New Publication from the Sheffield Alcohol Research Group: Model-based appraisal of the comparative impact of Minimum Unit Pricing and taxation policies in Wales

Three quarters of all alcohol consumed in Wales is drunk by less than a quarter of the adult population who are hazardous or harmful drinkers and spend up to £2,882 per year on booze, research has revealed.

A report looking into the potential impact of minimum unit pricing and taxation policies in Wales was published Thursday 22nd February by the Sheffield Alcohol Research Group at the University of Sheffield.

The publication, which found that the 3% of the population who are harmful drinkers, account for 27% of all alcohol consumed, comes after the Welsh Government announced a new Bill that, if agreed by the National Assembly, will introduce a minimum price for the sale of alcohol.

The Bill, which is designed to reduce hazardous and harmful drinking would make it an offence for alcohol to be supplied below that price.

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Health Secretary, Vaughan Gething said: “People who drink alcohol at hazardous and harmful levels drink 75% of the alcohol consumed in Wales.

“The introduction of a minimum unit price would be effective in reducing alcohol consumption among these groups, as well as reducing the number of alcohol-related deaths and hospitalisations.”

The availability of cheap, strong alcohol is estimated to lead to 50,000 alcohol-related hospital admissions a year, costing the Welsh NHS £120 million annually and, in 2015, there were 463 alcohol-related deaths in Wales.

The report reveals the population of Wales buys 50% of its alcohol for less than 55p per unit, 37% for less than 50p per unit and 27% for less than 45p per unit, with heavier drinkers being more likely to buy alcohol sold below these thresholds.

Mr Gething said: “The report shows the greatest impact of a minimum unit price would be on the most deprived harmful drinkers, while moderate drinkers would experience only small impacts on their alcohol consumption and spending.

“This is because moderate drinkers tend to buy alcohol which would be subject to little or no increase in price under the policy.

“If passed, this law will potentially save lives.”

The research also shows harmful drinkers spend an average £2,882 a year on alcohol, or around £7.80 per day, compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.

The Sheffield Alcohol Research Group, commissioned by the Welsh Government in June 2017 to update a 2014 appraisal of the likely impact of a range of minimum unit pricing policies, concluded a minimum unit price set at between 35p and 70p would be effective in reducing alcohol consumption among hazardous and, particularly, harmful drinkers.

Research highlights:

  • Moderate drinkers drink an average of 211 units of alcohol per year compared to 1,236 for hazardous drinkers and 3,924 for harmful drinkers.
  • Harmful drinkers spend an average £2,882 a year on alcohol compared to £1,209 for hazardous drinkers and £276 for moderate drinkers.
  • Alcohol-attributable deaths and hospital admissions are concentrated in hazardous and particularly harmful drinkers who are more deprived.

External news coverage:

75% of alcohol in Wales is drunk by just over a fifth of the population according to new report – ITV News

Minimum alcohol price help call for ‘hazardous’ drinkers – BBC News

75% of alcohol drunk in Wales consumed by 22% of the population, report says – Guernsey Press

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UKCTAS welcomes the ruling in favour of MUP! Minimum unit pricing will save lives, reduce hospital admissions and cut crime! #MUPsaveslives

In a landmark ruling, seven justices unanimously rejected a challenge led by the Scotch Whisky Association that Scottish proposals for strict price controls were illegal under EU trade rules. The ruling comes after a five-year legal battle against the measures, which were passed by the Scottish parliament in 2012 but then fought by the Scotch Whiskey Association and two European wine and spirits industry bodies all the way to the European court of justice.

Nicola Sturgeon, Scotland’s first minister, first suggested the measure nine years ago while acting as the Scottish health secretary. The supreme court ruled on Wednesday 15th November that “minimum pricing is a proportionate means of achieving a legitimate aim”.

Prof Petra Meier, director of the alcohol research group at the University of Sheffield, which published the data and evidence that Sturgeon’s proposals were based on, said a 50p minimum price would in time result in 120 fewer deaths and 2,000 fewer hospital admissions from alcohol abuse each year.

“Our research has consistently shown that minimum unit pricing would reduce alcohol-related health problems in Scotland by targeting the cheap, high-strength alcohol consumed by the heaviest and highest-risk drinkers. Moderate drinkers would be affected to a much smaller degree.”

They said protecting public health outweighed the damage to free trade which the spirits industry and EU wine producers said they wanted to protect. “The courts should not second-guess the value which a domestic legislator puts on health,” the judges stated.

With Welsh ministers and the Republic of Ireland introducing similar measures, health campaigners in England said the ruling left the Westminster government isolated, and removed the last legal barrier to minimum pricing.

Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance, said:

“We are delighted with the Supreme Court’s judgement that minimum unit pricing is legal and can be implemented in Scotland. The decision today represents a great victory for the health of the public.

“Five years ago the legislation introducing MUP passed through the Scottish Parliament without opposition. It has taken five years to implement for the simple reason that the Scottish Whisky Association and others chose to challenge it in the courts. In that time many families have needlessly suffered the pain and heartache of losing a loved one.

“This decision has implications far beyond Scotland. Wales, Northern Ireland and the Republic of Ireland are now clear to progress their own plans for minimum unit pricing.

“The spotlight should now fall on England, where cheap alcohol is also causing considerable damage.  Over 23,000 people in England die every year from alcohol-related causes, many of them coming from the poorest and most vulnerable sections of society. We urge the Westminster Government to act now and introduce the measure in England. A failure to do so will needlessly cost more lives.”

Scottish ministers are expected to introduce a minimum price of 50p a unit for alcoholic drinks by spring next year, in a bid to cope with increasing deaths and hospitalisations from alcohol abuse. Health campaigners say the strongest but cheapest ciders were so cheap in Scotland an adult could consume their maximum recommended weekly limit of alcohol – 14 units – for £2.52. The cheapest fortified wine came in at 27p per unit, while the cheapest vodka and gin was 38p. That rate will force up the price of all alcoholic drinks so that a standard bottle of whisky will cost £14, regardless of its wholesale cost, although the Scottish measures mean retailers will keep any surplus profits once prices rise.

The Welsh government has said it would press ahead with proposals it published last month to implement minimum pricing, with Welsh ministers also evaluating a 50p minimum price. Ministers in Northern Ireland have also backed the policy, but implementation has stalled after the collapse earlier this year of Stormont’s power-sharing administration. The Republic of Ireland is also considering similar measures.

The Alcohol Health Alliance UK, which includes the British Medical Association and the Royal College of GPs, is drafting a joint letter to the UK government formally urging ministers to reinstate plans for similar measures in England.

Urged on by the medical profession and some police commissioners, the UK government came close to following Scotland’s lead while David Cameron was prime minister, but after disputes in cabinet the proposal was dropped. The Home Office, which takes the lead on alcohol control policy, said it noted the supreme court’s ruling but said it would only keep the issue under review. A spokeswoman said ministers in London would watch its implementation in Scotland, but Home Office officials were unable to specify how long ministers would wait before reaching a decision.

The department said its focus now was on using other measures to control excessive alcohol consumption, including higher duties for high-strength ciders, and lower duty for lower strength wines. There were campaigns and initiatives by NHS England to support problem drinkers. The SWA acknowledged defeat, and said it would help ministers implement the strategy. But it warned that imposing strict price controls would increase the risk of other countries using the policy as justification for higher tariffs on Scotch whisky imports, damaging its £5bn-a-year export trade.

The brewing trade was split: major brewers, such as the makers of Tennents lager and Magners cider, with higher cost brands and a significant stake in supplying pubs, welcomed the court’s decision. The real-ale campaign group Camra denounced it, saying it “penalises moderate and responsible drinkers while doing little to support those who have issues with alcohol abuse”.

Dr Eric Carlin, director of Scottish Health Action on Alcohol Problems, a campaigning body backed by the medical profession, lambasted drinks companies for their “ferocious, cynical” opposition to the measure.

“The opponents to MUP have shamed the reputation of their industry by prioritising profits over people’s lives. As MUP has been delayed, we have seen the tragic, premature deaths of 24 people every week in Scotland as a result of alcohol misuse, many of them in our poorest communities, and affecting families across our nation,” he said.

Twitter posts about the decision:

News reports on the decision:

UK supreme court rules minimum alcohol pricing is legal – The Guardian

Minimum alcohol pricing: How will new policy affect you? – STV

Campaigners urge minimum alcohol price in England after Scottish ruling – The Guardian

Minimum alcohol pricing is a chance to tackle a problem which is ruining Scotland’s health – The Scottish Sun

Green light for minimum alcohol pricing in Scotland – PharmaTimes

Scots get set for ‘booze cruises’ into England as Supreme Court clears the way for minimum alcohol prices – Daily Mail

Full coverage of the decision on google.news!

Report conducted at the University of Sheffield provides ‘clear and compelling’ new evidence on the effectiveness of minimum unit pricing.

Alcohol consumption will cause 63,000 deaths in England over the next five years according to a new report from the University of Sheffield Alcohol Research Group.

alcoholThe report, published by the Foundation for Liver Research, predicts that 32,475 of the deaths – the equivalent of 35 a day – will be the result of liver cancer and another 22,519 from alcoholic liver disease.

In its new report, Financial case for action on liver disease, endorsed by the independent Lancet Commission on Liver Disease, the Foundation for Liver Research urges the Government to implement a suite of policy measures designed to mitigate the rising health and financial burden of alcohol, including the introduction of minimum unit pricing (MUP), re-institution of alcohol duty escalator and advertising restrictions.

  • Between 2017 and 2022 the total cost to the NHS of alcohol-related illness and deaths will be £17 billion.
  • Study shows introduction of minimum unit pricing for alcohol could significantly reduce the burden.

Providing evidence in support of Government intervention, new modelling shows that within five years of its introduction in England, a 50p MUP alone would result in:

  • ian gilmore quote21,150 fewer alcohol-related deaths
  • 74,500 fewer alcohol-related hospital admissions
  • Savings of £325.7m in healthcare costs
  • Savings of £710.9m in crime costs

The total financial savings to the public purse of MUP is forecast to be £1.1 billion – the equivalent cost of the Government’s recently announced investment package for Northern Ireland.

Colin Angus, Research Fellow at the University of Sheffield and part of the Sheffield Alcohol Research Group who conducted the research, said:

“These new findings show there will be 35 deaths and 2,300 hospital admissions due to alcohol every day in England over the next five years. We estimate this will cost the NHS £17 billion at a time when healthcare resources are already overstretched. Our research also shows that policies such as Minimum Unit Pricing have the potential to significantly reduce this burden.”

Liver disease is one of Britain’s biggest killers, claiming about 12,000 lives a year in England alone. The number of deaths associated with it has risen by 400% since 1970. It is estimated that 62,000 years of working life are lost every year as a result of it. People who develop serious liver problems also suffer some of the worst health outcomes in western Europe.

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Kettil Bruun Society 43rd Annual Alcohol Symposium | Sheffield 5-9th June, 2017

The 43rd annual symposium of the Kettil Bruun Society is hosted by the School of Health and Related Research (ScHARR) at the University of Sheffield. The symposium will be held in the Inox Dine area of the Student’s Union building.

For information about the Kettil Bruun Society, the Symposium, and to register, submit abstracts and book social tours, please click here.

To go straight to registration, please click here.

The conference is generously supported by the Insitute for Alcohol Studies, Alcohol Research UK, and the Society for the Study of Addiction.

The Kettil Bruun Society (KBS):

The principal aims of the Kettil Bruun Society (KBS) are to investigate social, epidemiological and cross-cultural research on alcohol use, to promote the exchange of scientific knowledge and experiences among researchers from various disciplines and to encourage international collaboration. The comparison of social and epidemiological developments found in different countries makes it possible to disentangle major trends from underlying patterns of alcohol use. This is particularly useful for the development of effective strategies to regulate alcohol use – an aspect which is of great interest to many countries.

The Symposium:

The primary purpose of the symposium is to provide a forum for researchers involved in studies on alcohol to exchange ideas about their ongoing research. The scope of the symposium includes studies of determinants and consequences of drinking, drinking culture and drinking patterns, social and institutional responses to drinking related harms, prevention and care. Empirical research, theoretical papers and reviews of the literature are welcome. Social and epidemiological studies have to be interpreted in a broad context as they include research in a variety of disciplines, such as psychology, sociology, criminology, economics, history and other sciences. Papers on other forms of substance use such as tobacco and drugs are also accepted, particularly papers considering the way they relate to alcohol use.

The symposium focuses on the discussion of papers that are pre-circulated electronically on this website. The author introduces the paper in a 10-minute segment, followed by prepared comments from a discussant and general audience participation. Any person submitting a paper may be asked to be a discussant or chair of a session.

Abstracts:

Please submit an abstract by 20 January 2017. The word limit for the abstract is 250 words and you should also include a conflict of interest statement and a maximum of three keywords (these are not included in the word count). For reports of empirical research, the abstract should be structured into sections: introduction, methods, results and conclusion.

All abstracts must include a conflict of interest statement. This should identify any author who has a relationship (financial or otherwise) which could be viewed as presenting a potential conflict of interest and give a full disclosure of this relationship.  If there are no conflicts of interest to report, please write ‘None’.

If you know in advance that you will only be able to attend the conference on certain days then please use the option in the submission form to indicate this and we will try to accommodate you when scheduling sessions.

 

UKCTAS welcome today’s ruling to introduce a minimum unit price in Scotland!

Plans to set a minimum price for alcohol in Scotland have been backed by the Scottish courts.

The Court of Session in Edinburgh ruled against a challenge by the Scotch whisky industry, who claimed the plans were a breach of European Law. The ruling now paves the way for the Scottish government to implement its policy, passed by MSPs in 2012.

Under the plans, a price of 50p per unit of alcohol would be set, taking a bottle of spirits to at least £14. The Scottish government, health professionals, police, alcohol charities and some members of the drinks industry believe minimum pricing would help address Scotland’s “unhealthy relationship with drink”.

Sir Ian Gilmore responding to the ruling made today in the Scottish courts in relation to minimum unit pricing in Scotland:

“We welcome this court ruling, and hope to see minimum unit pricing speedily implemented in Scotland. Now is the time to act, even if the global alcohol producers, prioritising commercial interests over Scotland’s health, try to delay further by another appeal.

Now is also the time for England and Wales to follow suit and introduce MUP. The UK government committed to introducing MUP in 2012, and the public support the measure. Government-commissioned research estimates that in the first year following the implementation of MUP in England, there would be nearly 140 fewer crimes per day.

MUP leaves pub prices untouched, and targets the cheap alcohol which is preferentially consumed by children and dependent drinkers. Recent AHA research has found that alcohol is being sold for as little as 16p per unit, with 3 litre bottles of white cider, which contain the same amount of alcohol as 22 shots of vodka, available for just £3.49.

MUP would also be of greatest benefit to those on low income, with 8 out of 10 lives saved coming from the lowest income groups, and greater harm reductions felt by these groups. The government has spoken of its commitment to even out life chances, and MUP would go a long way in furthering this agenda.”

Dr John Holmes from the University of Sheffield said:

“The policy would mainly affect harmful drinkers, and it is the low income harmful drinkers—who purchase more alcohol below the minimum unit price threshold than any other group—who would be most affected. Policy makers need to balance larger reductions in consumption by harmful drinkers on a low income against the large health gains that could be experienced in this group from reductions in alcohol-related illness and death.”

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Modelling by the University of Sheffield estimates that a 50p MUP in Scotland would have the following effects after one year:

· 60 fewer deaths

· 1,300 fewer hospital admissions

· 3,500 fewer crimes

According to the modelling, the health gains will continue to increase over 20 years. At this time, in Scotland there would be an estimated:

· 120 fewer deaths due to alcohol each year

· 2,000 fewer hospital admissions due to alcohol each year

Work commissioned by the Government from the University of Sheffield revealed that 1 year after introducing an MUP in England there would be:

· 50,700 fewer crimes

· 376,600 fewer days absent from work

· 192 fewer deaths

screen-shot-2016-10-21-at-12-03-42

Professor Petra Meier, Director of the Sheffield Alcohol Research Group, and another author of the study, added:

“Our study finds no evidence to support the concerns highlighted by Government and the alcohol industry that minimum unit pricing would penalise responsible drinkers on low incomes. Instead, minimum unit pricing is a policy that is targeted at those who consume large quantities of cheap alcohol.

“By significantly lowering rates of ill health and premature deaths in this group, it is likely to contribute to the reduction of health inequalities.”

Minimum pricing for alcohol effectively targets high risk drinkers, with negligible effects on moderate drinkers with low incomes – Research report from the University of Sheffield.

Press summary of the Opinion of the Court in the reclaiming motion by the Scotch Whisky Association and others against the Lord Advocate and the Advocate General for Scotland

 

Are recent attempts to quit smoking associated with reduced drinking in England? | Research report

 

This study sought to address the following research questions:

  • What is the association among smokers in England between a recent attempt to quit smoking and alcohol consumption?
  • What is the association among smokers with higher risk alcohol consumption in England between a recent attempt to stop smoking and a current attempt to cut down on their drinking?

The researchers looked at the association among smokers in England between a recent attempt to quit smoking and alcohol consumption. They identified smokers as light or heavy drinkers (light was indicated with an Audit-C score below 5 and heavy was indicated with an Audit-C score greater than 5) and analysed their recent attempt to stop smoking (identified by those who had attempted to quit in the last week with those who had not) and a current attempt to cut down on their drinking.

This was an observational study which means that it cannot demonstrate cause and effect. It may be that smokers choose to restrict their alcohol consumption when attempting to quit smoking to reduce the chance of relapse. Alternatively, it could be that people who drink less are more likely to quit smoking. If this is the case, smokers with higher alcohol consumption may need further encouragement to quit smoking.

Jamie Brown said “We can’t yet determine the direction of causality. Further research is needed to disentangle whether attempts to quit smoking precede attempts to restrict alcohol consumption or vice versa. We’d also need to rule out other factors which make both more likely. Such as the diagnosis of a health problem causing attempts to cut down on both drinking and smoking.”

This study is part of an ongoing Smoking Toolkit Study and Alcohol Toolkit Study, designed to provide tracking information about smoking, alcohol consumption and related behaviors in England. Each month a new sample of approximately 1700 adults aged 16 and over complete a face-to-face computer assisted survey. The Smoking Toolkit Study and the Alcohol Toolkit Study are primarily funded by Cancer Research UK and the NIHR School for Public Health Research respectively.

Background

Alcohol consumption during attempts at smoking cessation can provoke relapse and so smokers are often advised to restrict their alcohol consumption during this time. This study assessed at a population-level whether smokers having recently initiated an attempt to stop smoking are more likely than other smokers to report i) lower alcohol consumption and ii) trying to reduce their alcohol consumption.

Method

Cross-sectional household surveys of 6287 last-year smokers who also completed the Alcohol Use Disorders Identification Test consumption questionnaire (AUDIT-C). Respondents who reported attempting to quit smoking in the last week were compared with those who did not. Those with AUDIT-C≥5 were also asked if they were currently trying to reduce the amount of alcohol they consume.

Results

After adjustment for socio-demographic characteristics and current smoking status, smokers who reported a quit attempt within the last week had lower AUDIT-C scores compared with those who did not report an attempt in the last week (βadj = −0.56, 95 % CI = −1.08 to −0.04) and were less likely to be classified as higher risk (AUDIT-C≥5: ORadj  = 0.57, 95 % CI = 0.38 to 0.85). The lower AUDIT-C scores appeared to be a result of lower scores on the frequency of ‘binge’ drinking item (βadj  = −0.25, 95 % CI = −0.43 to −0.07), with those who reported a quit attempt within the last week compared with those who did not being less likely to binge drink at least weekly (ORadj = 0.54, 95 % CI = 0.29 to 0.999) and more likely to not binge drink at all (ORadj  = 1.70, 95 % CI = 1.16 to 2.49). Among smokers with higher risk consumption (AUDIT-C≥5), those who reported an attempt to stop smoking within the last week compared with those who did not were more likely to report trying to reduce their alcohol consumption (ORadj = 2.98, 95 % CI = 1.48 to 6.01).

Conclusion

Smokers who report starting a quit attempt in the last week also report lower alcohol consumption, including less frequent binge drinking, and appear more likely to report currently attempting to reduce their alcohol consumption compared with smokers who do not report a quit attempt in the last week.

Lead author Jamie Brown, from University College London, England, said:

“These results go against the commonly held view that people who stop smoking tend to drink more to compensate. It’s possible that they are heeding advice to try to avoid alcohol because of its link to relapse.”

   Who was involved?

Jamie Brown, Robert West, Emma Beard, Alan Brennan, Colin Drummond, Duncan Gillespie, Matthew Hickman, John Holmes, Eileen Kaner, Susan Michie.

BMC Public Health, 2016; 16 (1) DOI: 10.1186/s12889-016-3223-6

Read the full report on BMC here!

 

 

Unravelling the alcohol harm paradox: a population-based study of social gradients across very heavy drinking thresholds | Research report

 

Who was involved?

Dan Lewer – Imperial College Healthcare NHS Trust, Charing Cross Hospital

Petra Meier – ScHARR, University of Sheffield

Emma Beard – Department of Epidemiology & Public Health and Department of Clinical, Educational and Health Psychology, University College London

Sadie Boniface – National Addications Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London

Eileen Kaner – Institute of Health and Society, Newcastle University

Background to the research:

There is consistent evidence that individuals in higher socioeconomic status groups are more likely to report exceeding recommended drinking limits, but those in lower socioeconomic status groups experience more alcohol-related harm. This has been called the ‘alcohol harm paradox’. Such studies typically use standard cut-offs to define heavy drinking, which are exceeded by a large proportion of adults. Our study pools data from six years (2008–2013) of the population-based Health Survey for England to test whether the socioeconomic distribution of more extreme levels of drinking could help explain the paradox.

Methods used:

The study included 51,498 adults from a representative sample of the adult population of England for a cross-sectional analysis of associations between socioeconomic status and self-reported drinking. Heavy weekly drinking was measured at four thresholds, ranging from 112 g+/168 g + (alcohol for women/men, or 14/21 UK standard units) to 680 g+/880 g + (or 85/110 UK standard units) per week. Heavy episodic drinking was also measured at four thresholds, from 48 g+/64 g + (or 6/8 UK standard units) to 192 g+/256 g + (or 24/32 UK standard units) in one day. Socioeconomic status indicators were equivalised household income, education, occupation and neighbourhood deprivation.

Results of the study:

Lower socioeconomic status was associated with lower likelihoods of exceeding recommended limits for weekly and episodic drinking, and higher likelihoods of exceeding more extreme thresholds. For example, participants in routine or manual occupations had 0.65 (95 % CI 0.57–0.74) times the odds of exceeding the recommended weekly limit compared to those in ‘higher managerial’ occupations, and 2.15 (95 % CI 1.06–4.36) times the odds of exceeding the highest threshold. Similarly, participants in the lowest income quintile had 0.60 (95 % CI 0.52–0.69) times the odds of exceeding the recommended weekly limit when compared to the highest quintile, and 2.30 (95 % CI 1.28–4.13) times the odds of exceeding the highest threshold.

Conclusions

Low socioeconomic status groups are more likely to drink at extreme levels, which may partially explain the alcohol harm paradox. Policies that address alcohol-related health inequalities need to consider extreme drinking levels in some sub-groups that may be associated with multiple markers of deprivation. This will require a more disaggregated understanding of drinking practices.

Read the full report here.