Minimum booze price will rein in alcohol abuse

Binge drinking and preloading ? drinking cheap shop-bought alcohol before going to a bar ? are two behaviours the UK government hopes to curb by imposing a minimum price for alcohol. A 10-week consultation period for the policy, which could see a ban on alcohol being sold at less than 45 pence per unit in England and Wales, ends on 6 February. Meanwhile, Scotland is considering a minimum of 50 pence. But will the policy succeed in tackling alcohol overconsumption and its consequences?

"There's a huge amount of evidence that pricing is linked to consumption," says John Holmes at the University of Sheffield, UK, whose research into the link between alcohol pricing and public health was used by the government in framing the proposed pricing policy.

The government hopes that the impact of a minimum price will be felt mainly by those who drink more than is recommended, since they tend to drink cheaper alcohol. In the UK, the recommended limits are 21 units for a man and 14 units for a woman, per week. A unit is equivalent to 10 millilitres of pure alcohol.

The government claims that the policy could lead to a 3.3 per cent fall in consumption across all alcoholic drinks. This will in turn lead to at least 5200 fewer crimes, 24,600 fewer alcohol-related hospital admissions and over 700 fewer alcohol-related deaths per year after 10 years, it says.

Holmes and his colleagues used spending data from 9000 UK households to model how different demographics respond to price changes. The model shows that a minimum price of 35 pence per unit would lead to a significant cut in the amount that people drink. For "hazardous drinkers" ? men who drink over 50 units and women who drink over 35 units a week ? a 40 pence minimum price would reduce consumption by 4 per cent; 60 pence would reduce it by 16 per cent.

The team also used epidemiological evidence to link consumption with risk of harm. "The specific numbers can be debated, but most would agree that lower consumption generally leads to lower rates of harm," says Holmes. He estimates that reductions in public health costs and crime resulting from the new policy could lead to savings of about ?4 billion over 10 years. However, the policy will not help people with an alcohol dependency, he says, since they are likely to buy alcohol even at higher prices.

Canadian backing

Holmes's model is backed by evidence from Canada, which has set a minimum price for alcoholic drinks in British Columbia and Saskatchewan on several occasions ? most recently in 2010. Tim Stockwell at the University of Victoria in British Columbia and colleagues looked at data from both provinces over a 20-year period. On average, there was a 3.4 per cent fall in total alcohol consumption across the population for every 10 per cent increase in minimum price.

In Canada, the immediate effects of a higher minimum price included fewer acute hospital admissions and fewer deaths caused solely by alcohol, such as alcoholic gastritis. After two to four years there were also fewer cases of alcohol-related diseases.

The pricing model in Canada is not the same as that proposed for the UK. Rather than setting a minimum price per unit of alcohol, the Canadian policy sets prices for each type of alcoholic drink.

Stockwell thinks the UK's approach is preferable, since it takes the strength of the drink into account. "In my opinion, the model being proposed in the UK is perfect from the public health and safety point of view."

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