Minimum unit pricing may have helped reduce alcohol-related deaths in Glasgow

https://www.scotsman.com/health/scotland-s-minimum-unit-pricing-thought-to-be-a-factor-in-the-decline-of-glasgow-drinking-deaths-1-5007185

by DanBC • 7 years ago

72 104 7 years ago

scotsman.com

choeger• 7 years ago

Eli5 how does minimum unit pricing work exactly?

throwaway66920• 7 years ago

Presumably you can’t go below a certain price per liter

inops• 7 years ago

Per unit. The effects of a litre of vodka isn't the effects of a litre of cider.

recursion• 7 years ago

Basically. There is a minimum price set of 0.50 per unit. This means a bottle of whisky, 70cl at 37.5% ABV cannot retail for less than £14 whereas previously these would be on promotion sometimes at £11/£12/£13.

By setting it per unit instead of quantity of drink the government targets super strength cheap cider etc that were linked to lots of anti-social behaviour and crime.

alkonaut• 7 years ago

Yes - per liter of pure ethanol. If you buy a pint of regular lager beer you are buying basically 0.56L times 5.2% alcohol which is 2.9 cl pure ethanol, or as a brit would some times say "about 3 units". So a minimum proce per unit is the same as a minimum price per litre of pure ethanol. The minimum price per liter of ethanol is 100x the minimum price per unit (since one unit is 1 cl pure ethanol).

The reason this is so fantastically confusing is because sometimes even regulators use "alcohol" to refer to the drink, and not the ethanol.

brianmcc3• 7 years ago

Per unit of alcohol -> https://www.economicshelp.org/blog/7130/economics/minimum-pr...

baxter001• 7 years ago

Stronger drinks that contain more units of alcohol have a higher minimum price than drinks that contain less alcohol. Drinks that have been most affected include strong white cider, own brand vodka and gin, and super strength lager.

A bottle of wine containing 10 units of alcohol has to be sold for at least £5, and a can of lager containing 2 units of alcohol has to cost at least £1.

Unlike supermarkets and off-licences, most drinks sold in pubs, clubs and restaurants already cost more than 50p per unit so there is no real difference under minimum pricing.

Minimum pricing is an effective policy because it targets the drinkers causing the most harm to themselves and society, whilst having almost no effect on moderate drinkers.

pjc503• 7 years ago

http://www.legislation.gov.uk/asp/2012/4/section/1

All alcohol sold is marked with the number of "units" it contains. Multiply that by the minimum unit price (currently £0.50) to get a minimum total price.

Examples: https://www.independent.co.uk/life-style/scotland-minimum-al...

eyegor• 7 years ago

strength is taken to be the alcoholic strength by volume as indicated by the mark or label

This phrasing frustrates me quite a bit. I assume they're referring to "% concentration of ethanol by volume", but they chose to express it in this obtuse "units" and "strength" nomenclature. (Or is this referring to the "proof" as the strength in their formula? Is that metric used in Scotland?)

kerkeslager7• 7 years ago

Christ, that's terribly written. Legalese is not a good way to communicate even very basic scientific concepts.

The minimum price of alcohol is to be calculated according to the following formula—
MPU × S × V × 100
where—
MPU is the minimum price per unit,
S is the strength of the alcohol, and
V is the volume of the alcohol in litres.

It's hard to figure out, but I think "alcohol" actually means "alcoholic beverage" and "strength" means "percentage of alcohol in the alcoholic beverage". So with a MPU of £0.50 and pint (0.56 litres) of 3% alcohol cider, you'd have £.5 × .03 × .56L × 100 = £0.84. So it looks like the "unit" in "minimum price per unit" is "centiliters", although this unit is mentioned literally nowhere in the law.

It's a minimum price per centiliter of pure alcohol in the beverage. That's it.

Symbiote3• 7 years ago

A "unit" of alcohol is 1cL. This amount is commonly used in the UK -- the amount of alcohol in a drink is often printed on the label in "units", and people have some ideas around how many "units" one can drink safely. It's used in personal health education at school.

The minimum price was set to 50p per unit / centilitre of alcohol.

(Keeping easy metric amounts for simplicity. In bars beer and cider is sold in 568mL glasses, though wine and spirits are nice round metric amounts.)

A 1L bottle of vodka, at 40% ABV, contains 40cL of alcohol. The shop or bar must sell it for at least 40×£0.50 = £20. In England, Tesco's cheapest 1L bottle of vodka is £15, so this has increased the price by £5 in Scotland. A fancy vodka which costs £22 in England is unaffected.

A 2L bottle of cheap cider at 5% ABV must cost at least £5. At Tesco in England, this is available for about £2.

XJ63• 7 years ago

5% is considered weak for that kind of cheap cider too, white lightning was far stronger than that for a similar price. (And if I remember correctly usually came in 3L bottles)

kerkeslager7• 7 years ago

It's a minimum price per centilitre of pure alcohol.

microcolonel• 7 years ago

You must pay at least a certain amount of money for a certain mass of ethanol. The minimum price of any container of ethanol is determined by how much ethanol is in that container.

In Ontario, Canada, it works differently. They attempt to apply different minimum prices to various broad categories of alcoholic drink (beer vs wine vs liquor).

bodyfour• 7 years ago

On the other hand, maybe some are moving on to harder stuff? https://www.economist.com/britain/2019/07/18/scotland-overta...

nmeofthestate3• 7 years ago

That's a long-standing problem - middle-aged addicts are starting to suffer from a lifetime of drug abuse.

But yeah, maybe if you can't get ultra-cheap cider you pop out for some heroin instead.

tonyedgecombe• 7 years ago

Three-quarters of the dead were men and three-quarters were aged over 35.

This problem has been creeping up for a while, many of these people have been abusing themselves for a long time and are now paying the price.

krilly• 7 years ago

That's been the experience among my circle of friends (cash strapped students). Why spend a fortune on beer when you can get a strong pill for a fiver?

nmeofthestate3• 7 years ago

Minimum unit pricing doesn't really affect beer - certainly not in a way that makes it cost a "fortune". It makes cans cost a few pence more than ones that you could get on a special offer in England. And people have been taking pills forever - it's not something people have started resorting to now they have to pay fifty pence more to get pissed on lager.

fhbdukfrh2• 7 years ago

I've also heard this proposed as a risk of vaping. You get hooked on nicotine, can no longer afford expensive e-juice and switch to cigarettes. I think it's too early to know if this is the case, but the complete opposite of what vaping promoters try to sell

DanBC3• 7 years ago

England and Wales have also seena significant rise in drug related death, without moving to MUP for alcohol.

https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...

brianmcc3• 7 years ago

Apologies for some domestic political comment on HN - but surely the Scotsman isn't about to give the terrible SNP credit for something?!

Was there not a more negative spin they could've used, e.g. "deaths fall by smaller percent than promised/hoped"?

I note this policy is being mooted UK wide - good. Overuse - and outright abuse - of alcohol is so prevalent and "normal" in the UK it's shocking.

Impact to prices in bars and supermarkets has been totally negligible to anyone enjoying e.g. a pretty cheap £6 bottle of wine or four-beers-for-£5 bundles. It's the supercheap £3 for 2L of strong cider this policy's targeted at and it looks like it might be helping.

bArray2• 7 years ago

I note this policy is being mooted UK wide - good.

To moot is to argue, but then your next statement seems to suggest you want the policy to be rolled out across the UK? Are you for or against rolling this policy out across the UK?

I currently live in New Zealand where alcohol is relatively expensive and it has a massive drinking problem for young persons. When I go back to the UK, the problem is about the same, but the young people aren't going broke buying alcohol. I don't think it works. Increasing the price of Tobacco didn't do much to stop smoking, but vaping and preventing smoking in public areas did. Changing social attitudes to smoking is fundamentally what reduced it.

Personally, I think it's better to use the carrot and not the stick. It shouldn't be the responsibility of the state to raise people's children correctly.

I think this works in my experience. As a child, my parents would let me have a small drink with a meal. As I grew up I never felt the need to drink to excess, I knew how alcohol worked. My sibling had the same experience and doesn't drink. My younger sibling still, was prevented from drinking anything and then went crazy when they legally could.

twic3• 7 years ago

"mooted" here means "considered". The authorities are considering extending this policy from Scotland to the whole of the UK. brianmcc is in favour of this.

XJ63• 7 years ago

mooted also means suggested.

otabdeveloper4• 7 years ago

Increasing the price of Tobacco didn't do much to stop smoking

This is factually false.

nicoburns• 7 years ago

Agree with you on using a carrot. Iceland dealt with its youth drinking problem very effectively by building youth centres and sports/activities programs.

brianmcc3• 7 years ago

I'm meaning "the policy is being considered" as others mention.

Yeah I'm generally for it, but along with the wealth of consultation materials it's recognised as not being a panacea, it's a factor to help a country with a serious recognised problem.

It could be overdone - I'm not in favour of prohibitive pricing across the board - but it feels a sensible pragmatic starting point to me.

Rapzid• 7 years ago

I'm going to propose that your having a drink when you were a child and "knowing how alcohol worked" has absolutely nothing to do with your lack of a drinking problem..

ChrisSD• 7 years ago

Legalising safer drugs would also be an option.

samsari• 7 years ago

Unfortunately not something that's within the power of the Scottish Government to enact, as it is a "reserved" matter - a legal power not devolved to the Scottish executive.

There is a strong desire for "shooting galleries" in Scotland (safe spaces to take drugs where help and clean needles are available) but the UK government and the Scottish government have very different policies on drugs.

Scoundreller3• 7 years ago

You got that right. Alcohol is a straight up dirty drug that’s only around because it was simple to make and a part of Roman culture.

epicureanideal4• 7 years ago

I wonder if there's a startup (or multiple) here? If you take GABA supplements it has some minor version of the affect of alcohol, and if I remember correctly alcohol is a GABA inhibitor. Is there a way to engineer a better, safer, equally or more enjoyable alcohol, maybe with less judgement impairment?

hogFeast3• 7 years ago

England doesn't have this policy. The rate of alcohol-related deaths is half of that in Scotland. And alcohol is only one issue among many. Increasing the cost of alcohol may reduce the number of alcohol-related deaths but what is actually doing for people who need help? Either they have less money or they go somewhere else.

The meta of this policy is kind of interesting too. This kind of price tinkering, control freakery is very New Labour (and probably Conservatives now too, although to a lesser extent). It feels sophisticated, and it is usually accompanied by research from very serious civil servants who model the impact down to the decimal point.

The problem is that these policies always has unintended consequences, you use your blunt instrument to achieve your primary aim...but then other stuff happens. I get that we need to give economists jobs...but can't they just do it somewhere else?

Rather than tinkering with prices, why not focus on exactly why these people are making these choices? The govt has had long enough. And, from what I have read, NHS Scotland just whine about poverty (and now austerity the bogeyman de jour). We have known for years (over a decade iirc) that these effects still exist after income (rich people in Scotland die faster than in England too). Maybe that is a link worth examining: doctors playing politics and patients with poor life expectancy? Ineffective policy-makers (there is little evidence that the govt are particularly competent in anything other than railing against "Westminster")? Ineffective managers in the NHS?

DanBC3• 7 years ago

England doesn't have this policy

...yet, but it's probably coming.

We know that pricing works to change behaviour. We see this with tobacco, plastic bags, sugary drinks, alcohol.

It works, and it works really well.

Ideally the increased revenue would be hypothecated to alcohol treatment, but hypothecation is a tricky topic for some reason in the UK.

hogFeast3• 7 years ago

We know that pricing works to change behaviour.

Wut? That makes no sense. What we know is: higher prices of a certain product will cause consumption of that product to fall. Will it happen every time? No. And you don't necessarily know if it is going to change behaviour in the way you want (again, that is the kind of policy control freakery that has, generally, not worked very well but was so beloved of New Labour/Cameron). And it may have unintended consequences. There is no stone tablet inscribed with "price is everything" that the world must obey (although that stone tablet may certainly exist at the UoC).

And you missed the point. If England doesn't have this, and alcohol-related deaths are lower is it reasonable to conclude that other stuff is going on (the fact that Scotland has much lower life expectancy would suggest that this is a reasonable conclusion).

There is no "increased revenue" (apart from a one-time duty gain...presumably). It is just minimum pricing.

Hypothecation isn't a tricky topic, it hasn't been commonly used in govt finance globally since the late 19th century (and this term usually means hypothecating govt revenues to a creditor). If you mean reserving the proceeds of a tax for a certain use though, that happens very commonly in the UK (the reason people, usually, talk about this in the UK is because some edgelords have a problem that national insurance is allocated to the NHS whilst the NI "fund", there is no fund in a financial sense, says that the money can't be spent that way).

smileypete• 7 years ago

We know that pricing works to change behaviour.

Only to those in lower socio-economic groups materially affected by the change in prices.

So in one sense it's really just exerting more control over the poorer groups of society.

clucas2• 7 years ago

Serious question: what if the answer to "why these people are making these choices" turns out to be "culture"? As in, this is the way lots of big Scottish people have behaved in front of lots of little Scottish people for generations, and absent any opprobrium from the rest of society (which is something this law provides, in addition to its purely economic effect), it will continue that way for the foreseeable?

At that point would it be reasonable for Scotland, as a society, to decide to put its thumb in the scale through a measure like the one discussed in the article to try to reduce the harm?

Note: I've never been to Scotland, don't know any Scottish people, and certainly don't have my finger on the beating pulse of Scottish culture, so the above is purely a hypothetical! I'm just always curious to see how people who emphasize the economic causes of problems think about possible non-economic factors.

hogFeast3• 7 years ago

I am not emphasising the economic causes. I am saying precisely the opposite: this is a public health issue being solved by a civil servant like it is a problem in an economics textbook.

And yes, the issue is cultural. But that doesn't really matter either way (and if the issue is cultural then you can't solve it by increasing costs any way...you are just taxing people who have a problem).

pjc503• 7 years ago

Culture, and also despair. Perhaps similar to the US opiate crisis.

There are a lot of people in the UK who drink "too much", and a general distribution of people genetically predisposed to addiction. To drink yourself to death requires something more, usually falling off the edge of society. People who feel economically and socially unwanted, growing up in a "hard" culture.

Glasgow and Dundee in particular were cities of the Empire. When that came to an end in 1950 onwards there was a huge spike in unemployment, and a lot of the traditional heavy industries gradually left. This left a huge scar across both the physical infrastructure of Scotland (run down housing) and its culture. Trainspotting isn't exactly a documentary but it's a culturally appropriate portrait of how things were.

This is gradually changing as the country acquires 21st century industries (satellites, biosciences, video games, banking), but that on its own doesn't do a lot for the old drunks.

defertoreptar• 7 years ago

Glasgow has had a 21.5 per cent reduction in alcohol-related deaths from 2017 to 2018 - down from 186 to 146.

They really should be tracking all alcohol and drug-related deaths instead of pretending that we live in a world free of negative externalities.

DanBC3• 7 years ago

Why do you think they're not tracking drug related deaths?

https://www.nrscotland.gov.uk/statistics-and-data/statistics...

magashna• 7 years ago

Then they should note that drug related deaths went up by 27% from 2017-18

https://www.nrscotland.gov.uk/files//statistics/drug-related...

sparkzilla• 7 years ago

The total deaths went down by 40? How many of them can be directly attributed to this policy?

ck4253• 7 years ago

Is it not a bit soon to be drawing conclusions? Also there are so many other factors involved. I'm a scotsman and I'm personally not a fan of this law, nor the 10am-10pm licensing laws. They're blunt instruments that fail to tackle the root causes. I'm not saying they don't work or that they're not relatively easy to implement but I wouldn't be surprised if we soon see an increase in deaths from other drugs.

bArray2• 7 years ago

Agreed, correlation is not equal to causation. I think alcohol, drugs, mental illness and suicide should all be looked at together (at the very least). I suspect they might be just moving the problem elsewhere. Of course their statistics on drugs abuse will be approximations because people won't want to share their illegal habits.

I was told a funny story from my Russian friend where they introduced some law to prevent people buying hard liquor after 10pm to curb alcoholism. He was quite amused to see people running into the shop at 9:55pm with a trolley and back out just before 10pm with a trolley full of hard liquor.

wastedhours• 7 years ago

10am-10pm licensing laws

I didn't know this was a thing until going to Edinburgh for the first time a couple of years ago. The queue and item makeup at 9.45 made me see the flaw in this plan quite quickly.

dboreham• 7 years ago

Ugh. Now it's like England. I didn't know that either but I suppose because I'm old I've not tried to drink after 10pm recently.

Someone1234• 7 years ago

How should they tackle the "root cause?" It is fine to criticize the existing solutions, but this isn't offering a counter proposal that could be used when they're scrapped (and until this proposal exists and comes on-tap, they're better than nothing).

cptskippy3• 7 years ago

Well here in America we don't pass regulatory laws until there's a proven solution that has consensus from all parties.

ck4253• 7 years ago

The root causes vary, but include mental health issues and poverty in general. We should instead focus on those issues more.

The main alcohol related root cause is the culture of binge drinking. The way to tackle that is to create and encourage a culture of moderate drinking. Change licensing laws to make it easy for families to go to pubs for example.

tomjen32• 7 years ago

Jordan Peterson had a really good point when asked about alcohol and drugs, and he said the question should be why aren't we all doing them? His proposed solution to that was that people had to have some specific thing in their lives, that was powerful enough that it was more important to them than alcohol.

It is like societies response to suicide prevention: put up a fence, don't make the people who want to jump not want to jump.

tryitnow• 7 years ago

I actually support anything that makes alcohol harder to get, but I agree it's too soon to draw a conclusion.

I would be interested in seeing if there's been a decline in domestic violence and other forms of crime that have a strong historical relation with alcohol consumption.

My bet is that there's no such evidence.

I'm also curious to see how much variation in deaths there are year over year. Maybe 20% changes aren't uncommon, in which case this study is just picking up noise and no signal.

I'm also curious why they just don't implement a tax instead of minimum pricing, that way they could take that revenue and dedicate it to alcohol-related problems, at least somewhat offsetting the alcohol's cost to society.

Symbiote3• 7 years ago

I think they chose this method because Scotland isn't able to change the alcohol duty; that's set by the UK to be equal everywhere.

epicureanideal4• 7 years ago

I'd also be interested to see what the correlation is on family violence for different kinds of alcohol -- beer versus liquor versus wine for example.

hidiegomariani• 7 years ago

“May have”

reportgunner• 7 years ago

"may have" so it really hasn't ?

How do you read the title ?

Glasgow has had a 21.5 per cent reduction in alcohol-related deaths from 2017 to 2018 - down from 186 to 146

Yep.

epicureanideal4• 7 years ago

One year with numbers that small doesn't prove it yet though. Maybe they're just exited about the possibility of another referendum on Scottish independence. Who knows, with this data.

RichardHeart• 7 years ago

"Minimum unit pricing" Just means making alcohol more expensive. Headline from 6-19-2019 "Alcohol sales in Scotland hit 25 year low after minimum unit pricing introduced." Here's their governments website: https://www2.gov.scot/Topics/Health/Services/Alcohol/minimum...

ApolloFortyNine• 7 years ago

Japan is sitting at .25 deaths per 100k without any such law. [1]

Sounds like this is a case of "law of small numbers." The deaths dropped by 40 in a single year in a single city? 40 people? Does that not see drastically small to use to back something like this up?

I only thought of Japan because they sell alcohol (beer and sake) in vending machines there. Doesn't really get much easier to buy than that. And alcohol is popular there, it's not as if it's a country with prohibition.

[1] https://www.worldlifeexpectancy.com/cause-of-death/alcohol/b...

VangelicSurgeon• 7 years ago

I haven’t seen alcohol vending machines here in Tokyo in many years, however you are correct that alcohol is cheap and easily available. You can buy a 330ml can of 9% alcohol drink called Strong Zero at the supermarket for close to ¥100. Many restaurants offer ‘all you can drink’ specials for as little as ¥1200 for two hours.

I’m actually surprised that alcohol related deaths are so low.

sushid• 7 years ago

Just travelled to Osaka and I can confirm They have vending machine with alcohol here although I literally only found one so far in my trip.

Minimum unit pricing may have helped reduce alcohol-related deaths in Glasgow

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