Minimum Price
It’s that time again. The time the press has to decide between demonization of the drinking youth, or cries of nanny state and tax grubbing governments. Actually, usually they don’t have to choose, contradictory opinions that should cause significant amounts of cognitive dissidence are the norm in a hell of a lot of papers. If they can cause outrage then consistency is an optional extra.

So what am I talking about? The proposed introduction of a minimum price per unit of alcohol in drink in most of the UK. I say most as Scotland with it’s devolved powers has already put forth a 50 pence per unit minimum price. It’s being held up at time of writing (1), but is further ahead than the rest of the UK’s proposed 45 pence minimum.

Now there are a lot of people claiming this can, or can’t work because of many reasons. That minimum price won’t deter drinkers, in a similar fashion to the fact that high cigarette costs are not deterring smokers, that it’s just another tax for the government, that it will boost the quality beer of beer. A lot of claims, very little evidence being given for most.

So what is the evidence then? In an unusual step for what is normally an opinion piece I’m going to be doing a quick trawl of the net for the evidence and see what I can find.

1) Will it reduce drinking?

Here’s where I will attempt, however badly, to follow the advice of the great Ben Goldsmith, the writer of “Bad Science”(2) and frequent proponent of policies having evidence to back up their claims. So what do we have in the way of peer reviewed studies (the most useful),statistics, official policy advice and the like? Well I managed to find a UK based study based on a mathematical model (3), statements from the World Health Organisation on their advice, and contains links to the references used to make it (4) and a meta analysis of over a hundred studies (5). All came to the same conclusion. They show that Minimum price per unit is shown to reduce excessive drinking, and the meta analysis noted that it had very high correlation and showed particularly useful benefits amongst younger drinkers.

That last one, the meta analysis was of most interest to me. Meta analysis allows comparison of many many different studies to allow statistical oddities to be noticed. This way a single study having an unusual result will not take precedence over the weight of evidence against it.(6) Also, since meta analysis should show an expected statistical distribution of it’s results, if there has been publication bias (Which there often is(7)) then there would be signs of it when the results are plotted together(8).

Since I considered the meta analysis the most important I took a look at the summary to see if any obvious flaws in the study were noticeable. The studies were based on a mix of self reporting, and of studies of the amount sold by retailers. The self reporting is the less trust worthy of the two, human beings are very unreliable at giving accurate results when asked (9), however the sales figures are harder numbers and thus seem a firm basis for the studies, to my laymans opinion.

So what does this mean? Well to the best of my research, minimum pricing does work. People can put whatever reasons they think it doesn’t work up and for specific sub groups it may not be as effective (more on that later) but on the whole the evidence supports it. I’ve seen comments that there has not been a huge range of studies yet on the specific minimum price implementation that is being considered in the UK, so there is room for more targeted studies. So the question becomes

2) Should we do it?

Now this is a harder one, and a harder on to get solid facts on. We know that evidence supports the statement that minimum price reduces drinking. Is reducing drinking a goal we should be aiming for? Now I’m assuming a base axiom here that government action to try and gain a response is not intrinsically bad. Some libertarians and anarchists may disagree with that, as would some sections of the American Republican party, amongst others. However to address such disagreements would involve taking this essay far past it’s current remit, and would most likely require a discussion on its own, so if you could be so good as to grace me this one for the purpose of the discussion.

Given this then, my second assumption is that to assess if a policy should be implemented it’s costs and benefits to society should be looked at. A policy to reduce exercise would be a possibly policy, but it’s intrusion against personal choice also have no demonstrable benefit to society as a whole in exchange. I’d hold that, for a policy to be considered worthy, for the most part, the persons actions must impact others than just themselves, causing a ramification for society as a whole. Policies that curtail a person’s actions which affect only them must be held to a much higher standard before needing legislation than those where society as a whole is affected. This is because if the action affects only the person doing it then the matter of action and reaction affects solely them and therefore they can normally, though not always, be considered to consent to the results of that action. Where the effects are society wide it cannot, by comparison, be taken for granted that all actors within that society have consented to the results.

In this policy the freedom of businesses to decide their price is being curtailed, and with it the capability of the general public to get hold on very cheap alcohol. The action upon a person is limiting their ability to drink to excess.

To first establish the society effects we can see the link between excess alcohol and crime(10), including assaults (both perpetrator and victim(11)), and driving accidents(12). Domestic abuse(13) also shows high links, though a few articles suggested correlation rather than causation(14), however even with that excluded I think we can say that the effect to society has been established.

I consider alcohol, and alcohol beverages to be luxury items, in that they are not necessities to live. However I would also argue however that without the benefit of the luxuries in society a person is being denied full access and benefits of that society. However in this case the reduction is one of quantity by increase in price, not in preventing access. The metastudy commented that it was groups with low income, such as young people, who had the most alteration to their drinking habits where they previously were excessive. With the minimum price being double what is the cheapest quoted current price I could find, that would indicate that even low incomes they would have access to alcohol in reasonable but not excessive quantities given the change, and therefore would not be denied access to societies benefits.

Now this brings us to an important point that should be addressed. This policy would nigh solely have an impact on the lower incomes and as something that effects a specific sub group of society unevenly needs to be examined closely.

Those of moderate and above income will still have easy access to alcohol to drink in excessive amounts. Also where higher income households encounter health issues they are financially better prepared to have higher quality private healthcare available to them to treat it. I could read this policy as condoning excessive drinking and the related actions if performed by the wealthy. Which one would hope was not the intended result.

I would put forwards a potential counterbalance that could be put in place is, if alcohol related crime does fall given the minimum price, yet policing levels and resources remain the same that the chance of catching and prosecuting those who perform drunken crime would increase. Studies show that chance of being caught and punished is linked to deterrence, more so than, say the level of punitive punishment (15). Therefore, if the prosecution of people was applied evenly across wealth levels (admittedly a very large if) then the benefits would be applied more evenly across society. This however is conjecture on my part.

Therefore there does appear to be distinct benefits to society from the reduction of excess drinking, with the caveat that there should be measures to offset the inequalities by class resulting from it.

3) What effects are there to the brewing industry?

This proposal, more than most, has led to claims of alteration to the industry. Smaller brewers have been quoted as saying it will result in a better quality of beer in general, and thus will be of benefit to beer drinkers. The logic being that if drinks cannot be below a set price, that there will be no benefit to making beers with cheaper, and with low quality ingredients. Therefore quality beers will be more competitive in the marketplace.(16)

For a counter argument I would say it’s worth considering that the increased minimum price is mainly going to the brewer and stores, therefore the large macro breweries will be making more per item sold. Due to the already large output of their brewery, which would take time to alter in any case, they will have significant funds to put towards advertising and establishing a brand which can have a great affect on their sales, separate from the quality of the beer. However despite putting that forwards I consider that it is unlikely. Right now macrobreweries consider it worthwhile to sell at low cost and make up in quantity. So if their current business practises are correct then they may make less overall despite the higher profit per unit.

It is hard to find solid information to back this. In places such as Denmark and Sweden where the base cost of beer is high the quality beers are not much dearer than the cheaper ones. I cannot find any sources on amount of ingredients used per beer on average in those places, for some reason it doesn’t seem to have got a grant for research yet. Therefore I cannot use comparing ingredients as a base for quality. This would also be potentially misleading as taste is such an individual things and above a base level higher cost ingredients do not always mean better. Also it would not take into account cost of labour which would vary based on skill, nor take into account the brewing equipment used.

Review aggregator sites, such as ratebeer, are another consideration I looked at– to compare the average review scores for a given country. Again I feel that this would be flawed. Examination of the top 50 of ratebeer (17) shows a very heavy slant towards certain styles. There is also a comparison within style, but since it is most likely that beers would be primarily reviewed in their created and neighbouring countries it may be that the review comparisons show more about the scoring habits of those countries rather than the quality of the beer.

Aside from the subjective quality of beer a different marker could be to examine the number of startup micro brewers, and more importantly, how many are closing and compare between countries with and without minimum price, or before and after minimum price is introduced. I could not find any study of this sort, and feel that it could possibly be useful to see if the introduction of minimum price is a benefit to the craft beer scene. The idea put above is of course a loose one and would need controls on the data to compensate for different economic levels between the studied countries and times, and possibly a look at imported beer that is sold locally as well, but I feel the base concept is solid.

So with a dearth of solid information on this I will merely say that, by word of mouth in the beer scene, it is given that places like Sweden are credited with a quality beer reputation. That, combined with a reasonable method being suggested for why it may benefit the quality of beer I feel that it may be worth investigation. Even if only for understanding the economic impact this could have on existing small breweries and those who are wishing to start up. So with that said we return to a point touched upon earlier.

4) What groups may be harmed by this?

As we have looked at earlier, there is evidence that price controls in general seem to limit excessive drinking. We looked at the issues caused by excessive drinking, which gave evidence that such measures may be needed, and we looked at if this would unduly affect any economic class and what measures could be taken to limit that.

However the assumption of no undue affect is based on the excesses being curbed, there are potentially groups which would respond in a different manner to the general populace. There are people who are addicted to alcohol, and evidence that such people may be genetically predisposition to such addiction(18). This alcohol addiction should be seen separate from alcohol abuse in general as it is possible that with such addiction minimum pricing will not change their behaviour, and thus would instead merely create an increased financial burden.

Similarly there I found a correlation between both poverty and drinking (19), and depression and drinking(20). With poverty the last thing we should be trying to do is increase the financial burden on them, and similarly extra stress from financial worry will most likely worsen any depression issues. Notably the study on poverty and alcohol pointed out the uncertainty of causal status rather than just correlation, but emphasised the needs of measures to prevent a poverty cycle which links to the point being made here.

I could not see anything in the minimum price studies I could find about the specific impact on those groups and from the reporting on the minimum price I could see no mention of these matters being taken into account. Of interesting note is that the minimum price is not tax based, no extra money is going to the government(21). Why this is of interest to me is that any policy that could have an effect on the above mentioned groups could be in part mitigated by extra funding to either medical centres for treating addiction and depression, or to social policy to try assist those in extreme poverty. Both of these however would require extra funding which would have been neatly covered by the extra tax money and the elements could have been tied together. I do feel that any introduction of a minimum price should at least consider, and hopefully take steps to mitigate the harm to the groups mentioned above. To examine why the measures, and the tax revenue increase particular are not being implemented we move to the next question.

5)Will the public accept this?

Any new policy requires the expenditure of political capital, any that increases cost upon the public more so. At this point there is little in the public sphere that I can refer to, as such negotiation would go on behind close doors, but I shall consider a few possible reasons for the choices made and how it affects the policy’s acceptance by the public.

There does seem to be a lot of resistance to the new policy, including comments from alcohol lobby groups (22).Also going from comments and article focus in the papers (No references here, as they rely on the ever changing comments section of articles and the letters pages of daily papers) there seems to be the perception of the minimum price as a tax, and accusations of the government being greedy for implementing it. Odd as financial papers already referenced have commented that this is specifically not a tax, and the implementation of it as a duty tax would produce significant revenue for the government (see 21 again). I have considered then that the choice to not implement it as a tax was intended as a – failed – attempt to avoid such a backlash and rejection form the general public.

Another possibility may be impact on macro breweries. If my suggestion above is right, that they will lose money by the increase in minimum price even with the increased profit per unit, then an attempt to implement the measure without the fig leaf of extra cost per unit may have been even more unpalatable to the brewery companies. In such a case then the amount of money that brewers could bring to bear to lobby against such a measure could have had more of an influence on public opinion than a tax would have.

These are just my ideas, so do not put too much weight on them, but they could provide explanations for some of the choices made. They also would suggest that by whatever means minimum price is implemented it does risk a significant risk of public opposition, which would match with the current attempts to appeal to the EU to prevent the measures implementation in Scotland as hinted at before.

6) Limitations of the Investigation.

Despite my best intentions the investigation above does fall far short of the goal aimed for. I have used peer reviewed and meta analysis data where possible, but in several cases this has resulted in relying on the Abstracts as I have not got access to the pay wall barred articles, therefore cannot give a comprehensive investigation of their contents for flaws. Where I have not been able to find that I have used official statements and links to relevant organisations web sites. Worse still, I have often had to rely on conjuncture where I have not been able to find relevant studies. In my defence I offer that I have at least acknowledged where this is the case, and given all sources for examination, even when they are less sturdy than I would like. I have tried to remain impartial, my searches have been for the subject alone, without any attempts to bias the results one way or the other (As an example of doing it wrong, a search for “peer reviewed studies” on google brought up an autocomplete of “Peer review studies against global warming”. If you are only searching for your wished for conclusion you are doing it wrong). I also will admit this is my first attempt at such an article and as such my ability to find and furthermore identify as reputable articles is less than those who would have more experience in such things.

7) Further Investigation.

I considered following up on the linked Scottish law of a ban on multi buy sales (The offering of cheap deals on alcohol buy only if you buy a set amount). It is interesting to note that my experience of such things has not seen the ban causing alcohol to be more expensive, but merely that the individual bottles or cans are being sold at the price they would be per item in a multibuy price. Considering thus that it would have less financial impact on the consumer I would be interested to see what effect this has on excessive drinking. I.E. if the removal of an incentive to buy more in order to save money would result in more restrained drinking habits.

Also considering the points brought up in 4 above, I would be interested to see what effect the recent alterations to the NHS, and the cuts associated are having on the treatment of alcohol addiction and alcohol abuse linked with depression. Also the fact that a recent announcement from the government has declared an effective real world reduction (i.e below inflation rise) in benefits (23) means that consideration of the impact on poverty on alcohol abuse is more relevant than ever and the potential ramifications should be looked at and hopefully offset.

Conclusion

So with the data above I would conclude that Minimum Pricing looks to both be effective at reducing excessive drinking, and that goal is one worth aiming for. I am unsure if it will present a benefit to the beer scene as a whole, but can see mechanisms where it could do so and so will, for now, remain cautiously optimistic, with one eye on any new data coming in. I am nervous that the potentially vulnerable groups affected by this change do not seem to be getting the support they need and expect there to be at least some public resistance. Overall I warily feel that the measure is worth implementing, but I am nervous of the overall environment it is being launched in. Most obviously I am nervous that this measure seems to be standing in isolation, without backing by either help for those who would be affected by it, or attempts to alter the culture which promotes drinking for drunkenness sake. It therefore does not seem to be part of an overall coherent policy to tackle the wider issues regarding alcohol problems.

Finally I would say that this is but one look at such things, and one from someone who is not used to such investigations. I started this as a response to the very data light reports I have been seeing in the media, and hope that it will cause others to do similar. I am sure that many bloggers who write about alcohol in any form are better suited to this than I, and would encourage you to write similar articles based on your investigations. It does not matter if you agree or disagree with me, just that you bring evidence and sources to light to help people make up their minds. As I hope I have demonstrated here this Minimum Price may have more impact and unexpected consequences than is commonly expected and the better informed we are, the better able we are to respond to it.

Thanks for reading, and, despite the serious nature of this article

enjoy your drink

Sources
(1) http://www.bbc.co.uk/news/uk-scotland-20526338
(2) http://www.badscience.net/
(3) http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60058-X/abstract
(4) http://www.wpro.who.int/publications/PUB_9789290615033/en/index.html
(5) http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2008.02438.x/abstract
(6) Bad Science: Ben Goldacre: UK Paperback p54-57
(7) http://www.badscience.net/category/publication-bias/
(8) http://www.badscience.net/2008/03/beau-funnel/
(9) http://www.cdc.gov/healthyyouth/yrbs/pdf/validity.pdf
(10) http://www.ias.org.uk/resources/factsheets/crime.pdf
(11) http://www.jsad.com/jsad/article/The_Role_of_Alcohol_in_Physical_Assault_Perpetration_and_Victimization/644.html
(12) http://europepmc.org/abstract/MED/37067/reload=0;jsessionid=gsuh5fErYcbk3AJMPbAx.6
(13) http://informahealthcare.com/doi/abs/10.1080/146598901753325075
(14) http://alcoholism.about.com/cs/abuse/a/aa990331.htm
(15) http://www.sentencingproject.org/doc/deterrence%20briefing%20.pdf
(16) http://www.brewdog.com/blog-article/brewdog-backs-minimum-pricing
(17) http://www.ratebeer.com/beer/top-50/
(18) http://pubs.niaaa.nih.gov/publications/arh312/111-118.pdf
(19) http://www.vaada.org.au/resources/items/2005/08/16142-upload-00001.pdf
(20) http://www.rcpsych.ac.uk/expertadvice/problems/alcoholanddrugs/alcoholdepression.aspx
(21) http://www.ifs.org.uk/publications/6084
(22) http://metro.co.uk/2012/11/28/theresa-may-to-seek-minimum-alcohol-price-of-45p-per-unit-551320/
(23) http://www.bbc.co.uk/news/uk-politics-20621313

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