Representatives of leading health organisations have written an open letter to The Lancet challenging assertions by Scottish Conservative health spokesperson Dr Sandesh Gulhane that the impact of MUP in Scotland has been overstated.
The signatories – who include representatives from the BMA, the London School of Hygiene and Tropical Medicine, and the European Alcohol Policy Alliance – express concern that support for MUP could be weakened, despite ‘high-quality’ evidence that it had reduced alcohol-specific deaths in Scotland by 13 per cent. The policy is subject to a ‘sunset clause’ which means that it will lapse next year unless the Scottish Parliament renews it.
Dr Gulhane had written to the UK Statistics Authority to say that the findings in Public Health Scotland’s (PHS) evaluation report had overstated MUP’s impact, and called for a review of the report to be carried out. Of the 40 independent studies cited by the document, just eight mentioned MUP’s health implications, he said, with seven ‘inconclusive’ and the remaining study conducted by a PHS adviser.
The PHS report stated that there was ‘quantitative evidence that MUP was associated with a reduction in deaths wholly attributable to alcohol consumption, relative to England where MUP was not implemented’. Comparing trends in Scotland and England, ‘including during the pandemic when alcohol deaths were increasing in many countries, is an entirely appropriate approach,’ the open letter states. ‘This summary of MUP research is comprehensive, including interviews with individuals who fear the policy will be detrimental to them personally and or financially. The Public Health Scotland approach of emphasising population level findings is the right one for assessing population level interventions like minimum unit price. The alternatives proposed by the Scottish Conservatives are neither feasible or appropriate.’
Policy makers could be confident that there are ‘several hundred low-income people in Scotland who would have died from alcohol, who are alive today as a result of minimum unit pricing’, the letter concludes.
The PHS Scotland report did acknowledge, however, that for people with alcohol dependence there was ‘limited evidence of any reduction in consumption’, and some evidence that people with alcohol dependence on low incomes prioritised spending on alcohol over food and other essentials. Despite the introduction of MUP, Scotland’s alcohol death rate in 2021 was 1,245, the highest for almost 15 years.
Letter at www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01584-2/fulltext