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Balance calls for minimum unit price for alcohol (MUP) in England

Joanne Good

Joanne Good supports action on cheap alcohol

Posted 29/05/21

Following a record year in 2020 for alcohol deaths, North East campaigners are calling on the Government to introduce a minimum unit price for alcohol in England, as a new study shows that the policy is having a lasting impact on some of the heaviest-drinking households in Scotland and Wales.

Balance has welcomed the study led by researchers from Newcastle University and published in The Lancet Public Health which shows a minimum unit price (MUP) policy for alcohol introduced in Scotland in 2018 continues to have a positive impact more than two years on.

The study also found that a more-recently introduced MUP policy for Wales has had a similar impact on heavier drinking households – despite the policy being launched in March 2020 at the start of a national Covid-19 lockdown period, where many adults were reportedly drinking more at home. The greatest reductions overall were seen in the purchase of ciders and spirits.

Currently it is possible in England to buy 2.5 litres of 7.5% cider for £3.70 – the equivalent of 19 shots of vodka.

The findings come as the North East continues to experience some of the worst alcohol-related harms in the country, with alcohol estimated to cost the region more than £1bn each year. Alcohol deaths rose by around 20.5% in the North East in 2020 from 16.6 per 100,000 people in 2019 to 20.0 per 100,000 people.

Sue Taylor, Acting Head of Alcohol Policy for Balance and Fresh, said: “This important new evidence shows the real impact minimum unit pricing in Scotland and Wales is having on people’s lives.

“Meanwhile in the North East, we continue to suffer disproportionately from alcohol harms. Alcohol addiction is causing untold harm to families, many in our most deprived communities. It’s not right that you can buy a week’s worth of alcohol for the price of a coffee. The cheaper alcohol has become, the more harm it inflicts on individuals, families and wider society.

“The bulk of alcohol harm falls on the most deprived people in our communities and they stand to gain the most from MUP. If the Government is committed to levelling up and tackling health inequalities, the evidence is clear – minimum unit price is one of the most effective interventions available to the Government and it must act now to save lives and narrow the gap between our most and least affluent communities.

“While no single measure offers a silver bullet, MUP is an evidence-based way of reducing alcohol consumption. MUP has been shown to save lives, reduce crime and relieve pressure from alcohol on the NHS.

“We’re urging the Government to listen to the evidence and introduce MUP in England, as part of a comprehensive national alcohol strategy to address the rising burden of alcohol harm.”

North Tyneside mum Joanne Good, whose daughter Megan tragically died in her sleep after drinking strong white cider at a friend’s New Year’s Eve party, is also backing the calls to introduce MUP in England.

In England it is possible to buy 2.5 litres of strong 7.5% cider for just £3.70 – the equivalent of 19 shots of vodka, but the same bottle would now sell for over £10 in Scotland.

Joanne said: “Alcohol is too cheap and far too often ends up in the hands of children. I fully support any measure that increases the price of cheap alcohol and helps the young and vulnerable. I know the impact cheap, strong alcohol can have on people’s lives, because it has devastated ours. My beautiful daughter Megan didn’t wake up after she drank alcohol at a party, and I never want anyone else to go through that.

“It’s clear that minimum unit price is having a positive impact in Scotland and Wales. We really need it here too, now more than ever after a record year of alcohol deaths and worrying numbers of people drinking more since the pandemic. MUP is targeted at the pocket money priced alcohol which causes the most harm and won’t affect the price of alcohol in a pub. We’ve got to do it for the next generation and the most vulnerable in society.”

Dr James Crosbie, GP and consultant gastroenterologist and Clinical Lead for Alcohol for the North East and North Cumbria Integrated Care System, said: “Last year as the pandemic struck we saw a record year for alcohol deaths, with the worst rates in the country here in the North East, and around three quarters of a million hospital admissions from alcohol nationally.

“Liver disease is on the rise and since 1970, deaths due to liver disease have increased by 400%. NHS colleagues across the country see the harm cheap alcohol causes on a daily basis.

“But this is not just about people drinking at very heavy levels and suffering from conditions such as liver disease. We see patients for a whole range of conditions linked to alcohol consumption, from high blood pressure to seven different types of cancer. The introduction of MUP would prevent a great deal of suffering, and ease the pressure on NHS services.”

In the North East death rates from alcohol rose from 16.6 per 100,000 people in 2019 to 20.0 per 100,000 people in 2020 – a rise of around 20.5%.

Professor Sir Ian Gilmore, Chair of the Alcohol Health Alliance, said: “This is powerful real-world evidence of the success of minimum unit pricing as a harm reduction policy.

“Westminster has said time and time again that it is waiting for evidence from Scotland and Wales on minimum unit pricing, meanwhile, 80 people a day are dying from an alcohol-related cause. The evidence is here – it’s time for the Government to introduce minimum unit pricing in England in order to save lives, cut crime and reduce pressure on our NHS and emergency services.”

The latest evidence follows the publication of modelling by the University of Sheffield in 2020 , which calculated that in the North East a 50p minimum unit price would:

• Prevent almost 2,000 deaths over the next 20 years.
• Avoid over 3,200 hospital admissions a year.
• Prevent over 4,300 crimes a year.

Background to the study

A minimum unit price (MUP) policy was implemented in Scotland in May 2018, of 50p per unit (8g) of alcohol. The policy aimed to reduce alcohol consumption – and as a result reduce the health harms caused by alcohol, and related costs to health and care systems.

An earlier study – also led by researchers from Newcastle University – showed that the MUP policy in Scotland had an early and immediate impact. This latest study shows that impact is still maintained two years on.

A MUP was more-recently introduced in Wales – in March 2020. This new research shows that Wales has experienced similar levels of early impact as that of Scotland in 2018.

The impact was mainly seen in households that buy the most alcohol – with the exception of high purchasing, very lowest income households, who didn’t change their habits.

These consistent results for both Scotland and Wales suggest that the MUP policy is effective in reducing the amount of alcohol bought by heavier purchasing households.

What this means

Professor Peter Anderson from Newcastle University, led the study. He said: “Our previous work suggested that the introduction of a MUP in Scotland during May 2018 was associated with an immediate reduction in the amount of alcohol that households purchased from shops or supermarkets.

“This latest analysis shows that the policy has continued to make an impact, with data showing a sustained drop in overall units of alcohol bought by some of the highest-consuming households, two years on.

“We can now see that the introduction of a MUP in Wales at the beginning of March 2020 has had a similar impact to the one we saw in Scotland in 2018. It will be interesting to see if this impact is sustained in Wales in the medium term, as it has been in Scotland.”

Professor Eileen Kaner, Professor of Public Health and Primary Care Research at Newcastle University and Director of the NIHR ARC North East and North Cumbria, co-authored the study.

She said: “Alcohol use is a leading risk factor for ill-health and premature death, and if we can reduce alcohol consumption, especially in the heaviest drinkers, we can reduce the alcohol-attributable health burden.

“We know that drinkers at the greatest risk of harm tend to consume the cheapest alcohol, particularly from shops and supermarkets, where prices are much lower. This is why minimum unit price as a public health policy specifically targets lower cost products – and this impact has been seen the most in products such as ciders and to some extent, spirits.

“Overall, Minimum Unit Price is an effective policy that could be widely and easily implemented, and this evidence suggests that it is a powerful but also highly-targeted option to reduce alcohol purchases and, hopefully, levels of consumption.”

NHS Health Scotland is also leading a comprehensive evaluation to assess the impact of MUP on a range of outcomes, the complete findings of which will be reported in 2023.

The research

In an attempt to reduce consumption and the harm done by alcohol, Scotland introduced a minimum price of 50 pence per unit of alcohol (8 grams) sold on 1st May 2018. Wales followed suit on 2nd March 2020 with the same minimum price.

This study analysed household purchase data based on bar codes to assess the impact of these policy options in the medium term for Scotland and in the immediate term for Wales.

The team carrying out the research used data from Kantar WorldPanel’s household shopping panel. They looked at over 35,000 British households providing detailed information on 1.24 million separate alcohol purchases between 2015 and 2018, and the first half of 2020.

The investigation looked at:
• Price paid per gram of alcohol purchased
• Alcohol purchased
• Amount of money spent on alcohol.

By using purchase information, rather than in-person surveys, the team could work with a larger and more objective data set.

They analysed the impact of introducing a MUP in Scotland – using purchases in Northern England as a control. They also looked at the impact of introducing a MUP in Wales – with Western England as the control.

They found that data from consumers in both Scotland and Wales, showed the households that tended to buy the most alcohol were those most likely to reduce the amount they bought after the introduction of a MUP.

However, they also found that the highest purchasing households that fell into the very lowest income bracket (the lowest fifth) did not seem to reduce the amount of alcohol they purchased, and so their expenditure on alcohol increased in line with the increase in price.

Lower purchasing households, including those with the very lowest incomes, did not increase their expenditure on alcohol, following the introduction of MUP.

COVID-19 confinement did not affect the results. Whilst household purchases of alcohol increased overall in all four areas during COVID-19 ‘lockdown’ periods, the level of impact of MUP between Scotland vs Northern England, and between Wales vs Western England stayed the same.