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Crawford M.J., Parry A.M.H., Weston A.R.W. et al.
Alcohol and Alcoholism: 2012, 47(6). p. 738–742.
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With this first UK survey providing data on price paid for alcohol plus consumption and income, the evidence is converging on the conclusion that poor heavy drinkers would be most affected by a minimum per unit price, gaining most in health, but losing most either in having to spend more or cut back on their drinking.
Summary The cost of alcohol and average consumption are closely linked; when the price increases, consumption falls. This fact has led to calls for an increase in the price of alcohol to no less than £0.50 per UK unit (10ml or about 8g of alcohol), the level planned by the Scottish Government. However, there are concerns that raising the price in this way would be unfair to low-risk drinkers and disproportionately affect poorer drinkers.
This study addressed the issue of whether low-income moderate drinkers would be disproportionately disadvantaged by a £0.50 minimum per unit price for alcohol, the level planned by the Scottish Government.
Based on a ‘street’ survey of people who had recently shopped for alcohol, it seemed that a lower proportion would be affected than poor but heavier drinkers (the highest proportion of whom would be affected) or better-off drinkers.
The evidence is converging on the conclusion that poorer, heavy drinkers and their families would be most affected by a minimum per unit price, gaining most in health, but losing most either in having to spend more or cut back on their drinking.
To assess the validity of these concerns, during the first half of 2011 researchers approached people in the public, commercial areas of London, Bristol, Bath, Milton Keynes and three other towns in the south of England, asking them to take part in a survey of their shopping habits and health. Among the questions were some about the last time they bought alcohol for their own use in a shop or other off-licence premises – the main source of low-priced alcohol in the UK and the focus of the greatest concern about alcohol pricing. Of the 1300 people who agreed to answer questions, 515 had bought off-licence alcohol in the past week and were included in the featured analysis. Also in the survey were the three questions which constitute the AUDIT-C screening questionnaire, which assesses how much someone has been drinking over the past year. Nearly two-thirds of the sample registered a score of five or more, considered indicative of higher risk drinking. Other questions were about age, health and household income. Incomes of below £15,000 yearly were considered low.
The findings suggested that higher risk drinkers also on a low income would be most affected by a £0.50 minimum per unit price because they were the subgroup most likely to have bought their drink at below this price.
Averaged across the beverages bought at their last off-trade purchase within the past week, about 42% of respondents had paid under £0.50 per UK unit of alcohol. Among respondents on low incomes, higher risk drinkers typically (median price) paid about £0.48 per unit but lower risk drinkers about £0.56. Higher income drinkers had spent about the same regardless of whether higher or lower risk drinkers – around £0.53 chart.
These differences were reflected in the proportions of the sample who, had the minimum unit price been set at £0.50, would have had to pay more for their last purchase. Whether higher or lower risk drinkers, just under 40% of higher income consumers had spent less than this minimum so would have been forced to pay more or drink less. Among the poorer consumers, relatively few lower risk drinkers would have been similarly affected – around a third – but many more of the higher risk drinkers – about 55%. Once age and sex differences had been accounted for, a higher risk, low income drinker was 29% more likely to buy alcohol at under £0.50 per unit than to pay more. The odds were the other way round for lower risk, low income drinkers; they were nearly half as likely to buy sub-£0.50 per unit alcohol as to pay more.
This survey of over 500 members of the public in England found that people on low incomes who were lower risk drinkers were less likely to purchase off-trade alcohol at under £0.50 per unit than other respondents. The fact that low income drinkers spend less per unit was due to the cheaper drink bought by the heavier drinkers amongst them. These findings contradict concerns that low income moderate drinkers would (relative to other drinkers) be disadvantaged by a £0.50 minimum unit price. In this sample, two-thirds had already spent more than this at their last purchase.
The main limitations of the study are that it was confined to the south of England and that the sample in those areas was not necessarily representative of all people who buy alcohol at off-licensed premises.
commentary In line with the findings of this survey, government impact assessments for both Scotland and England have acknowledged that those hit hardest in the pocket by a minimum unit price would be poor regular drinkers, though they too stood to gain most in health terms if they responded as expected by cutting back their drinking. At the UK government’s request, this issue was specifically addressed by the University of Sheffield team whose simulation models (for England, Scotland and Wales) have been influential in promoting minimum pricing. Their model was used to make a stab at predicting how the different income groups would respond to a £0.45 per unit minimum price. In contrast to government assessments based on their earlier work, they calculated that low income drinkers would cut back so much that they would spend less on drink if the price was set at £0.45. By far the greatest savers would be the heaviest of drinkers among the poor, who would find hunting out cheap drink no longer a viable strategy for maintaining consumption.
Whether in reality the poorer of the UK’s heavier drinkers would respond to a high per unit price by cutting their drinking and saving money, or maintaining their drinking and cutting back on other spending, remains a matter for debate. Either way the evidence is converging on them and their families being most affected by such a policy, standing to gain most in health terms, and to lose most either in income available for other purposes or by having to cut back on their drinking.
Because the aim was to relate spending to consumption, the featured survey had to restrict itself to people who had “purchased alcohol for their own use”. Many other drinkers have alcohol bought for them or for family consumption as part of the family’s shopping, so would not have figured in the survey.
For more on research, policy and politics in relation to setting a minimum per unit price for alcohol in the UK see this Effectiveness Bank hot topic.
Last revised 03 June 2015. First uploaded 27 May 2015
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HOT TOPIC 2015 A minimum price for drink?