Minimum prices for alcohol fail to curb intake by most vulnerable, study finds

British Medical Journal survey may pose questions for public health policy in context of take-home drink sales in Ireland rising since introduction of minimum unit pricing

Take-home alcohol sales rose 11 per cent compared to pre-pandemic levels despite the minimum pricing law. While this would appear to raise question marks, analysts said more time was required to ascertain the impact of the public health measures. Inflationary pressures have led some people to drink at home rather than in bars and restaurants. Photograph: Ina Fassbender/AFP
Take-home alcohol sales rose 11 per cent compared to pre-pandemic levels despite the minimum pricing law. While this would appear to raise question marks, analysts said more time was required to ascertain the impact of the public health measures. Inflationary pressures have led some people to drink at home rather than in bars and restaurants. Photograph: Ina Fassbender/AFP

Minimum alcohol pricing does not necessarily curb consumption among the heaviest and most vulnerable drinkers, new research has found.

With take-home sales of alcohol in Ireland having increased since minimum unit pricing (MUP) was introduced at the beginning of the year, UK research has identified possible shortfalls in policy outcomes.

The study, published by the British Medical Journal in its open access section, BMJ Open, found while MUP was associated with large reductions in consumption among heavier drinkers overall, there were some caveats.

“Women, who are less heavy drinkers in our data and in almost all surveys worldwide to date, reduced their consumption more than men,” the researchers found.

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“Second, the 5 per cent of heaviest drinking men had an increase in consumption associated with MUP; and, third, younger men and men living in more deprived areas had no decrease in consumption associated with MUP.”

The BMJ study examined the effects of the policy in Scotland, drawing on data from there and from parts of England.

MUP in Scotland was set at 50 pence per unit (8g) of pure alcohol (ethanol) sold from May 2018, as part of a larger national alcohol strategy targeting drinkers at the greatest risk of harm.

Data for the study was taken from the KWP Alcovision survey, a diary of weekly alcohol consumption which annually samples about 30,000 adults in the UK.

Weekly consumption

The analysis included diaries completed by 106,490 respondents (53,347 women and 53,143 men) from England and Scotland between 2015 and 2018.

When compared with residents in England, Scottish MUP was associated with a drop in reported weekly consumption of just under 6g a week, or a fall of just over 6 per cent.

The reductions were larger for women (8.6g a week) than for men (3.3g a week), and were greater among heavier drinkers than lighter drinkers, except for the 5 per cent of heaviest drinking men among whom consumption increased by 10 per cent.

Further analyses showed that falls in consumption were greater among older survey respondents and those living in less-deprived areas.

The study does not analyse behaviour in Ireland, which saw the introduction of MUP in January.

Under Irish regulations, an average bottle of wine cannot be sold for less than €7.40, while a can of beer costs at least €1.70. The base price of spirits also increased, with bottles of vodka or gin costing a minimum of €20.70, and whiskey at least €22.09.

Take-home alcohol sales rose 11 per cent compared to pre-pandemic levels despite the new law. While this would appear to raise question marks, analysts said more time was required to ascertain the impact of the public health measures – grocery sales in general remain higher than the comparative 2019 period, while inflationary pressures have led some people to drink at home rather than in bars and restaurants.

Meanwhile, a separate study has found that restricting salt intake too much can actually have a negative effect on some people who have suffered a common form of heart failure, despite it being recommended generally.

Research published in the journal Heart found the optimal restriction range (from less than 1.5 g to less than 3 g daily) and its effect on patients who suffer heart failure with preserved ejection fraction was not clear.

This specific condition accounts for half of all heart failure cases and occurs when the lower left chamber of the heart is unable to fill with blood.

“Over-strict dietary salt intake restriction could harm [this set of] patients and is associated with worse prognosis,” the researchers found. “Physicians should reconsider giving this advice to patients.”

Mark Hilliard

Mark Hilliard

Mark Hilliard is a reporter with The Irish Times