The Cost of Alcohol:

1

The Cost of Alcohol The Advocacy for a Minimum
Price per Unit in the UK
Martin Hagger Curtin University, Australia
Adam Lonsdale University of Nottingham, UK
Rob Baggott, Demontfort University Gillian Penny,
Northampton University Matt Bowen, OurLife
2
Alcohol, price and health

• Annual cost to taxpayers of excessive alcohol
  consumption is estimated 7.3 billion (DoH, 2009)
• Price increases have been shown to be effective
  in reducing alcohol consumption (Wagenaar et al.,
  2009)
• Focus on price has been oriented toward increased
  duty and leads to uniform rise in price
• Disparity between prices at high and low end of
  the alcohol market
• Heavily discounted/low-cost alcohol sales
  prevalent
• Discounting trends in the retail industry (e.g.,
  BOGOF, happy hours)
• Changes in drinking patterns (e.g., binge
  drinking, pre-loading)
• Patients with alcohol-related harms purchased
  more of their weekly consumption very cheaply
  compared to wider drinkers

3
Alcohol, price and health

• Pricing policy based on strength has been
  proposed price based on units of alcohol
• A minimum price of 50 pence-per-unit (ppu) would
  reduce consumption by 6.9 (Brennan et al., 2008)
• Estimated savings of 9.7 billion in costs
  associated with excessive alcohol consumption
• Minimum price also has support from medical
  community (Donaldson, 2009) and advocacy groups
  (NICE, 2010)
• Proposal of 45ppu tabled in Scottish Executive
• Little evidence on public perceptions of minimum
  price

4
The Present Research

• Research consistently shows public support for
  treatment and information rather than price
  change (Greenfield et al., 2004)
• Public likely to be opposed to minimum price
• No formal investigation to date on public
  attitudes and beliefs toward the policy
• Aims
• Investigate knowledge, attitudes and beliefs with
  respect to minimum price
• Under what conditions are people more likely to
  endorse minimum price?

5
Method

• Research Design Qualitative investigation using
  focus groups
• Participants N 217 in 28 focus groups from one
  of ten target groups

Sixth form students University students
Blue-collar workers White-collar workers
Unemployed Older adults
African-Caribbean South-Asian
Rural community Hazardous drinkers

• Procedure Semi-structured interview schedule
  with a facilitator (90-mins typical length)
• Explanation of policy
• Generate discussion of pertinent issues
• Opinions on minimum price and implementation
• All participants encouraged to contribute

6
Method

• Data analysis Qualitative analysis using
  inductive thematic content analysis of
  transcribed interview data
• NVIVO software used to categorise and organise
  data
• Main emergent themes and sub-themes identified
• Multiple readings using an iterative approach
  until theme saturation achieved
• Theory building rather than theory testing
• Advantageous in areas where little knowledge
  known/available

7
Results Themes

• Minimum price is unlikely to be effective
• Where theres a will, theres a way
• Wont work for heavy or dependent drinkers
• Perceived failure of previous pricing policy
• Minimum price will have only a limited effect
• Change peoples choice of drink
• Affect binge drinking
• Affect young people
• Short-term reductions
• Long-term effects

8
Results Themes

• Dislike for minimum price policy
• Punishing the moderate or sensible
• Restriction on personal freedoms
• Unfairly targets the poor
• Theres more to alcohol reduction than price
• There must be a better way than this
• Suspicion of government motives
• Support for minimum price
• Need to curb excessive alcohol consumption
• Improved public health
• It doesnt bother me, I dont drink that much

9
Results Major Findings

• Major Finding 1.
• Participants expressed largely negative views of
  a minimum price per unit policy
• Scepticism of its effectiveness
• Disliked it unfair to sensible drinkers
• Might create or exacerbate other existing social
  problems (e.g., crime and drug abuse)
• Misconceptions surrounding the policy
• Major Finding 2.
• A number of participants accepted that a minimum
  price per unit might be necessary tackle excess
  alcohol
• The need for action
• Prospect of improved public health particularly
  in the young
• Perceived not to have significant effect on their
  own habits

10
Results Major Findings

• Major Finding 3.
• Suggested ideas that would make minimum price
  more acceptable
• Introduce as part of a broader package of
  policies to address excessive alcohol consumption
• Revenue generated by higher prices should be used
  to fund other interventions
• Little evidence that participants views of
  minimum price and its acceptability varied across
  gender and age groups.

11
Summary and Conclusion

• Participants were largely sceptical of the
  minimum price policy and expressed doubts
  regarding its effectiveness
• The policy would be more acceptable if introduced
  as part of a wider strategy
• Participants objections were the result of 4
  main issues
• Misunderstanding of the policy itself
• Equating the policy with other pricing policies
  (e.g., duty)
• Failure to recognise the public health
  significance of small reductions in alcohol
  consumption
• Preoccupation with the effects on heavy and
  dependent drinkers
• Policymakers introducing a minimum price policy
  should
• Focus on dispelling the misconceptions
• Highlighting the key features of the policy
• Introduce in conjunction with other measures

12
Thank yoU
www.alcoholresearchuk.org
www.martinhagger.com