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Minimum unit pricing for alcohol saves lives, so why is it not implemented more widely?

BMJ 2024; 384 doi: https://doi.org/10.1136/bmj-2023-077550 (Published 12 March 2024) Cite this as: BMJ 2024;384:e077550

Linked Opinion

Commercially driven efforts to frame alcohol harms have no place in UK health policy development
  1. Peter Anderson, consultant1,
  2. Tim Stockwell, scientist, professor emeritus and adjunct professor2 3,
  3. Guillermina Natera, scientist, director4,
  4. Eileen Kaner, professor of public health and primary care research5
  1. 1World Health Organization, Copenhagen, Denmark
  2. 2Canadian Institute for Substance Use Research, University of Victoria, Canada
  3. 3Department of Psychology, University of Victoria, Canada
  4. 4WHO Collaborating Center for Research and Training in Mental Health and Substance Abuse, Ramón de la Fuente Muñiz National Institute of Psychiatry, Ciudad de México, Mexico
  5. 5Population Health Sciences Institute, University of Newcastle upon Tyne, UK
  1. Correspondence to: E Kaner Eileen.kaner{at}newcastle.ac.uk

Minimum unit pricing (MUP) saves lives, particularly among heavy drinkers, and should be widely rolled out for the benefit of all, say Peter Anderson and colleagues

Key messages

  • Failure to implement minimum unit pricing (MUP) for alcohol is a cause of preventable death, injury, and illness

  • MUP reduces alcohol consumption among heavy drinkers and those with alcohol dependence, disproportionally benefiting people with low incomes

  • Current implementation of MUP is scarce, despite evidence that it can be a core component of comprehensive and effective alcohol policy

  • Factors beyond empirical evidence influence policy decisions on the implementation of MUP

Minimum unit pricing (MUP) for alcohol sets a price below which alcohol cannot be legally sold based on alcohol content. In Scotland, the price was set in 2018 at 50p per unit (8 g of alcohol)1 and will increase to 65p in September 2024.2 A major justification for MUP is to target cheaper, high strength alcohol, which is disproportionately purchased by people who drink heavily.1 MUP is one of a suite of alcohol pricing policies, including excise taxes,3 endorsed for implementation by all member states of the World Health Organization.4

Minimum pricing for alcohol was introduced in Ontario, Canada, soon after prohibition was repealed in the 1920s.5 Minimum prices were used to stabilise alcohol markets that were operated by government alcohol monopolies, an important source of government revenue.5 Widespread adoption across all Canadian provinces began in the 1990s,6 with evidence of public health benefits.7 Some countries have MUP for spirits, but not for all alcohol (Armenia, Belarus, Kazakhstan, Kyrgyzstan, and Russia), for which it has been difficult to evaluate a unique effect, owing to multiple policies being implemented at the same time.8

There has been considerable interest in evaluating the effects of MUP in Scotland. …

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