Minimum unit pricing 'cut alcohol deaths by 156 per year'

A study published today in the prestigious Lancet journal estimates that MUP has cut alcohol-specific deaths by 13.4 per cent compared to the number that would have occurred without it.

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The effect was most pronounced in relation to chronic illnesses caused by long-term alcohol abuse, including alcoholic liver disease and alcohol dependency syndrome, as well as among men and people living in the 40 per cent most deprived postcodes.

It also estimates that some 411 alcohol-specific hospitalisations per year were avoided, equivalent to a reduction of 4.1%, though it is less clear whether this can be directly link to unit pricing.

Researchers based their projections on trends before and after implementation - from January 2012 to April 2018, and May 2018 to December 2020 - with England, where MUP is not in place, used as the control population.

The analysis shows that that while alcohol-specific mortality rates in Scotland continued to exceed England by the end of 2020, the difference between the two nations had shrunk.

The ratio of alcohol-specific ('wholly attributable' conditions) deaths has narrowed between Scotland and England from around 2 to nearly 1.5 (Image: PHS)

In addition, the authors note that while the actual number of alcohol-specific deaths registered in Scotland climbed from 1,190 in 2020 in 1,245 in 2021, England had experienced a steeper year-on-year increase of 7%.

As a result, the researchers say it is unlikely that including more recent data - after 2020 -w ould have altered their key finding that MUP curbs the number of deaths caused by alcohol.

However, they caution that as this is an observational study it is impossible to say with 100% certainty that unit pricing is responsible, only that it is the most probable factor.

The Lancet study follows on from previous analysis which estimated that alcohol sales - a proxy for consumption - had reduced by 3% in the first three years after implementation.

A major report pulling together all the findings to date on MUP, covering key outcomes including its effect on consumption, mortality, the economy, and crime, is due to be submitted to the Scottish Parliament by Public Health Scotland (PHS) in June.

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Dr Grant Wyper, a co-author of the Lancet study and a public health intelligence adviser at PHS, said: “Our study estimates that, following more than two and a half years of implementation, around 150 deaths, and around 400 hospital admissions, wholly attributable to alcohol consumption, were averted each year due to MUP.

“The greatest reductions were seen for chronic alcohol health harms, in particular alcoholic liver disease, which were slightly offset with less certain evidence of increases in acute alcohol health harms.

“The findings highlight that the largest reductions were found for males, and for those living in the 40% most deprived areas, groups which are known to experience disproportionally high levels of alcohol health harms in Scotland.

“We know that those living in the most socio-economically deprived areas in Scotland experience alcohol-specific death rates more than five times higher compared to those living in the least deprived areas.

“The results published today are therefore very encouraging in addressing this inequality, and the overall scale of preventable harm which affects far too many people.”

Modelling by academics at Sheffield University, carried out in 2016, forecast that MUP would prevent 121 deaths per year in Scotland.

Alison Douglas, chief executive of Alcohol Focus Scotland said, said the results are exceeding expectations and called on ministers to “renew and uprate” the minimum unit price.

“The whole point of minimum unit pricing is to save and improve lives; this research shows it is doing just that,” said Ms Douglas.

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Dr Sadie Boniface, head of research at the Institute of Alcohol Studies, said evidence that the decrease in deaths “was bigger in the more disadvantaged group...fits with the findings from modelling studies that minimum pricing helps to narrow health inequalities”.

She added: “Previous evidence suggests these health gains should continue into the future, although high levels of inflation risk watering down the impact of the policy as it currently stands.”

Dr Alastair MacGilchrist, a liver specialists and chair of Scottish Health Action on Alcohol Problems (SHAAP), said: “This report should serve as an important reminder to whoever becomes Scotland’s next First Minister: taking forward evidence-based measures to reduce the number of people suffering due to alcohol is the right thing to do.”