# Public health impacts of increasing the minimum unit price for alcohol in Scotland: A model-based appraisal

## TL;DR

Raising Scotland's minimum alcohol price to £0.65 could reduce drinking, alcohol-related deaths, and health inequalities, especially among the most deprived and heavy drinkers.

## Contribution

This study is the first to examine the impact of increasing an existing minimum unit price policy for alcohol.

## Key findings

- Increasing the MUP to £0.65 leads to a 12.0% decrease in alcohol consumption and 3,385 fewer deaths over 20 years.
- The policy reduces harmful drinking by 29.4% and benefits the most deprived population quintile the most.
- Raising the MUP threshold leads to greater public health benefits than maintaining or lowering it.

## Abstract

Governments in several countries have introduced a minimum unit price (MUP) for alcohol. Evaluation studies suggest this has reduced alcohol-related harm, but MUPs must increase with inflation to remain effective. This paper estimates the impact of the impact of the Scottish Government’s decision to increase its MUP from £0.50 to £0.65 in September 2024 and, alternative options where the MUP changes to between £0.40 and £0.80. It examines impacts on alcohol consumption, spending, and related health outcomes, how impacts vary across the population with regard to deprivation, and how drinkers move between lighter and heavier alcohol consumption groups.

Policy appraisal using the Sheffield Tobacco and Alcohol Policy Model, a dynamic microsimulation model that combines data on alcohol purchasing and consumption for 10 beverage types and 800 subgroups comprising adults in the Scottish population with price elasticities and an epidemiological model. Deprivation is measured using quintiles of the Scottish Index of Multiple Deprivation. Drinker group is categorised as moderate (<14 units/week, 1 UK unit = 8 g ethanol), hazardous (>14 to ≤35/ ≤50 units/week for women/men), and harmful (>35/50 units/week for women/men). The policy appraisal estimates that, compared to retaining Scotland’s MUP at £0.50, increasing the MUP to £0.65 leads to an estimated 12.0% decrease in alcohol consumption, 2.1% decrease in alcohol spending, 3,385 fewer deaths overall, and 2,578 fewer deaths wholly attributable to alcohol over 20 years. Estimated effects are largest in the quintile of the population living in the most deprived areas. Increasing the MUP to £0.65 is also estimated to reduce the proportion of drinkers consuming at harmful levels by 29.4% and the proportion consuming at hazardous levels by 8.0%. Key limitations of the study include relying on data on alcohol consumption and spending collected before the COVID-19 pandemic, synthesising consumption and spending data from separate datasets, and assuming no supply-side responses (e.g., price changes above the MUP threshold).

Increasing the threshold of an established MUP can lead to additional reductions in alcohol consumption, related harm, and health inequalities. Benefits accrue particularly to the most deprived and heaviest drinkers.

Minimum unit pricing (MUP) sets a floor price for a unit (10 ml or 8 g) of alcohol below which retailers cannot sell alcohol to consumers.

It is important to increase the floor price over time to prevent inflation, making it less effective, but no study has examined the impact of changes in existing MUP policies.

The Scottish Government introduced MUP at £0.50 per unit in May 2018 and then raised this to £0.65 per unit in September 2024.

We used the Sheffield Tobacco and Alcohol Policy Model to estimate the impact of increasing Scotland’s MUP threshold to £0.65 per unit and compared this to alternative policy options.

The model estimates that increasing the MUP threshold to £0.65 could lead to reductions in alcohol consumption, harmful drinking, and deaths or hospitalisation caused by alcohol. Reducing the threshold would lead to increases in these outcomes.

The estimated effects are largest among heavier drinkers and those living in deprived areas.

Increasing the MUP threshold can lead to additional reductions in the harm caused by alcohol beyond those arising from introducing the policy.

MUP policies will become less effective if the price threshold is not increased over time and this will lead to increases in alcohol-related harm.

Governments that are considering introducing MUP should also consider including automatic increases in the MUP within the relevant legislation.

Key limitations of this study include relying on data on alcohol consumption from before the COVID-19 pandemic, merging data on alcohol consumption and spending from different sources, and assuming that alcohol producers and retailers did not adjust their business strategies in response to MUP.

In this modeling paper, John Holmes and colleagues analyzed the effects on public health of changing the minimum unit price of alcohol in Scotland.