Scotland and Wales introduced a minimum price for alcohol – now evidence is needed to show that it works

With effect from the second of March 2020, a minimum price for alcohol is in force in Wales. This means that one unit of alcohol must cost at least 50 pence. The minimum price is a control policy measure whereby a higher price for a product leads to lower consumption. If people buy less alcohol, alcohol consumption decreases, and the assumption is that reduced consumption leads to fewer harms.

Researchers in Sheffield have been working to develop the model now in use in Scotland and Wales and politicians in both countries have decided that the minimum price now used in both countries is to be 50 pence.

− The mechanism is a measurable unit, which is in itself a problem because people do not buy alcohol in units. Nobody goes into a bar and asks for two units of beer or ten units of wine. But people understand the model when you say what a drink costs before the change in the law and what it costs afterwards, says Wulf Livingston, alcohol researcher from Wrexham Glyndŵr University in Wales.

Some drinks are affected

The minimum price affects different types of drinks in different ways and thus also different types of users.

− In England today you can buy a three-litre bottle of strong cider of 7 to 8 per cent alcohol by volume, which means 22 units in a bottle, almost as much as a bottle of whisky. It currently costs £3.50 in England, but in Scotland, after the minimum pricing, it costs £11.50. A bottle of vodka previously cost around £11, but now costs £14, so the increase is only £3. The price of a bottle of wine costing £10 is not affected at all, as it has ten units of alcohol and the price is one pound per unit.

In Scotland, there has been a 3.6 per cent drop in total consumption, and the reduction in cider consumption is especially great: 18.6 per cent according to a report from the BBC.

The legal process dragged on

Scotland is the first country in the world to introduce a minimum price; in Canada and Australia it has been introduced in smaller areas. The minimum price was introduced in Scotland in May 2018 after a legal process that took several years.

− It took many years for Scotland to introduce a minimum price, because the whisky industry opposed the change in the law and took the matter to court. This led to a process that dragged on.

There is a difference in the legislation between Scotland and Wales, and the path to the minimum price has been different in the two countries. Scotland has far more autonomy and more resources than Wales, which is more dependent on Westminster.

− There is no common strategy in the United Kingdom for alcohol and drugs, and the different legislations in all three countries affect alcohol and drug policy and services.

Evaluation at two levels

Minimum pricing is something that has been evaluated and will continue to be evaluated. An important reason for the need for proof is that the law is a so-called sunset clause. This means that the law is not passed forever, but that the law must be re-examined in parliament in order to remain in force, otherwise it will lapse, like a sun going down.

−Therefore, proof is needed, and it is needed at two levels: firstly, proof is needed that the law works, i.e. that the minimum price reduces total consumption and, secondly, that no damage is caused due to the law. If you introduce a law that allows everyone who drinks to start using heroin, you won’t get the law renewed, will you?

In the case of Scotland, 19 evaluation studies have been or will be carried out. The first published was about consumption, and a couple of others have been about whether young people’s drinking is affected.

−It was found that young people’s lives are too disorganised for them to be affected by minimum pricing. They are impulsive buyers who are not affected so much by the price.

Switching from alcohol?

Wulf Livingston is involved in one of the Scottish studies and in four out of the five studies conducted for Wales. One study has already been carried out in Wales, which looked at the risk scenario that, after minimum pricing has come into force, users switch from alcohol to other drugs instead.

−We asked people what they think will happen after the minimum price has come into force. We did both interviews and surveys, both with people who work on treatment and with those with alcohol problems. We also did a small survey among those who drink but do not have problem drinking.

The results show that most would change their consumption, but they would not switch from alcohol to other drugs, but instead from one alcoholic drink to another.

−Those who have alcohol problems said that they would not stop drinking; they could possibly imagine that they would drink a little less. The results also showed that those who already use drugs might use drugs as an alternative to expensive alcohol, but in this case it would be about benzodiazepines, possibly cannabis. People who only use alcohol would not suddenly switch from alcohol to illegal drugs.

One visible change that the minimum price may lead to in Wales is cross-border trade. This has not yet been evidenced as a problem in Scotland, which also does not have as integrated a border with England as Wales has.

− There are towns and villages located half in Wales and half in England. There is concern that cross-border trade is on the rise in Wales.

Wulf Livingston believes that a number of results from Scotland will be published by the end of the summer.

− Many people are following what is happening in Scotland, it’s like a test country. If the minimum price works, it may be a control method that countries wishing to abolish a monopoly could use instead.