In March 2020 Wales brought in a minimum price for alcohol with the aim of cutting down on problem drinking. The hope was that a legally-enforcible minimum price would have a small effect on most people but the biggest impact on the cheapest ciders and spirits causing health and social problems.
At the time the legislation was controversial with some opposition politicians labelling at " Strongbow tax " which would punish the least well off in society. Given that two and a half years have passed since the introduction of the legislation it is worth taking a look at what the impact of the new rules have been. To do this we will be drawing heavily on the work of Bonnie Evans from Senedd Research.
What was the new minimum price?
The minimum unit price (MUP) was set at 50p. So the calculation to work it out was: Minimum unit price (50p) x strength (% alcohol by volume) x volume (litres).
Why did the Welsh Government introduce minimum pricing for alcohol?
In 2017, one in five adults in Wales were hazardous or harmful drinkers (drinking over the UK guidelines of 14 units of alcohol per week). Hospital admissions linked to alcohol were estimated to cost the Welsh NHS £120 million a year. Modelling found that the introduction of minimum pricing for alcohol would be the most effective policy for reducing drinking and associated harm in Wales.
How has the minimum price changed alcohol consumption?
Before we assess the impact of the new rules it is important to point out that within weeks of their introduction Wales went into the first Covid lockdown. This massively change behaviours (all pubs were closed for example) making assessment of their impact of the minimum price harder. It is worth mentioning that from March to July 2020, alcohol purchased from shops in England, Wales and Scotland increased. However, as pubs, bars and clubs closed due to the national lockdown, overall alcohol sales were lower than pre-Covid trends.
Research published in the Lancet showed an immediate effect on alcohol sales in shops after MUP was introduced in Wales. Alcohol sales dropped by 8.6% as prices rose by 8.2%. This drop in alcohol purchasing came mainly from households that usually bought the most alcohol, suggesting MUP was effective at targeting heavier drinkers.
However, research from the University of South Wales and Glyndwr University reported that MUP had little effect on their alcohol consumption. Changes to drinking behaviour were overwhelmingly attributed to the COVID-19 pandemic rather than minimum pricing.
There were other suggestions that MUP had made a bigger difference with research from Alcohol Change six months after minimum unit pricing for alcohol was introduced in Wales, one in ten drinkers said they have been drinking less as a result. Andrew Misell, director for Wales at Alcohol Change UK, called the figures "encouraging" adding. "There seems to be much greater awareness of MUP, and there are some early indications that it has been reducing alcohol consumption.
“There is good evidence that raising the price of cheap alcohol, like strong white ciders, is one of the best ways to get the heaviest drinkers drinking less. Prior to MUP, big 3-litre bottles of 7.5% ABV cider were on sale in Wales for as little £3.99 – just 18p per unit. At 50p per unit, these same bottles cannot be sold for less than £11.25. MUP has priced them out of the market.”
There is also mixed evidence from Scotland where MUP was brought in in 2018. Alcohol sales have decreased year on year since the introduction of minimum pricing in 2018. This further suggests minimum pricing for alcohol is effective at reducing population-level alcohol consumption. However, a report by Public Health Scotland concluded that: "Among those drinking at harmful levels or people with alcohol dependence, the study found no clear evidence of a change in consumption or severity of dependence."
What’s been the impact on deaths and hospitalisations?
Before the Covid-19 pandemic, Scotland saw a reduction of 10.6% in alcohol-specific deaths from 2018 to 2019. This suggests it may be too soon to tell if minimum pricing could reduce alcohol-specific deaths in Wales, due to the confounding effects of the Covid-19 pandemic.
In Wales, alcohol-attributable hospital admission rates decreased by 23% in the 2020/21 financial year compared to 2019/20. However, overall emergency hospital admissions also decreased by 13.2% during the pandemic, as many people avoided seeking healthcare. The reasons for additional reductions in alcohol-attributable hospital admissions are likely to be multi-faceted.
The rate of alcohol-related hospital admissions was also lower in Scotland in 2020/21 compared to 2019/20. However, Public Health Scotland has noted a steady decrease in the rate of alcohol-related hospital admissions since 2007/08.
So ultimately, has MUP worked and what is the future?
A study of the situation in both Wales and Scotland found that MUP is "associated with increases in the price of alcohol and decreases in purchased alcohol to remarkably similar extents". It added that "the changes were much greater in households that bought the most alcohol. Households that bought small amounts of alcohol, and, in particular, those with low incomes, did not increase their expenditure on alcohol following the introduction of MUP".
It did stress that more evidence on health outcomes was needed but that "the evidence presented here suggests that MUP is a powerful and highly targeted pricing policy option to reduce alcohol purchases that could be widely implemented"
This has been backed up by the World Health Organisation’s report on minimum pricing for alcohol, which concluded minimum pricing is an effective policy to reduce alcohol consumption and harm, but should be complementary to taxation on alcohol.
Minimum pricing for alcohol will end in Wales in March 2026, unless the Welsh Government makes regulations to extend it.
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