Wales’ legislation on minimum pricing for alcohol came into effect in March 2020, just a few weeks before lockdown. It sets a baseline price for the sale and supply of alcohol in Wales, and makes it an offence for alcohol to be sold below that price.
The amount a drink can be sold at is calculated using the formula below, which is based on a ‘minimum unit price’ (MUP). In Wales this is currently set at 50p.
Minimum Unit Price (50p) x strength (% Alcohol by Volume) x volume (litres)
This article looks at whether the introduction of minimum pricing 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 minimum pricing for alcohol?
In 2017, 1 in 5 adults in Wales were hazardous or harmful drinkers (drinking over the UK guidelines of 14 units of alcohol per week). Hospital admissions linked to alcohol were estimated to cost the Welsh NHS £120 million a year.
Modelling found that the introduction of minimum pricing for alcohol would be the most effective policy for reducing drinking and associated harm in Wales. This led to a bill being introduced in the Senedd (see timeline below).
The Welsh Government said (emphasis added):
The ultimate objective of the [then] Bill is to tackle alcohol-related harm, including alcohol-attributable hospital admissions and alcohol-related deaths in Wales, by reducing alcohol consumption in harmful and hazardous drinkers. In particular, the [then] Bill is targeted at protecting the health of harmful and hazardous drinkers (including young people) who tend to consume greater quantities of low-cost and high-alcohol content products.
What do we know about changes in alcohol consumption?
Research showed an immediate effect on alcohol sales in shops after MUP was introduced in Wales. Alcohol sales dropped by 8.6% as prices rose by 8.2%. This drop in alcohol purchasing came mainly from households that usually bought the most alcohol, suggesting MUP was effective at targeting heavier drinkers.
From March to July 2020, alcohol purchased from shops in England, Wales and Scotland increased. However, as pubs, bars and clubs closed due to the national lockdown, overall alcohol sales were lower than pre-COVID trends.
Drinkers reported that MUP had little effect on their alcohol consumption. Changes to drinking behaviour were overwhelmingly attributed to the COVID-19 pandemic rather than minimum pricing.
Alcohol Change UK found that 10% of drinkers had reduced their drinking because of the introduction of minimum pricing in Wales. However, 23% were drinking less due to the COVID-19 pandemic, and 29% were drinking more.
In Scotland, alcohol sales have decreased year on year since the introduction of minimum pricing in 2018. This further suggests minimum pricing for alcohol is effective at reducing population-level alcohol consumption.
However, a report by Public Health Scotland concluded that:
Among those drinking at harmful levels or people with alcohol dependence, the study found no clear evidence of a change in consumption or severity of dependence.
What’s been the impact on deaths and hospitalisations?
Alcohol-specific deaths rose by 17.8% in Wales from 2019 to 2020.
In June 2021, the First Minister acknowledged the increase in alcohol-specific deaths and said:
…more data is needed to confirm and to assess this. The reasons for any rise may be complex and will need additional analysis.
Scotland also saw an increase in alcohol-specific deaths in 2020 by 13.5%.
Before the COVID-19 pandemic, Scotland saw a reduction of 10.6% in alcohol-specific deaths from 2018 to 2019. This suggests it may be too soon to tell if minimum pricing could reduce alcohol-specific deaths in Wales, due to the confounding effects of the COVID-19 pandemic.
In Wales, alcohol-attributable hospital admission rates decreased by 23% in the 2020/21 financial year compared to 2019/20. However, overall emergency hospital admissions also decreased by 13.2% during the COVID-19 pandemic, as many people avoided seeking healthcare. The reasons for additional reductions in alcohol-attributable hospital admissions are likely to be multi-faceted.
The rate of alcohol-related hospital admissions was also lower in Scotland in 2020/21 compared to 2019/20. However, Public Health Scotland has noted a steady decrease in the rate of alcohol-related hospital admissions since 2007/08.
What other ways have people been affected?
During Senedd scrutiny of the then Bill, concerns were raised that increased alcohol prices would cause drinkers to switch to cheaper, illegal drugs.
Reports by the Welsh Government published in 2019, 2021 and 2022 found that substance switching in hazardous and harmful drinkers was unlikely, except in drinkers with a previous history of drug use. In Scotland, very few drinkers reported a switch to illegal drugs.
There were also concerns that the then Bill would disproportionately impact low income groups, causing drinkers in these groups to cut back on other expenses such as food and heating.
Research into alcohol sold in shops in Wales found spending on alcohol increased faster for low-income households after the introduction of minimum pricing. The lowest income households that usually bought the most alcohol didn’t reduce the amount of alcohol they purchased, and as a result their spending on alcohol increased.
Findings from Scotland show that low income groups did increase their expenditure on alcohol. This led to some dependent drinkers reducing their spending on food and utilities.
What is the future of minimum pricing?
Minimum pricing for alcohol will end in Wales in March 2026, unless the Welsh Government makes regulations to extend it. Further evaluation of the effectiveness of the policy, which is a requirement of the legislation, will be crucial to this decision.
In Scotland, alcohol charities have called for the Scottish Government to raise MUP to 65p to reflect the increase in inflation since minimum pricing was introduced, and to realise greater benefits from the policy.
The World Health Organisation’s report on minimum pricing for alcohol concluded it is an effective policy to reduce alcohol consumption and harm, but should be complementary to taxation on alcohol.
Article by Bonnie Evans, Senedd Research, Welsh Parliament
Senedd Research acknowledges the parliamentary fellowship provided to Bonnie Evans by the Medical Research Council which enabled this Research Article to be completed.