Chief Medical Officer for England calls for Minimum Pricing of Alcohol

A minimum price should be set for a unit of alcohol, according to Professor Sir Liam Donaldson, the chief medical officer for England, the most senior medical adviser to the UK Government.

The recommendation, made in his latest annual report on the state of the public health in England in which Sir Liam focused on the problem of “passive drinking” - consumption of alcohol which causes harm to people other than the drinkers themselves - came at a time of considerable public concern about the scale of alcohol problems in the UK, with a widespread belief that cheap sales of alcohol from supermarkets were partly to blame. Sir Liam’s idea is that no alcohol retailer should be allowed to sell a unit of alcohol, in whatever beverage it is contained, below a minimum price set by law. Previously, the Scottish Government had made a similar proposal, but critics claim that such a policy might well be contrary to European Union law.

In his report, Sir Liam noted that over the preceding 20 years, the country’s disposable income had risen faster than alcohol taxation, and alcohol had become ever more affordable. As a result, alcohol consumption had risen, and so too had the level of alcohol related harm.

In 2008, the UK Government commissioned research by a team at Sheffield University to examine how changes in alcohol prices would affect its consumption and related harms. The team analysed the likely impact of pricing changes on the population as a whole. They also specifically examined the impact on three groups of particular concern – drinkers aged under 18 years, 18-24 year old binge drinkers and harmful drinkers (women drinking more than 35 units per week and men drinking more than 50 units per week).

There was found to be a clear relationship between price and consumption of alcohol.

The researchers concluded that as price increases, consumption decreases, although not equally across all drinkers. Price increases generally reduce heavy drinkers’ consumption by a greater proportion than they reduce moderate drinkers’ consumption. The specific means of increasing prices can be targeted further to minimise the impact on those who drink at low-risk levels while significantly decreasing the consumption of those who drink above these levels. This is possible because those who drink more tend to choose cheaper drinks. Introducing a minimum price per unit of alcohol would therefore affect heavier drinkers far more than those who drink in moderation.

Sir Liam calculated that if the minimum price per unit were set to 50 pence, for example, this would decrease consumption by high-risk drinkers by 10.3%, while consumption by low-risk drinkers would fall by only 3.5%. For some high-risk drinkers, such a decrease would be sufficient to bring them out of the high-risk category and would benefit drinkers’ own health. However, decreasing consumption of alcohol in this way would also substantially reduce the impact of passive drinking in England.

The Sheffield University team examined the impact of various potential pricing policies on health, crime and the wider economy. They concluded that positive benefits would be seen as soon as a pricing policy was implemented and that decreases in violent crime and workplace absence would be among the first effects. Other effects would take years to reach their maximum level as the benefits of decreased drinking accumulated.

Sir Liam argued that, after 10 years, a 50p minimum price per unit would be expected to reduce the annual number of deaths from alcohol-related causes by over one-quarter. It would reduce the annual number of crimes by almost 46,000 and hospital admissions by nearly 100,000. It would significantly reduce absenteeism and unemployment. Implementing this particular pricing policy would save an estimated £1 billion every year.

The work by Sheffield University provided a number of alternative solutions, including different minimum prices in on-trade and off-trade settings. For example, off-trade prices (applicable in offlicences and supermarkets) could be set to a minimum of 40p per unit. On-trade prices (at restaurants, bars and pubs) could be set to a minimum of £1 per unit. This policy also has an estimated benefit of nearly £1 billion per year.

Establishing minimum pricing requires government action. Supermarkets are particularly liable to sell alcohol at low prices. Currently, no single supermarket chain would increase its prices and risk losing customers to competitors, and Competition Commission rules prevent supermarkets working together to set prices. A minimum price per unit would overcome this problem and help reduce the harms caused by selling alcohol sometimes for as little as 11p a unit.

This recent research provides strong evidence for a clear and effective way in which the government can act to tackle the country’s alcohol problem. It is vital that such action is taken urgently to improve the health of those who drink and to protect those whose health and well-being suffer because of the drinking of others.