The impact of Scotland's minimum unit pricing for alcohol policy on people accessing services for alcohol dependence: A difference-in-difference structured interview study

Introduction: A minimum unit price (MUP) for alcohol of £0.50 per unit (1 UK unit = 10 mL/8 g alcohol) was introduced in Scotland in May 2018. Few previous studies have examined the impact of alcohol pricing policies on people who are alcohol dependent. This study aimed to evaluate the effect of MUP on people who are alcohol dependent including changes in alcohol consumption and health status, as well as potential unintended consequences.

Methods: Three waves of cross-sectional data were collected in Scotland (intervention) and Northern England (control) at 0-6 months pre-implementation then 3-9 months and 18-22 months post-implementation. The sample was N = 706 people receiving treatment related to their alcohol use. We collected structured interview data including recent drinking information via a 7-day timeline-follow-back drinking diary. Difference-in-difference analyses estimated change in indicators in Scotland compared to England at both post-implementation timepoints.

Results: The proportion of participants consuming alcohol costing on average <£0.50 per unit in Scotland decreased from 60.6% at 0-6 months prior to MUP implementation to 6.3% at 3-9 months post-implementation (p < 0.0004). There was no significant change in the indicators for alcohol consumption, severity of dependence, health status, other substance use, deprivation level or parenting.

Discussion and conclusions: The introduction of MUP in Scotland was associated with increases in the prices paid for alcohol by people with dependence and presenting to treatment services. There was no evidence of changes in their alcohol consumption or health status. There was also no evidence of harmful unintended consequences for this population.