Alcohol deaths in Scotland fall 10% in first year of minimum pricing

Pete Whitehouse, director of Statistical Services said: “Since our records began in 1979, there have only been three other occasions where we have seen a reduction in the number of alcohol-specific deaths of around 10 per cent or more in a single year.

“However, although an annual decrease of this magnitude is notable, further data will be required to see if this reduction continues and whether we will see a sustained shift in alcohol-specific deaths in Scotland.”

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Experts cautioned that while the decline was encouraging, it was largely due to a drop in deaths from liver disease.

A spokeswoman for Scottish Health Action on Alcohol Problems (SHAAP), an umbrella body for medics and public health experts in the the field, said: “We are cognisant that the alcohol-specific deaths definition does not include deaths where alcohol is known to be a contributory factor - such as deaths due to cancer, suicide and road accidents.

“There is therefore still much work to be done to continue reducing alcohol-related harm and mortality in Scotland, which remains high.”

Direct alcohol deaths are nearly three times higher than they were in 1979, when 389 were recorded, but experts believe we are already seeing the impact of minimum pricing.

The policy came into effect in Scotland in April 2018, setting a threshold of 50 pence per unit of alcohol which triggered significant price hikes on high-strength products such as white cider.

Dr Peter Rice, chair of SHAAP and a former consultant psychiatrist in NHS Tayside’s Alcohol Problems Service, said: “Although it takes many years to develop liver disease, whether or not you die depends on your drinking in the last year.

“Often people won’t have symptoms until late and then become very ill, very quickly. We think what minimum pricing will have done is that people who were at risk without knowing it will have been moved away from becoming ill as a result of their consumption reducing.

“There’s quite a lot of research going on into this in Scotland right now, but the Sheffield University modelling - which got a fair amount of criticism, particularly from the industry - predicted that there would be a fall in the first year that minimum unit pricing was in operation.

“They estimated about 60 fewer deaths, so on that they’ve done not badly. So it’s not unexpected to see an initial fall [in alcohol-specific deaths] but we would expect even bigger decreases in years two and three.”

Dr Rice added that it would be vital to review the 50 pence threshold, and said he would like to see the cost per unit increase.

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Prior to MUP, alcohol-specific death rates among men in Scotland were twice as high compared to men in England and Wales, and 55% higher for females.

There has recently been evidence of changes in consumption between the two nations, however. In 2018, 9.9 litres of pure alcohol were sold per adult in Scotland - the lowest since 1994.

The volume of pure alcohol sold per head in Scotland in 2018 was still 9% higher than in England & Wales, but the gap was narrowing as alcohol sales grew in England and Wales but fell in Scotland - driven by a decline in off-trade purchases.

This is the first full year of data that on alcohol-specific death has become available since MUP was introduced.

BMA Scotland chair Dr Lewis Morrison said the figures were “moving in the right direction” in terms of changing Scotland’s relationship with alcohol.

“We know there is still work to be done but this is very encouraging for minimum unit pricing’s long-term strategy.

"The aim of minimum unit pricing was to change our country’s relationship with alcohol in the long-term and for generations to come, and these figures indicate that a better future for the nation’s health is achievable.”

Alison Douglas, chief executive of Alcohol Focus Scotland, said: “The evidence from the evaluation of MUP so far has shown that it is having the intended effect on alcohol consumption, and now it looks like we may be beginning to see this translate into health benefits.”

However Ms Douglas stressed that the changes were “within the normal range of fluctuation”, and other measures such as marketing restrictions should be considered.

She added: “That’s why the full and robust evaluation of MUP by Public Health Scotland is so important as it will provide detail on the impact of the policy over a longer timescale.

"MUP alone was never expected to solve Scotland’s alcohol problem. There’s still much more we can do to tackle alcohol harm.”