Minimum alcohol pricing is a success. Now for unhealthy foods

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Their continued presence under this warm spring sun didn’t happen by accident or coincidence. A major study on the impact of minimum unit pricing (MUP), published this week in The Lancet medical journal, found that a 13.4 per cent reduction in deaths followed its introduction in 2018, compared to how many deaths there would have been otherwise. It also found a narrowing in the different rates of alcohol-related death between Scotland and England.

How can it be judged a success when alcohol-related deaths have actually increased recently? Researchers point to a steeper rise in England than in Scotland, concluding that if it weren’t for the MUP, the rise in Scotland would have been even worse.

READ MORE: Think the SNP is finished? You are very much mistaken

This is an observational study so we can’t say with cast iron certainty that the changed trend in deaths is down to the MUP but it’s the most probable cause and echoes modelling done prior to the MUP being introduced. In other words, this is the best evidence available and strongly suggests that MUP is having a significant impact.

This is a Scottish public policy success. The MUP legislation required politicians to be bold, focused and committed, and to hold their nerve in the face of a protracted legal challenge spearheaded by the Scotch Whisky Association, which did all it could to derail it. This is the hard, unsexy work of good government, chipping away bit by bit at hard-to-solve problems, being willing to innovate in the public interest and standing firm against hostile vested interests. It stands alongside Scotland’s bold 2006 ban on smoking in public places, which cut heart attacks by 17 per cent in one year, as one of Holyrood’s proudest moments.

So now the question must be: what next? This should be just the turbo-boost ministers need to get further, critical public health measures over the line, on restricting the marketing of alcohol, vapes (which are increasingly used by children) and foods high in fat, salt and sugar.

But there are signs this new generation of SNP ministers may lack the appetite to keep up the fight.

A consultation on ways of restricting alcohol marketing has just taken place, but both Kate Forbes and Humza Yousaf have sounded unenthusiastic about it and hedged about what action they would be prepared to take in its wake.

Minimum alcohol pricing appears to save lives (Image: free)

The goodwill of drinks producers and retailers in Scotland has been tested to breaking point by the mishandling of the deposit return scheme and all the SNP leadership candidates are understandably keen to build bridges. Clearly no business welcomes restrictions on its freedom to advertise.

But what’s the alternative here – to retreat? Are we simply to tolerate the huge burden of preventable disease and death? Or perhaps the argument is that we tinker round the edges or fall back on anaemic measures like public health campaigns that have yielded disappointing results in the past?

Two thirds of Scottish adults are overweight or obese. The British Heart Foundation Scotland estimates that around 10,000 deaths a year could be prevented through public health action on alcohol, foods high in fat, sugar and salt, and tobacco.

The effect is seen predominantly in the most deprived areas, where people can expect to live in good health for 24 years less than those in the wealthiest areas, due to conditions like cardiovascular disease and diabetes.

So will the Scottish Government place restrictions on alcohol advertising, as well as on promotions of “unhealthier food and drink promotions”, as promised?

There is strong evidence that price promotions in supermarkets influence buyer behaviour and that they tend to be skewed towards unhealthy foods (as a doctor recently remarked to me, you never see three-for-twos on apples). Heck, even the populist right-wing government of Boris Johnson was convinced by this and passed legislation, though it angered campaigners by delaying restrictions on buy-one-get-one-free deals and a ban on pre-watershed TV adverts, which are still to come into force.

As for alcohol marketing, it should surprise precisely no-one that reviews of the evidence clearly show an association between exposure to alcohol marketing and alcohol consumption. A big worry is the research showing a link between sports sponsorship and drinking amongst children. So again: restricting alcohol marketing, such as sports sponsorship, has a powerful public health rationale and has been implemented in many other European countries without ruining the drinks industry. It’s the UK that’s the outlier, sadly.

As for vaping, for a product that is supposedly a smoking cessation aid, there are a lot of new users among children. The latest figures for Scotland show regular e-cigarette use has tripled among 15-year-olds and more than doubled among 13-year-olds in the last five years. Vaping fluid contains nicotine, which is of course addictive, and the long-term effects of vaping on young developing lungs are unknown. Can it really be right to allow vapes to be marketed freely? The WHO notes that children who vape are up to three times more likely to use tobacco products in future. Polling shows the Scottish public would strongly support an advertising ban.

All these measures together can help put a real dent in Scotland’s dismal public health statistics and the next First Minister needs to take them forward as a priority. Instead, the two frontrunners in the SNP leadership contest sound lukewarm at best.

Do they really want to head up the first post-devolution government in Scotland to retreat on public health, putting at risk a hard-earned international reputation for leadership and innovation?

Scotland's Public Health Minister Maree Todd said of The Lancet study: "We're determined to do all we can to reduce alcohol-related harm which is one of the most pressing public health challenges that we face in Scotland."

She might be, but will the future First Minister be made of the same stuff?