Government ‘health watchdog’ calls for minimum price of alcohol

A minimum price for a unit of alcohol should be introduced to help tackle the rise in problem drinking in Britain. This is one of the main recommendations of the Guidance issued by the National Institute for Health and Clinical Excellence (NICE) on preventing hazardous and harmful drinking. The guidance is intended for the NHS but also for government as a whole, industry and commerce and all those whose actions influence the population’s attitude to, and use of, alcohol.

The Guidance was welcomed by the Alcohol Health Alliance, the British Medical Association and other public health practitioners and advocates, but criticised by representatives of the alcohol industry. Simon Litherland of Diageo GB said: “Yet again it is disappointing to see continued support for minimum pricing despite no credible empirical evidence that it would be an effective measure in reducing alcoholrelated harm.”

Andrew Opie, Food Policy Director at the British Retail Consortium, said: “It’s too simplistic to say the UK’s alcohol problems are down to price. Irresponsible alcohol consumption is primarily a cultural issue that needs to be addressed through education and information.”

However, the month before the publication of the NICE Guidance, Sir Terry Leahy, the boss of Tesco, came out in favour of minimum pricing.

Health Secretary Andrew Lansley also distanced the Government from the NICE recommendation, saying that ministers instead favoured banning supermarkets and off-licences from selling alcohol “below cost price”. Mr Lansley said: “It is not clear that [Nice’s] research examines specifically the regressive effect on lowincome families [of a minimum price], or proves conclusively that it is the best way to impact price in order to impact demand.”

The NICE Guidance is based on the findings that one in 4 men and women are currently drinking dangerous amounts of alcohol that are causing, or have the potential to cause, physical and mental damage, and that the number of alcoholrelated deaths has more than doubled in the past 16 years, with over 8,000 people dying of conditions such as alcohol poisoning and liver cirrhosis every year.

NICE argues that introducing a minimum price for alcohol alongside other measures that make it harder to buy alcohol, like reducing the number of outlets selling alcohol in a given area or the days and hours that it can be purchased, will help to save thousands of lives each year.

Professor Anne Ludbrook, a health economist from the University of Aberdeen who helped develop the NICE guidance on alcohol-use disorders, said: “Alcohol is much more affordable now than it ever has been, and the price people pay does not refl ect the cost of the health and social harms that arise.

“When it is sold at a very low price, people often buy and then consume more than they otherwise would have done. It is a dangerous pattern which many people have unknowingly fallen into.”

Professor Ludbrook, who was speaking at the guidance launch in London, added that there are over 100 studies showing that increasing the price of alcohol will reduce levels of drinking and the harms associated with drinking.

“Increasing the price is likely to be the most cost-effective way of reducing drinking,” she said.

Economic modelling work for the guidance was carried out at the University of Sheffield, where researchers found that introducing a minimum price of 50p per unit reduced levels of alcohol consumption by 10.3 % among harmful drinkers and 3.8 % among moderate drinkers.

But Professor Mike Kelly, Director of Public Health at NICE, stressed that it was not down to the Institute to set a price for a unit of alcohol.

“What we do is review the evidence not specify a minimum price. The decision is one for Parliament and for ministers to take,” he said.

Professor Kelly added: “Alcohol misuse is a major public health concern which kills thousands of people every year and causes a multitude of physical, behavioural and mental health problems.

“What’s more, it costs the NHS over £2 billion annually to treat the chronic and acute effects of alcohol - this is money that could be spent elsewhere to treat conditions that are not so easily preventable.

“This is a big-ticket issue and the recommendations on minimum pricing chime very well with those made by the Conservatives in their working paper. The Chief Medical Officer and the Scottish Government have all been moving in this direction, and the signals from the Department of Health look quite promising.” Professor Sir Ian Gilmore, President of the Royal College of Physicians and Chair of the Alcohol Health Alliance UK, has long been an advocate of minimum pricing and welcomed NICE’s careful and systematic review of the evidence for minimum pricing.

‘It is reassuring to hear these recommendations from NICE. Week in, week out I see the burden of alcohol misuse in my clinics. There is not a family out there that has not been affected by it. “

Elsewhere, the guidance addresses the problem of alcohol-misuse from an individual level with recommendations to screen young people aged 16 and 17 and adults for alcohol problems.

Professor Eileen Kaner, Chair of the Development Group and a public health researcher at the University of Newcastle, said: “The guidance calls for GPs and other public service workers to ask some simple questions about people’s drinking habits as early as possible if they ever suspect that there may be a problem.

“Just 5-10 minutes of brief structured lifestyle advice is sufficient to make changes in drinking behaviour. This can help make people aware of the potential risks they are taking or harm they may be doing at an early stage.”