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Minimum Unit Pricing to be considered as Substance Misuse Strategy development continues

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Friday 18 October 2019

The Drug & Alcohol Strategy Action Plan 2015 - 2020 includes the aim of reducing the availability of cheap, heavily-discounted alcohol and irresponsible promotions through increases in duty on alcohol products.

While there is not, currently, a specific direction on the setting of excise duty on alcohol, since 2014 the Policy & Resources Committee has recommended an increase of 5% per annum. This has similarly been proposed within the 2020 Budget.

While it is recognised that excise duties can go some way in discouraging excessive consumption and changing individual choices, it can be somewhat of a blunt instrument, notwithstanding steps over recent years to introduce higher excise duty rates on very high strength alcohols, when compared to more targeted policies such as Minimum Unit Pricing ("MUP").

MUP, as the name suggests, sets a minimum price below which a unit of alcohol cannot be sold. Evidence shows that, internationally, as alcohol has become more affordable, alcohol-related harms have increased. Alcohol is the seventh most important global risk factor for premature death and accounts for a wide range of acute and chronic conditions, for example certain cancers and liver disease.

A MUP policy is specifically targeted at addressing the cheapest alcohol. It was implemented in Scotland at 50 pence per unit in May 2018 and is due to come into force in Wales in March 2020.

A report published on the implementation of MUP in Scotland showed that owing to the higher prices typically found in the on-trade sector (pubs, clubs and restaurants), these businesses had been largely unaffected by the implementation of MUP. However, encouragingly, assessment of the off-trade sector (convenience stores and supermarkets) were largely compliant with MUP legislation. This is a critical first stage in the implementation. Early modelling suggested a reduction in alcohol consumption in Scotland following the introduction of 50 pence per unit MUP would be around 3.5% for each drinker annually. This would correspond in the 20 years after implementation to more than 2,000 fewer deaths, and around 39,000 fewer hospital admissions for Scotland as a whole. However, there was an observed reduction of up to 7.6% in purchases, which were more than double the modelling based estimates. This suggests that the health benefits could be substantially greater.

The Committee for Health & Social Care, since assuming responsibility for the Drug & Alcohol Strategy in 2017, has sought to best understand the steps that government, and the wider community can take to reduce the harms associated with alcohol misuse. This has included consideration of the current approach towards excise duty and the impact of a MUP. Research conducted earlier this year illustrated that, given the relatively high baseline prices locally, were a MUP set locally at 50 pence per unit, it would affect 49% of products. Notably, it would increase the cost of the cheapest products, typically cheap ciders, by around 20%. It would only be by increasing the MUP to 70 pence per unit that the majority of the products sampled in the research would be affected.

It is clear that no individual step can, in isolation, address alcohol misuse and to be successful a full suite of initiatives are needed. This would involve incorporating fiscal changes, support, education and awareness. MUP should be regarded as one component of the overall strategy. Other approaches to reducing the availability of low cost alcohol should therefore also be considered. For example, prior to MUP Scotland had banned multi-buys and special offers which was another example of reducing the amount of low cost alcohol.

This is an approach that we could consider locally. However such a decision should be made in a structured way to ensure the right policies are being adopted in the right way, for the right reasons. Work is currently ongoing to explore the unification of the Bailiwick Drug and Alcohol Strategy and the Tobacco Control Strategy into a single Substance Misuse Strategy, recognising the benefits of a single, coordinated approach. A joint strategic needs assessment is currently ongoing to inform the Strategy's development. Through research, professional expertise and engagement with the community, the Committee will be able to define need, make evidence based recommendations as to the Strategy's area of focus and monitor progress. It is anticipated that proposals will be brought before the Assembly in the first half of 2020.

Deputy Soulsby, President of the Committee for Health & Social Care said:

"Through the Partnership of Purpose, the States of Guernsey unanimously approved a "health in all policies" approach and it is vital that Committees work together to create an environment which best supports health and wellbeing. It is premature at this stage to determine whether this includes the introduction of a MUP but careful consideration will be paid to this, and other options, as part of the development of a Substance Misuse Strategy."

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