Heavy Drinkers’ Perspectives on Minimum Unit Pricing for Alcohol in Scotland

Abstract

The irrefutable consequence of Scottish excessive alcohol consumption has prompted implementation and proposal of alcohol policy measures. The purpose of this study is to explore with heavy drinkers their awareness of and identify potential implications of policy introducing alcohol minimum unit pricing (MUP). Face-to-face semi-structured interviews were conducted with drinkers with alcohol-related harm ( n = 20; 15 males, five females; aged 34 to 67 years old) in Scotland’s two largest cities (drinkers were participants within a larger quantitative study, through attendance for treatment for alcohol-related harms at National Health Service [NHS] centers). Median weekly consumption among participants was 130.7 units (range: 28-256.3 U.K. units). Views regarding the impact of increased alcohol prices, through MUP, were mixed. While some drinkers indicated potential reduction in intake, thus possibly reducing alcohol harms in the long term, the expected, or even desired, from a public health perspective, effects on consumption and associated harms might not be fully realized in this group. To mitigate possible unintended short-term detrimental effects of MUP on the most vulnerable, careful planning and appropriate resourcing may be required prior to implementation.

Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18

“…This evaluation should permit additional scrutiny of any adverse impacts on this group of drinkers. Although very heavy drinkers, who are already experiencing severe economic deprivation, might respond to price increases by reducing their drinking, they might also respond to price increases by forgoing essentials, such as by rebudgeting to purchase alcohol instead of food 5960. As such, there is a risk that MUP could intensify the economic hardships experienced by both economically deprived very heavy drinkers and their families 61.…”

Adapting existing behaviour: Perceptions of substance switching and implementation of minimum pricing for alcohol in Wales

“…2 However, while effect of price on alcohol consumption is well documented, far less is known about the fuller and wider impacts on drinkers and the communities in which they live. The small volume of literature concerning unintended consequences is explored further in our discussion, but in summary suggests that: harmful coping strategies are rarely deployed among this population when alcohol becomes less affordable, switching is only likely amongst those with previous history of drug use, and unintended consequences tend to be short term (Holloway et al, 2019;Black et al, 2011;Erickson et al, 2018;Falkner et al, 2015;O'May et al, 2016;Stockwell, Auld et al, 2012). A commitment was therefore made to commission research that would investigate these concerns prior to the legislation's enactment.…”

Heavy Drinkers and the Potential Impact of Minimum Unit Pricing—No Single or Simple Effect?

“…Certainly, some participants' only income was social security benefits. Close relatives and friends were reported by some as alternative sources of funds while others, conversely, had their funds controlled by relatives (O'May et al, 2016). Holmes et al (2014) suggest that harmful drinkers on low incomes purchase most alcohol at less than MUP, consequently they would be most affected by MUP.…”

“…On the other hand, the type of drinker who might want to maintain the level of consumption despite MUP is the addictive drinker. O'May et al (2016) in this sample documented accounts of purchasing alcohol specifically to selfmedicate to avert withdrawal seizures, i.e. the drivers impacting on sourcing alcohol may not only be economic.…”

“…Furthermore, we did not record income and we cannot reliably predict how participants will finance more expensive alcohol following the instigation of MUP should they wish to maintain their consumption level. Our previous work (O'May et al, 2016) documented accounts from drinkers who advised that alcohol was purchased after necessities had been financed while, for others, drink took precedence over other outgoings. We have already mentioned how alcohol dependence might influence a more reasoned decision around purchasing.…”