Minimum Unit Pricing (MUP) Continuation and future pricing: Equality Impact Assessment - Results

Background

MUP forms part of the Scottish Government’s wider whole population approach to reducing alcohol related harm, which is set out in the range of twenty actions contained in the 2018 Alcohol Framework^[6].

Alcohol-related harm continues to be a key public health challenge in Scotland. In 2021, the latest year for which data is available, Scots bought enough alcohol for everyone aged over 16 to drink 18.1 units of alcohol every week (9.4 litres)^[7]. This is equivalent to around 36 bottles of spirits, or around 90 bottles of wine, per adult each year. This is nearly 30% more than the lower-risk UK Chief Medical Officers’ guidelines of 14 units per week.

The high levels of consumption in Scotland causes a range of harms. High levels of alcohol consumption causes significant harm both at the individual and the population level. Alcohol increases the risk for developing liver disease, a range of cancers as well as for heart disease and stroke.

For example, the most recent figures published by National Records for Scotland showed that there were 1,276 alcohol-specific deaths in Scotland in 2022^[8]. Whilst recognised as a problem across the UK, the evidence shows that alcohol-related harm through alcohol misuse is greater in Scotland, with rates of alcohol-specific deaths highest in Scotland.^[9] Mortality rates for chronic liver disease, of which alcohol consumption is one of the most common causes, are also markedly higher in Scotland compared to the UK as a whole and other Western European countries.^[10]

MUP is subject to a ‘sunset clause’ that means that policy will expire at the end of 30 April 2024 unless Parliament agrees to extend its effects. Ministers were under a duty to lay a report before Parliament setting out their assessment of MUP over its period of operation. This report was laid before Parliament on 20 September 2023^[11].

To support their assessment of MUP, the Scottish Government commissioned Public Health Scotland to undertake an extensive evaluation of the policy, the conclusions of which were published in 2023. The PHS evaluation considered the evidence of the effects and effectiveness of MUP over a number of years, including the impacts on a range of groups some of whom are have, or are likely to have, a protected characteristic.

Broadly, the evaluation concluded that there was evidence that MUP had reduced alcohol specific deaths and likely to have reduced hospitalisations wholly attributable to alcohol during the periods relevant studies considered. There was evidence that MUP has contributed to a population level reduction in alcohol consumption of around 3% in the period considered.

The evaluation found that the estimated reductions in wholly attributable deaths and hospital admissions were greatest among men and those living in the most deprived areas of Scotland. There was some evidence of some negative impacts on people with alcohol dependency as a result of the increase in the price of alcohol.

The Scottish Government has set out that it will continue MUP and set the unit price at 65 pence per unit, if Parliament agrees the legislation giving effect to that decision. It is expected that this change, that both seeks to ensure the minimum unit price is increased in response to inflation and seeks to increase the public health benefits of the policy, will have similar types of effects – both positive and negative - as have been found to date.

This assessment was reached in consideration of the evidence base relating to MUP to date as well as modelling undertaking by Sheffield University on the potential effects of a unit price at different rates. (sarg-scottish-mup-report-2023.pdf (sarg-sheffield.ac.uk). The Scottish Government has considered this in its deliberations.

Overall continuation of MUP, and an increase to the price per unit, are expected to have significant positive public health effects. The PHS evaluation reports some evidence of impacts on people with alcohol dependency as a result of the increase in the price of alcohol. For example, this included negative impacts, such as increased financial strain, and concern about switching from weaker to stronger alcohol drinks, and positive impacts, such as deciding to seek treatment.

As a whole population policy (rather than a clinical intervention) MUP alone is not specifically designed to reduce consumption in people with alcohol dependency. People dependent on alcohol require specialist treatment and support services – such as those provided by Alcohol and Drug Partnerships (ADPs) that the Scottish Government has allocated £112 million of funding to in the financial year 2023/2024.

The Scottish Government is also undertaking a range of actions in relation to support for people with the highest levels of alcohol consumption including ongoing work with the UK Government in reviewing and updating alcohol treatment guidelines and commissioning PHS to undertake further work to investigate the reduction in numbers for referrals to alcohol treatment services.

The Scottish Government will keep the impacts of the increased price under review.