Welsh Legislation on the minimum price of alcohol came into force in March 2020, just weeks before the lockdown. It sets a base price for the sale and supply of alcohol in Wales and makes it an offense to sell alcohol below that price.
The amount a drink can be sold for is calculated using the formula below, which is based on a “minimum unit price” (MUP). In Wales it is currently set at 50p.
Minimum unit price (50p) x concentration (% alcohol by volume) x volume (litres)
This article examines whether the introduction of a minimum price has reduced alcohol consumption and related harm; the effect of the COVID-19 pandemic on drinking habits; and evidence from Scotland, which implemented similar legislation two years before Wales.
Why did the Welsh Government introduce a minimum price for alcohol?
In 2017, 1 in 5 adults in Wales were dangerous or harmful drinkers (consumption UK guidelines of 14 units of alcohol per week). Alcohol-related hospital admissions are estimated to cost the Welsh NHS dearly £120m per year.
The modeling revealed that introducing a minimum price for alcohol would be the most effective policy to reduce alcohol consumption and associated harm in Wales. This led to the introduction of a bill in the Senedd (see timeline below).
The Welsh government has said (emphasis added):
The ultimate goal of the [then] The bill aims to address alcohol-related harm, including hospital admissions attributable to alcohol and alcohol-related deaths in Wales, by reduce alcohol consumption in harmful and hazardous drinkers. In particular, the [then] The bill aims to protect the health of harmful and dangerous drinkers (including young people) who tend to consume larger amounts of cheap and high-alcohol products.
What do we know about the evolution of alcohol consumption?
Research has shown an immediate effect on alcohol sales in stores following the introduction of MUP in Wales. Alcohol sales fell 8.6% while prices rose 8.2%. This decline in alcohol purchases came primarily from households that typically purchased the most alcohol, suggesting that the MUP was effective in targeting heavy drinkers.
From March to July 2020, alcohol purchased from stores in England, Wales and Scotland increased. However, as pubs, bars and clubs have closed due to the nationwide lockdown, overall alcohol sales have been below pre-COVID trends.
Drinkers said MUP had little effect on their drinking. Changes in drinking behavior have been overwhelmingly attributed to the COVID-19 pandemic rather than minimum pricing.
Change of alcohol in the UK found that 10% of drinkers had reduced their consumption due to the introduction of a minimum price in Wales. However, 23% drank less due to the COVID-19 pandemic and 29% drank more.
Reasons given for increasing alcohol consumption included Anxiety depression, boredom and loneliness. Those who drank less attributed it to socialize less Where want to protect their health.
In Scotland, alcohol sales have fallen year on year since the introduction of a minimum price in 2018. This further suggests that minimum alcohol pricing is effective in reducing alcohol consumption at the population level.
However, a Public Health Scotland report concluded that:
Among those who drink at harmful levels or those with an alcohol addiction, the study found no clear evidence of a change in drinking or addiction severity.
What was the impact on deaths and hospitalizations?
Alcohol-related deaths rose by 17.8% in Wales from 2019 to 2020.
In June 2021, the Prime Minister has acknowledged the increase in alcohol-related deaths and say:
…more data is needed to confirm and assess this. The reasons for any increases can be complex and will require further analysis.
Scotland has also seen an increase in alcohol-related deaths in 2020 by 13.5%.
Before the COVID-19 pandemic, Scotland recorded a 10.6% reduction in alcohol-related deaths from 2018 to 2019. This suggests it may be too soon to tell whether minimum pricing could reduce alcohol-related deaths in Wales, due to the puzzling effects of the COVID-19 pandemic.
In Wales, alcohol-attributable hospital admission rates decreased by 23% during the 2020/21 financial year compared to 2019/20. However, the total number of hospitalizations in the emergency room also fell by 13.2% during the COVID-19 pandemic, as many people avoided seeking treatment. The reasons for the further reductions in hospital admissions attributable to alcohol are likely to be manifold.
The rate of alcohol-related hospital admissions were also lower in Scotland in 2020/21 compared to 2019/20. However, Public Health Scotland noted a steady decrease in the rate of alcohol-related hospitalizations since 2007/08.
In what other ways have people been affected?
During Senedd review of the then billconcerns have been expressed that rising alcohol prices will cause drinkers to turn to cheaper illegal drugs.
Welsh Government reports published in 2019, 2021 and 2022 found that substance switching among hazardous and harmful drinkers was unlikely, except among drinkers with a history of drug use. In Scotlandvery few drinkers reported switching to illicit drugs.
There were also fears that the bill at the time would have a disproportionate impact on low-income groups, forcing drinkers in these groups to cut back on other expenses such as food and heating.
Discovery of research into alcohol sold in shops in Wales alcohol expenditure grew faster for low-income people households after the introduction of minimum pricing. The lowest-income households that typically purchased the most alcohol did not reduce the amount of alcohol they purchased, and therefore their alcohol expenditures increased.
Findings from Scotland show lower income groups increased their spending on alcohol. This has led some addicted drinkers to reduce their spending on food and utilities.
What is the future of the minimum price?
Minimum alcohol pricing will end in Wales in March 2026 unless the Welsh Government issues regulations to extend it. Further evaluation of the effectiveness of the policy, which is a requirement of the legislation, will be essential to this decision.
In Scotland, alcohol charities have called on the Scottish Government to raise the MUP to 65p to reflect the increase in inflation since the introduction of minimum pricing and to derive greater benefits from the policy.
The World Health Organization’s report on the minimum price of alcohol concludes that it is an effective policy to reduce alcohol consumption and harm, but should be complementary to alcohol taxation.
Article by Bonnie Evans, Senedd Research, Welsh Parliament
Senedd Research acknowledges the Parliamentary Fellowship awarded to Bonnie Evans by the Medical Research Council which made the writing of this research article possible.