# Reduction in sugar intake after the introduction of minimum unit pricing for alcohol in Scotland: a difference-in-differences analysis

## TL;DR

Scotland's minimum alcohol pricing policy led to a small but significant decrease in sugar purchases, mainly from alcoholic drinks.

## Contribution

This study is the first to show that minimum alcohol pricing reduces sugar intake, particularly from alcohol.

## Key findings

- MUP in Scotland reduced sugar purchases by 1.6% or 8 g per adult equivalent per week.
- The reduction was mainly due to a 16.6% decrease in sugar from alcoholic drinks.
- No significant changes in overall diet quality were observed.

## Abstract

In 2018, Scotland introduced a minimum unit pricing (MUP) policy to remove very-low-cost alcoholic drinks from the market in an effort to reduce the adverse impacts of excessive alcohol consumption. Any increased spending on alcohol may be associated with reduced food and lower diet quality.

This study aimed to estimate the relationship between MUP and dietary energy, nutrients, and diet quality.

Difference-in-differences analyses were conducted on household-level purchase data, collected by Kantar Worldpanel (KWP) over 53 wk before and 54 wk after the implementation of MUP, from 1987 households in Scotland and 6064 households in the north of England. The Poisson pseudomaximum likelihood regression model with household fixed effects was used, with estimates adjusted for age of main shopper, household composition, duration of KWP participation, total spending on nonfood items, and month of the year. Primary outcomes were dietary energy, energy density, Diet Quality Index, and foods and nutrients relevant to the Scottish dietary goals after adjustment to per adult-equivalent values. Secondary outcomes explored the differential effects of MUP by area-level deprivation and levels of alcohol purchase.

The introduction of MUP in Scotland was associated with a 1.6% [95% confidence interval (CI): 0.02%, 3.16%] reduction in the purchase of sugar from food and beverages or 8 g per adult equivalent per week. This reduction was partly a result of a 16.6% (95% CI: 7.15%, 25.96%) reduction in sugar from alcoholic drinks purchased. No other significant associations were found. Households from more deprived areas, and households with greater alcohol purchases, had greater levels of sugar reduction from alcohol.

MUP in Scotland is associated with small, but beneficial, statistically significant reductions in the purchase of sugar. There is no significant change in overall diet quality.