Effects of Minimum Unit Pricing for Alcohol in South Africa Across Different Drinker Groups and Wealth Quintiles: A Modelling Study
Abstract
Objectives
To quantify the potential impact of minimum unit pricing (MUP) for alcohol on alcohol consumption, spending and health in South Africa. This study provide these estimates disaggregated by different alcohol user groups and wealth quintiles.
Design
The researchers developed an epidemiological policy appraisal model to estimate the effects of MUP across sex, alcohol user groups (low-dose, occasional binge, heavy) and wealth quintiles. Stakeholder interviews and workshops informed model development and ensured policy relevance.
Setting
South African alcohol using population aged 15+.
Participants
The population (aged 15+) of South Africa in 2018 stratified by alcohol user group and wealth quintiles, with a model time horizon of 20 years.
Main outcome measures
Change in standard drinks [alcoholic beverages] (SDs) (12 g of ethanol) consumed, weekly spend on alcohol, annual number of cases and deaths for five alcohol-related health conditions (HIV, intentional injury, road injury, liver cirrhosis and breast cancer), reported by alcohol user groups and wealth quintile.
Results
This study estimates an MUP of R10 per SD would lead to an immediate reduction in consumption of 4.40% (−0.93 SD/week) and an increase in spend of 18.09%. The absolute reduction is greatest for heavy alcohol users (−1.48 SD/week), followed by occasional binge alcohol users (−0.41 SD/week) and low dose alcohol users (−0.40 SD/week). Over 20 years, the study estimates 20,585 fewer deaths and 900,332 cases averted across the five health-modelled harms. Poorer alcohol users would see greater impacts from the policy (consumption: −7.75% in the poorest quintile, −3.19% in richest quintile). Among the heavy alcohol users, 85% of the cases averted and 86% of the lives saved accrue to the bottom three wealth quintiles.
Conclusions
This study estimates that MUP would reduce alcohol consumption in South Africa, improving health outcomes while raising retail and tax revenue. Consumption and harm reductions would be greater in poorer groups.
