GAPA scientist involved in call to Scottish Parliamentarians on minimum pricing of alcohol

Professor Sally Caswell, Chair of the GAPA Scientific Advisory Panel, is one of a group of internationally known alcohol researchers who have urged the Scottish Parliament to introduce legislation on the minimum pricing of alcohol. They say that doing so would allow Scotland to lead and advise the world on the best means of tackling alcohol harm.

Setting a minimum price for a unit of alcohol below which it would be illegal to sell alcoholic beverages of whatever kind is the main plank in the Scottish Government’s campaign to reduce the high level of alcohol harm in Scotland. However, the proposal is politically controversial, and there is also doubt as to whether it would be legal under European Union law.

Nevertheless, it is the key measure in an Alcohol Bill presented to the Scottish Parliament which also includes proposals for further bans on irresponsible promotions and restricting marketing activity in off-sales locations such as supermarkets; ensuring smaller measures of wine are made available in on-sales; placing a duty on Licensing Boards to consider raising the purchase age of alcohol to 21 in all or part of their area; and establishing the power to introduce a Social Responsibility Fee for some retailers.

Now, four internationally known alcohol researchers have published an open letter to Scottish Parliamentarians urging them to support the introduction of minimum pricing and to carefully evaluate its impact. The other researchers are Dr Peter Anderson, Specialist in Public Health and Advisor to the European Commission and World Health Organization; Thomas Babor, Professor and Chairman in the Department of Community Medicine and Health Care, University of Connecticut School of Medicine, USA, and Robin Room, Professor of Social Research in Alcohol, School of Population Health, The University of Melbourne, Australia.

The text of the letter reads:

“As scientists who advise governments across the globe on effective alcohol policy, we have been observing with interest and anticipation the approach that the Scottish Government has adopted in response to Scotland’s growing burden of alcohol-related harm. Scotland’s problems are not unique. Today, many countries across the world are experiencing a rise in alcoholrelated harm. Harmful alcohol use is now recognised as one of the major risk factors for poor health globally. Nearly three million people die an alcoholrelated death in the world each year which is of the same order as mortality from HIV/AIDS. Harmful alcohol use not only damages people’s health, it can have a devastating impact on families and communities, compromising both individual and societal development.

The rise in alcohol-related harm in Scotland, as in other countries around the world, is linked to the increased availability, affordability and promotion of alcohol. The way in which alcohol is produced and distributed in many countries has been transformed over the past few decades. A process of globalisation and industrialisation of alcohol production has resulted in higher volumes of alcohol being produced at a lower unit cost, with large sums of money being invested in the promotion and marketing of alcohol brands. Along with this there has been, in many countries, a liberalisation of licensing laws that have led to alcohol being sold in more places, at more affordable prices, at virtually any time of the day. Supermarkets and all-purpose convenience stores have become main sources for off-sales, and have frequently used low prices of alcoholic beverages as loss leaders to attract customers. In Scotland and elsewhere, the relative price of alcoholic beverages in comparison to other goods has dropped markedly.

Many of the measures outlined in the Scottish Government’s alcohol strategy are supported by an extensive amount of scientific evidence on what works best to reduce alcohol-related harm. Controls on the price and availability of alcohol are known to be two of the most effective means of alleviating alcoholrelated problems. Establishing a minimum price for a unit of alcohol is an innovative measure responding to widespread concern about the availability and use of very cheap forms of alcohol, particularly amongst vulnerable groups of drinkers. Economic research suggests that minimum pricing is likely to have the most impact on the cheapest forms of alcohol and alcohol sold below cost. Although this particular measure has not yet been implemented in many places and has not been evaluated extensively, there is a generally positive experience in Canada with minimum pricing of beer, and the implementation in some Australian localities of bans on the sale of the cheapest form of alcohol (which amounts to raising the minimum price) has resulted in reductions in alcohol problems. Overall, the evidence of effectiveness of price increases in reducing alcohol consumption is very strong. There is therefore good reason to believe that minimum pricing will reduce the amount of drinking, particularly the hazardous drinking, that is linked to cheap alcohol.

For too long now the protection afforded to the populations of many countries against experiencing alcohol-related harm has been inadequate. Weak policy measures, such as education and ‘responsible drinking’ campaigns, have failed to prevent a rise in alcohol consumption and alcohol-related death and disability. However, there is growing recognition that the aggressive marketing of alcohol through price reductions and the lack of appropriate regulation of availability and price competition have generated the conditions for increasing levels of drinking and alcohol-related problems, particularly amongst poorer populations that experience a disproportionately higher level of alcohol-attributable harm. Strengthened regulatory controls on health-damaging commodities such as alcohol are increasingly being viewed as necessary to limit health harm, and for the achievement of health equity. Other countries, like Scotland, are facing up to the reality of harmful alcohol use. Russia, in the grip of its own mortality crisis linked to alcohol use, has recently introduced a minimum retail price for vodka in an effort to stem consumption and harm. France, Italy and Spain are other European countries that have recently taken steps to restrict the availability of alcohol in response to rising rates of alcohol-related harm. Australia, following the lead of a number of European countries, has raised the taxes on beverages particularly appealing to young people.

That countries appear increasingly willing to prioritise the protection of public health over other private economic interests is encouraging. The scale of alcoholrelated harm across the globe demands an effective national and international response. Our advice is that Scotland should implement a minimum price for alcoholic beverages, along with a strong evaluation of its effects. We look forward to the results of such an action, which will provide Scotland with concrete evidence as a basis for future policy, and will also put Scotland in a position to lead and advise the world on this important initiative.”

UK National Institute for Health and Clinical Excellence (NICE)

As we go to press, NICE, a National Health Service organisation, which gives advice on how to help improve people’s health and prevent disease, has recommended that a minimum price for alcohol, advertising bans and early screening for problem drinkers, must be introduced to curb the nation’s binge drinking culture.