MINIMUM unit pricing did not reduce alcohol consumption among the heaviest drinking men, young men, or males living in more deprived areas of Scotland, according to new analysis.
Researchers said the Scottish Government-led policy had been "strongly motivated by an interest in decreasing health inequalities through a reduction in alcohol consumption among the heaviest and most vulnerable drinkers", but that the evidence suggests "this goal may not be fully realised".
The findings, published today in the journal BMJ Open, are based on comparing self-reported weekly alcohol intakes between tens of thousands of adults in Scotland and England who participate in the ongoing Kantar Worldpanel’s Alcovision survey, before and after the 50 pence-per-unit threshold was introduced in Scotland in May 2018.
READ MORE: Scots still drinking too much as fall in consumption stalls
Kantar participants provide detailed data on their drinking during the previous seven days, including details on brands and volumes drunk.
Consumption covers alcohol purchased on-trade, in venues such as pubs and restaurants, and off-trade.
The research was led by Professor Peter Anderson, of Newcastle University's Population Health Sciences Institute, in collaboration with colleagues in Canada, Netherlands, Germany and Spain.
Overall, the researchers found that MUP was associated with a 6.2 per cent drop in average alcohol consumption among Scottish drinkers compared to those in England.
The reduction was "largely driven by women", whose cut in intake was roughly two and a half times higher than male drinkers. Proportionately, older women cut back consumption more than younger women.
The drop in consumption was also "larger for heavier drinkers than for lighter drinkers, with the exception of the top 5% of heaviest drinking men for whom there was an increase in consumption associated with the introduction of MUP".
Among this group, consumption increased by 10% on average.
For men under 32, and those living in the two fifths of neighbourhoods with the highest deprivation scores, "there was no decrease in consumption associated with MUP".
READ MORE: Push to increase minimum price of alcohol amid 'devastating' increase in deaths
In contrast, minimum pricing was associated with a reduction in alcohol intake among older males and men living in more affluent areas.
The authors note that the findings for the heaviest 5% of drinkers are puzzling, stating: "Several studies have found that overall, heavier drinkers - including people with alcohol use disorders - react less to price than the general population...However, while this may explain lower reductions, it cannot explain an increase in consumption."
They add that the results could "imply a diminished impact on alcohol-attributable hospitalisations and mortality, which have been shown to be strongly associated with heavy drinking in men and in those of lower socioeconomic status".
However, they also caution that the results are observational, are not necessarily representative of the population as a whole, and do not prove MUP as the cause of either increased or reduced alcohol consumption.
Covid-related lockdowns were blamed for "polarising" alcohol consumption between moderate and heavy drinkers, and contributing to 1,190 alcohol-specific deaths in Scotland during 2020 - the highest since 2008.
A report by Public Health Scotland in June also found that problem drinkers had cut back on food and heating to continue to fund their alcohol habit when prices increased as a result of MUP.
There is also some evidence that reductions in overall consumption which followed MUP may have stalled, with 18.1 units sold per adult per week in Scotland during 2021 - unchanged from 2020, and still in excess of the recommended maximum of 14 units per week.
READ MORE: Has minimum unit pricing failed? The picture is not black and white
Prof Anderson and colleagues stressed that more analysis is needed to gauge MUP's potential impact for other countries, but concluded that "if indeed the findings of our study are corroborated, then additional and/or different pricing mechanisms may need to be considered”.
A Scottish Government spokeswoman said: “An independent evaluation of minimum unit pricing is currently being carried out by Public Health Scotland and is due to be completed in 2023.
"Any relevant studies will be considered as part of this, including this latest research published in the BMJ.
“It is important that this work is carried out thoroughly to ensure we have as much evidence as possible to determine whether we continue Minimum Unit Pricing.
“A review of the level current level of 50p per unit is also underway and any changes would be subject to parliamentary scrutiny and approval.”
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