, it needs to be harder for people to drink in excess.

To reduce alcohol consumption in heavy drinkers a different approach was needed. In 2008 the Department of Health asked the 91̽�� Alcohol Research Group to do a systematic review of the evidence around the effectiveness of different forms of alcohol pricing policy. Whilst conducting their research, the idea of Minimum Unit Pricing began to emerge as a potential policy option.

“Minimum Unit Pricing means that every unit of alcohol has to cost at least a certain amount, regardless of whether that unit is wine, vodka or cider for example. So if the minimum unit price is 50p and you have a standard can of beer which might be two units, the minimum price this can be sold for is £1,” explains Colin. 

So how does this affect alcohol pricing? Most alcohol sold in shops, pubs and bars wouldn’t be affected because they already cost well above this minimum level  set by a 50p per unit policy. For example if a bottle of wine contains 10 units, at 50p a unit of that bottle would have to cost at least £5 but most wine already costs at least that. “The impact would be on cheap alcohol that’s commonly consumed by heavy drinkers - it’s your 2.5l bottles of white cider like Frosty Jacks or cheap supermarket own-brand spirits that are affected,” says Colin. 

A 2.5l bottle of Frosty Jacks costs around £3.70 and contains 18.8 units of alcohol – an absolute steal for anybody looking to drink for as little cost as possible. But under Minimum Unit Pricing this bottle would cost at least £9.50. These higher price tags act as a deterrent to heavy drinkers. This is particularly true of lower income communities where 9 out of 10 lives saved by minimum unit pricing are predicted to come from.

Minimum Unit Pricing is a policy with huge potential to reduce the substantial burden that alcohol places on our society and to do so in a way that effectively targets those who are suffering the most harm, while not ’penalising’ moderate drinkers.

Colin Angus

Senior Research Fellow, University of 91̽�� Alcohol Research Group

“Our research finds that while many people would end up paying slightly more for their alcohol, the impact on people drinking within the guidelines is tiny – around £2.50 extra over the course of an entire year. However for the heaviest drinkers in the most deprived groups, we estimate that their spending on alcohol would decrease as a result of the reduction in the amount of alcohol they buy.”

In December 2017, Scotland got the go ahead to put in place Minimum Unit Pricing as a key policy against heavy drinking. However, this was after a huge legal challenge brought about by alcohol industry interests, led by the Scottish Whisky Association. They claimed the policy would disproportionately affect moderate drinkers and wouldn’t be effective at reducing the consumption of harmful drinkers.

“As a team our aim was to establish, based on the available evidence, whether Minimum Unit Pricing provided a benefit to heavy drinkers, health care and crime that couldn’t be achieved through other means like raising taxes on alcohol for example. That benefit also couldn’t disproportionately affect those not being targeted by the policy,’ explains Colin. 

After five years of dispute, the policy came into effect in May 2018. Wales quickly followed suit, implementing its own version of the policy in March 2020. It will take 20 years before the full health impacts of the policy are known. However, Wales is expecting a cost saving of £92 million for the NHS over that 20 year period, equating to £4.6 million a year. This is due to a 3.6% reduction in alcohol consumption annually resulting in fewer deaths and hospital admissions and 2093 fewer crimes attributed to alcohol each year. In Scotland the results so far are showing a similar trajectory. There’s been a 3.5% fall in average alcohol consumption and 121 fewer deaths attributed to alcohol as a result.

It’s a bold public health policy and the fact that the Scottish and Welsh governments have managed to implement it in the face of significant opposition from the alcohol industry, show that it’s possible to prioritise health over corporate interests when making policy

Colin Angus

Senior Research Fellow, University of 91̽�� Alcohol Research Group

Implementing strategies and policies to protect all those at risk from the harmful effects of alcohol is difficult. Resistance from the alcohol industry alone is a challenge. But despite the policy still being in its infancy it has great potential to fundamentally change drinking habits in Scotland, Wales and the Republic of Ireland for the better. In 2021, further research was commissioned by Ireland that led to a sunset clause for a Minimum Unit Pricing Policy. Evidence has also been provided to Northern Ireland with hopes of being advocated for in the future. 

Written by Alicia Shephard, Research Marketing and Content Coordinator

Graphics by Ella Marke, Visual Designer

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For further information contact:

Amy Pullan
Media Relations Officer
University of 91̽��
+44 114 222 9859
a.l.huxtable@sheffield.ac.uk