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      Immediate impact of minimum unit pricing on alcohol purchases in Scotland: controlled interrupted time series analysis for 2015-18

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          Abstract

          Objective

          To assess the immediate impact of the introduction of minimum unit pricing in Scotland on household alcohol purchases.

          Design

          Controlled interrupted time series analysis.

          Setting

          Purchase data from Kantar Worldpanel’s household shopping panel for 2015-18.

          Participants

          5325 Scottish households, 54 807 English households as controls, and 10 040 households in northern England to control for potential cross border effects.

          Interventions

          Introduction of a minimum price of 50p (€0.55; $0.61) per UK unit (6.25p per gram) for the sale of alcohol in Scotland on 1 May 2018.

          Main outcome measures

          Price per gram of alcohol, number of grams of alcohol purchased from off-trade by households, and weekly household expenditure on alcohol.

          Results

          The introduction of minimum unit pricing in Scotland was associated with an increase in purchase price of 0.64p per gram of alcohol (95% confidence interval 0.54 to 0.75), a reduction in weekly purchases of 9.5 g of alcohol per adult per household (5.1 to 13.9), and a non-significant increase in weekly expenditure on alcohol per household of 61p (−5 to 127). The increase in purchase price was higher in lower income households and in households that purchased the largest amount of alcohol. The reduction in purchased grams of alcohol was greater in lower income households and only occurred in the top fifth of households by income that purchased the greatest amount of alcohol, where the reduction was 15 g of alcohol per week (6 to 24). Changes in weekly expenditure were not systematically related to household income but increased with increasing household purchases.

          Conclusions

          In terms of immediate impact, the introduction of minimum unit pricing appears to have been successful in reducing the amount of alcohol purchased by households in Scotland. The action was targeted, in that reductions of purchased alcohol only occurred in the households that bought the most alcohol.

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          Most cited references35

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          • Article: not found

          Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behavior change strategies.

          In an interrupted time series (ITS) design, data are collected at multiple instances over time before and after an intervention to detect whether the intervention has an effect significantly greater than the underlying secular trend. We critically reviewed the methodological quality of ITS designs using studies included in two systematic reviews (a review of mass media interventions and a review of guideline dissemination and implementation strategies). Quality criteria were developed, and data were abstracted from each study. If the primary study analyzed the ITS design inappropriately, we reanalyzed the results by using time series regression. Twenty mass media studies and thirty-eight guideline studies were included. A total of 66% of ITS studies did not rule out the threat that another event could have occurred at the point of intervention. Thirty-three studies were reanalyzed, of which eight had significant preintervention trends. All of the studies were considered "effective" in the original report, but approximately half of the reanalyzed studies showed no statistically significant differences. We demonstrated that ITS designs are often analyzed inappropriately, underpowered, and poorly reported in implementation research. We have illustrated a framework for appraising ITS designs, and more widespread adoption of this framework would strengthen reviews that use ITS designs.
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            A rapid evidence review of the effectiveness and cost-effectiveness of alcohol control policies: an English perspective.

            This paper reviews the evidence for the effectiveness and cost-effectiveness of policies to reduce alcohol-related harm. Policies focus on price, marketing, availability, information and education, the drinking environment, drink-driving, and brief interventions and treatment. Although there is variability in research design and measured outcomes, evidence supports the effectiveness and cost-effectiveness of policies that address affordability and marketing. An adequate reduction in temporal availability, particularly late night on-sale availability, is effective and cost-effective. Individually-directed interventions delivered to at-risk drinkers and enforced legislative measures are also effective. Providing information and education increases awareness, but is not sufficient to produce long-lasting changes in behaviour. At best, interventions enacted in and around the drinking environment lead to small reductions in acute alcohol-related harm. Overall, there is a rich evidence base to support the decisions of policy makers in implementing the most effective and cost-effective policies to reduce alcohol-related harm.
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              • Article: not found

              The effectiveness of tax policy interventions for reducing excessive alcohol consumption and related harms.

              A systematic review of the literature to assess the effectiveness of alcohol tax policy interventions for reducing excessive alcohol consumption and related harms was conducted for the Guide to Community Preventive Services (Community Guide). Seventy-two papers or technical reports, which were published prior to July 2005, met specified quality criteria, and included evaluation outcomes relevant to public health (e.g., binge drinking, alcohol-related crash fatalities), were included in the final review. Nearly all studies, including those with different study designs, found that there was an inverse relationship between the tax or price of alcohol and indices of excessive drinking or alcohol-related health outcomes. Among studies restricted to underage populations, most found that increased taxes were also significantly associated with reduced consumption and alcohol-related harms. According to Community Guide rules of evidence, these results constitute strong evidence that raising alcohol excise taxes is an effective strategy for reducing excessive alcohol consumption and related harms. The impact of a potential tax increase is expected to be proportional to its magnitude and to be modified by such factors as disposable income and the demand elasticity for alcohol among various population groups. Published by Elsevier Inc.
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                Author and article information

                Contributors
                Role: faculty fellow
                Role: professor
                Role: associate professor
                Role: research associate
                Role: professor
                Role: professor
                Journal
                BMJ
                BMJ
                BMJ-UK
                bmj
                The BMJ
                BMJ Publishing Group Ltd.
                0959-8138
                1756-1833
                2019
                25 September 2019
                : 366
                : l5274
                Affiliations
                [1 ]Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon Tyne NE2 4AX, UK
                [2 ]Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
                [3 ]Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
                [4 ]ESADE Business School, Ramon Llull University, Barcelona, Spain
                [5 ]Institute of Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
                [6 ]Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
                [7 ]Institute of Medical Science, University of Toronto, Toronto, ON, Canada
                [8 ]Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
                [9 ]Department of Psychiatry, University of Toronto, Toronto, ON, Canada
                [10 ]Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
                [11 ]Department of International Health Projects, Institute for Leadership and Health Management, IM Sechenov First Moscow State Medical University, Moscow, Russian Federation
                Author notes
                Correspondence to: P Anderson peter.anderson@ 123456newcastle.ac.uk
                Author information
                http://orcid.org/0000-0003-4605-9828
                Article
                odoa050565
                10.1136/bmj.l5274
                6759563
                31554617
                4cd30529-569f-476f-a045-032820f59328
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 02 August 2019
                Categories
                Research
                1778

                Medicine
                Medicine

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