Statistics from the National Records for Scotland have recorded an over 10% decrease in alcohol-specific deaths in 2019. This is the first data a full year after Scotland’s historical minimum unit pricing (MUP) policy came into force.
In this article we delve into what the decrease means for MUP and the historical shifts in alcohol use and related harm in Scotland.

Statistics released by the National Records for Scotland show that alcohol-specific deaths decreased from 1,136 in 2018 to 1,020 in 2019. This is 116 deaths less or a 10.2% fall in alcohol-specific deaths. This is the first data on alcohol-specific deaths since a full year after Scotland implemented the MUP policy setting a 50 pence minimum price per unit of alcohol.

Alcohol deaths decline
Scotland sees a 10.2% fall in alcohol-specific deaths from 2018 to 2019.

It must be noted that these data only account for alcohol-specific deaths. This means that deaths caused directly by alcohol such as alcoholic liver disease are reflected by the latest statistics. However, alcohol is known to contribute to a large number of diseases such as cardiovascular disease, cancer, and others. According to the 2019 Global Burden of Disease Study alcohol caused  a total of 3,177 deaths in Scotland.

Historical alcohol harm

Scottish alcohol harm is massive, rooted in the country’s pervasive alcohol norm. Movendi International has previously reported about the alcohol burden in Scotland.

In Scotland alcohol harm and resulting deaths grew rapidly with the advent of supermarket sales of alcohol. The change can be seen in the statistics from the National Records of Scotland.

Graph: The Herald Scotland, Data: National Records of Scotland

Analysis by The Herald shows that between 1979 and 1992, the number of alcohol-specific deaths rose only slightly, from 389 to 410. Then within the next 14 years the figure grew rapidly, peaking in 2006 with 1417 deaths.

The increase in deaths coincides with rising off-trade alcohol sales along with the increasing supermarket sales of alcohol. This made alcohol more affordable in all of the United Kingdom (UK). By 2018, alcohol was 64% more affordable than 1987.

While this trend of increasing alcohol harm and deaths is similar in all of the UK, Scotland was particularly hard hit. Among men aged 45 to 64 years, the mortality rate from liver disease in Scotland in 2006 was more than double that seen in England and Wales.

The 1990s also saw alcohol being normalized as any other commodity and sold next to other goods in supermarkets. This led to price wars, cheap and package offers and other marketing strategies by alcohol pproducers to push as much alcohol from their brand on people.

Additionally selling alcohol with other goods exposes children to alcohol harm and normalizes alcohol from a young age which could lead to later harm. Recently alcohol prevention advocates have started calling on the Scottish government to separate alcohol in supermarkets again to save children and youth from alcohol harm – a policy that was recently introduced in Ireland.

Customer practice changed in the 1990s. Alcohol moved out from being in a separate bit of the shop – incidentally something we’re pushing to be brought back – to being displayed on the mainstream shelves, where it became subject to price wars,” said Dr. Peter Rice, chair of Scottish Health Action on Alcohol Problems (SHAAP), as per The Herald.

Much of what we’ve been pushing for in the last 10 to 15 years has been driven by that analysis: that supermarkets have been the driver.”

Dr. Peter Rice, Chair, Scottish Health Action on Alcohol Problems (SHAAP)

The push for MUP

The rising alcohol harm and deaths led alcohol prevention advocates and public health experts to call for the government to introduce the minimum unit pricing (MUP) policy. The MUP policy setting a 50 pence minimum price per unit of alcohol has been in force in Scotland since May 1, 2018.

This minimum unit pricing policy was hard won and is constantly threatened by Big Alcohol.  The Scotch Whiskey Association who lost their case against the minimum unit price in Scottish courts had applied to appeal in the UK Supreme Court but ultimately lost in their tour through Scottish, British and European courts.

Since the introduction of MUP reports have been coming in of reduced alcohol sales, decreasing alcohol consumption and improved health in Scotland.

New data: cautions optimism

The modeling done prior to the introduction of MUP by the University of Sheffield team who developed the Scottish MUP model, estimated a 7.4% fall in overall alcohol-related deaths across 20 years. These are not alcohol-specific deaths only but all deaths related to alcohol.

The new data suggest that MUP has exceeded expectations on the short-term with a 10.2% reduction in alcohol-specific deaths within one year.

The actual impact of MUP on the reduction in all alcohol-related deaths is probably much higher, therefore, this data likely underestimates the reduction in alcohol deaths as a result of MUP.

Looking more in depth into the data reveals:

  • Deaths from alcoholic liver disease – the largest contributor to alcohol specific death in the UK – reduced substantially by 10.6% since 2017 (decreasing both in 2018 and 2019).
  • Alcohol-specific deaths fell the most among those between 45 – 74 years of age.

The data from the first year looking only into alcohol-specific deaths show that MUP is promising. Considering that clinical evidence indicates that improvements to health from reductions in alcohol consumption can sometimes take years, the MUP policy would prove even more effective in the long-term in improving Scottish health.

For now, Colin Angus, Senior Research Fellow at the University of Sheffield says that the data calls for cautious optimism that MUP is working as it should.

I think it’s fair to say that these numbers are good news, and provide cautious optimism that the reductions in alcohol consumption we’ve seen in Scotland are beginning to be reflected in improvements in health. Indeed, if anything these numbers suggest that our modelled estimates of the impact of MUP might be on the conservative side,” said Colin Angus, Senior Research Fellow at the University of Sheffield, as per Alcohol Focus Scotland.

These figures are a really encouraging sign, but they represent only a part of the overall picture, and are, by their nature, subject to some random fluctuation from year to year.”

Colin Angus, Senior Research Fellow, University of Sheffield

We know there is still work to be done but this is very encouraging for minimum unit pricing’s long-term strategy,” said Dr. Lewis Morrison, Chair of the British Medical Association in Scotland, as per The Herald.

Dr. Lewis Morrison, Chair, BMA Scotland

More to be done

The MUP data show that Scotland is moving in the right direction in preventing and reducing alcohol harm but public health experts and advocates say there is still a long way to go.

We are cognisant that the alcohol-specific deaths definition does not include deaths where alcohol is known to be a contributory factor – such as deaths due to cancer, suicide and road accidents,” said a spokeswoman for the Scottish Health Action on Alcohol Problems (SHAAP), as per The Herald.

There is therefore still much work to be done to continue reducing alcohol-related harm and mortality in Scotland, which remains high.”

Scottish Health Action on Alcohol Problems (SHAAP)

Alison Douglas, chief executive of Alcohol Focus Scotland stressed that the changes shown in data were within normal range of fluctuation and called for further improvements to alcohol policy in Scotland and for the implementation of further solutions, such as marketing restrictions which is a World Health Organization recommended and scientifically proven, cost-effective measure to reduce the alcohol burden.

Public Health Scotland has been evaluating the MUP policy in Scotland since its establishment. Different areas are evaluated according to the evaluation plan. These results provide more detail into the impact of MUP and the future evaluations are expected to provide details on long-term impact of MUP.


Alcohol Focus Scotland: “Alcohol Deaths and Minimum Unit Pricing

The Herald: “Alcohol deaths in Scotland fall 10% in first year of minimum pricing

The Herald: “Why the 1990s marked a dangerous wrong turn in Scotland’s relationship with alcohol