The Cost of Alcohol:The Advocacy for a Minimum

Price per Unit in the UK

Martin HaggerCurtin University, Australia

Adam LonsdaleUniversity of Nottingham, UK

Rob Baggott, Demontfort UniversityGillian Penny, Northampton UniversityMatt Bowen, OurLife

Alcohol, price and health• Annual cost to taxpayers of excessive

alcohol consumption is estimated £7.3 billion (DoH, 2009)

• Price increases have been shown to be effective in reducing alcohol consumption (Wagenaar et al., 2009)

• Focus on price has been oriented toward increased duty and leads to uniform rise in price

• Disparity between prices at high and low end of the alcohol market• Heavily discounted/low-cost alcohol sales prevalent• Discounting trends in the retail industry (e.g., BOGOF, happy hours)• Changes in drinking patterns (e.g., binge drinking, pre-loading)• Patients with alcohol-related harms purchased more of their weekly

consumption very cheaply compared to wider drinkers

Alcohol, price and health

• Pricing policy based on ‘strength’ has been proposed – price based on ‘units’ of alcohol

• A minimum price of 50 pence-per-unit (ppu) would reduce consumption by 6.9% (Brennan et al., 2008)

• Estimated savings of £9.7 billion in costs associated with excessive alcohol consumption

• Minimum price also has support from medical community (Donaldson, 2009) and advocacy groups (NICE, 2010)

• Proposal of 45ppu tabled in Scottish Executive• Little evidence on public perceptions of

minimum price

The Present Research• Research consistently shows public

support for treatment and information rather than price change (Greenfield et al., 2004)

• Public likely to be opposed to minimum price

• No formal investigation to date on public attitudes and beliefs toward the policy

• Aims• Investigate knowledge, attitudes and

beliefs with respect to minimum price• Under what conditions are people more

likely to endorse minimum price?

Method• Research Design: Qualitative investigation

using focus groups• Participants: N = 217 in 28 focus groups from

one of ten target groups:

• Sixth form students • University students

• Blue-collar workers • White-collar workers

• Unemployed • Older adults

• African-Caribbean • South-Asian

• Rural community • ‘Hazardous’ drinkers

• Procedure: Semi-structured ‘interview’ schedule with a facilitator (90-mins typical length)

• Explanation of policy• Generate discussion of pertinent issues• Opinions on minimum price and implementation• All participants encouraged to contribute

Method• Data analysis: Qualitative analysis using

inductive thematic content analysis of transcribed interview data

•NVIVO software used to categorise and organise data

•Main emergent themes and sub-themes identified

•Multiple readings using an iterative approach until ‘theme saturation’ achieved

•Theory building rather than theory testing•Advantageous in areas where little knowledge

known/available

Results: Themes

• Minimum price is unlikely to be effective• “Where there’s a will, there’s a way”• Won’t work for heavy or dependent drinkers• Perceived failure of previous pricing policy

• Minimum price will have only a limited effect• Change people’s choice of drink• Affect ‘binge drinking’• Affect young people• Short-term reductions• Long-term effects

Results: Themes

• Dislike for minimum price policy• Punishing the moderate or ‘sensible’• Restriction on personal freedoms• Unfairly targets the poor• “There’s more to alcohol reduction than price”• “There must be a better way than this”• Suspicion of government motives

• Support for minimum price• Need to curb excessive alcohol consumption• Improved public health• “It doesn’t bother me, I don’t drink that much”

Results: Major Findings

• Major Finding 1.• Participants expressed largely negative views of a

minimum price per unit policy:• Scepticism of its effectiveness• Disliked it – ‘unfair to sensible drinkers’ • Might create or exacerbate other existing social problems

(e.g., crime and drug abuse)• Misconceptions surrounding the policy

• Major Finding 2.• A number of participants accepted that a minimum price

per unit might be necessary tackle excess alcohol • The need for action• Prospect of improved public health particularly in the young• Perceived not to have significant effect on their own habits

Results: Major Findings

• Major Finding 3.• Suggested ideas that would make ‘minimum

price’ more acceptable• Introduce as part of a broader package of policies to

address excessive alcohol consumption• Revenue generated by higher prices should be used

to fund other interventions• Little evidence that participants’ views of minimum

price and its acceptability varied across gender and age groups.

Summary and Conclusion• Participants were largely sceptical of the minimum price

policy and expressed doubts regarding its effectiveness• The policy would be more acceptable if introduced as

part of a wider strategy• Participants’ objections were the result of 4 main issues:

• Misunderstanding of the policy itself• Equating the policy with other pricing policies (e.g., duty)• Failure to recognise the public health significance of small

reductions in alcohol consumption• Preoccupation with the effects on heavy and dependent drinkers

• Policymakers introducing a minimum price policy should• Focus on dispelling the misconceptions • Highlighting the key features of the policy • Introduce in conjunction with other measures

www.martinhagger.comwww.alcoholresearchuk.org