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Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland

Categories: Office for National Statistics, Health & wellbeing, Impact, Policy, Potential

26 September 2023

Evaluating the impact of alcohol minimum unit pricing on deaths and hospitalisations in Scotland

This research used data made available via the Office for National Statistics (ONS) Secure Research Service, which is being expanded and improved with ADR UK funding.

Authors: Dr Grant Wyper, Catriona Fraser, Clare Beeston, Lucie Giles (Public Health Scotland), Professor Daniel Mackay, Professor Jim Lewsey (University of Glasgow) and Dr Mark Robinson (University of Queensland)

Date: March 2023

Research summary

In May 2018, Scotland implemented a minimum unit price for alcoholic drinks sold in licensed premises. A research study using secure data estimated that this policy significantly reduced deaths wholly attributable to alcohol consumption by 13.4%. On average, it averted 156 deaths wholly attributable to alcohol consumption each year.

This study received significant media coverage, and the attention of the Public Health Minister for Scotland. In August 2023, senior UK public health published a letter of support for the main research finding.

Alcohol minimum unit pricing was implemented as part of a comprehensive strategy to reduce levels of alcohol consumption in Scotland. The policy aimed to reduce health and social-related alcohol harms in Scotland, given their disproportionate scale compared to the rest of the United Kingdom and other western European countries.

This research used routine administrative data to estimate the impact of alcohol minimum unit pricing on deaths and hospital admissions attributable to alcohol consumption in Scotland. It analyses data collected during the first 32 months of the policy.

Data used

The project accessed death records for England through the ONS Secure Research Service. Scottish death records were sourced from the National Records of Scotland.

Researchers also used hospital admissions data. Scottish data was sourced based on individuals admitted to hospital as a general inpatient or day case from the Scottish Morbidity Record 01 (SMR01) dataset. The data also included mental health inpatient and day cases from the SMR04 dataset. English hospital admissions data was sourced from the Hospital Episode Statistics dataset, provided by NHS Digital. This data did not include an equivalent component of mental health inpatient and day cases.

Methods used

Researchers used controlled interrupted time series methods - a type of method used to assess the effects of interventions, such as policy changes, by comparing the data before and after the intervention was introduced. They assessed whether the implementation of minimum unit pricing was associated with a change in the rate of alcohol-attributable deaths and hospital admissions.

Scotland was used as the intervention group, with England acting as the control group where minimum unit pricing has not been implemented. The study period was 1 January 2012 to 31 December 2020. This provided data for more than six years before and more than two and a half years after the implementation of minimum unit pricing in Scotland.

The research team used several methods to strengthen the interpretation of the impact of the policy, including:

  • Employing multiple approaches to incorporate data for England - the geographical control - into the analyses
  • Adjusting all statistical models for underlying seasonal and secular trends, as well as the Covid-19 pandemic and related restrictions
  • Performing a range of sensitivity analyses to test the robustness of the results
  • Shortening the study period following minimum unit price implementation to assess the impact of minimum unit pricing on alcohol-attributable deaths and hospital admissions  prior to the Covid-19 pandemic.

Research findings

After more than two and a half years of implementation, researchers estimated that minimum unit pricing significantly reduced deaths wholly attributable to alcohol consumption by 13.4% in Scotland. Researchers estimated that an average of 156 deaths wholly attributable to alcohol consumption were averted each year over the study period following the implementation of the policy.

Hospital admissions for conditions wholly attributable to alcohol consumption were estimated to have reduced by 4.1%. An estimated average of 411 hospital admissions wholly attributable to alcohol consumption have been averted each year over the study period following the implementation of minimum unit pricing.

The research demonstrated that minimum unit pricing has been effective in reducing levels of alcohol-attributable harm, with the greatest reductions occurring in the 40% most socio-economically deprived areas in Scotland. This suggests that the policy acted to reduce inequalities in alcohol-attributable deaths and hospital admissions.

Research impact

The research received widespread media coverage. Maree Todd, Scotland’s Public Health Minister at the time, said of the research: “I am very pleased with these findings which point to more than 150 lives a year being saved and 411 fewer hospital admissions, further underlining the value of our world-leading minimum unit pricing policy which has helped reduce alcohol sales to their lowest on record. We’re determined to do all we can to reduce alcohol-related harm, which is one of the most pressing public health challenges that we face in Scotland.”

In August 2023, several senior UK public health jointly published a letter of support for the main research finding in The Lancet.

Research outputs

Publications and reports

Blogs, news posts, and videos

Presentations and awards

About the ONS Secure Research Service

The ONS Secure Research Service is an accredited trusted research environment, using the Five Safes Framework to provide secure access to de-identified, unpublished data. If you use ONS Secure Research Service data and would like to discuss writing a future case study with us, please ensure you have reported your outputs here: Outputs Reporting Form.

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