Alcohol pricing and heavy drinkers in Scotland

Professor Jonathan Chick

Medical Director, Castle Craig Hospital

Jonathan Chick MA MPhil DSc MBChB FRCPE FRCPsych graduated from Cambridge University in Natural Science and from Edinburgh University in Medicine. He has worked for the Medical Research Council for Epidemiological Studies in Psychiatry, and as Consultant Psychiatrist, Royal Edinburgh Hospital and Senior Lecturer, Department of Psychiatry University of Edinburgh.

He is a practising psychiatrist and Medical Director, Castle Craig Hospital, Scotland.

As Honorary Professor, Health Sciences, Edinburgh Napier University, his current research is into the effects of legislation regarding pricing of alcohol. Over previous years he led numerous randomised controlled studies into treatments, both psychological and pharmacological for alcohol problems.

He is the Chief Editor of the international journal Alcohol and Alcoholism. He has been an advisor to the World Health Organisation and government departments in Australia, Canada, USA and Brazil. He was till recently a Non-Alocholic Trustee of the General Services Board of Alcoholics Anonymous, UK.

Dr Jan Gill

Dr Jan Gill is a Reader based within the Department of Nursing, Midwifery and Social Care at Napier University in Edinburgh. She is a pharmacologist with interests in the evidence base and public understanding of the UK health guidelines around alcohol consumption. Recent research output in this area includes the appraisal of Alcohol Brief Intervention training for healthcare undergraduate students. Her research interests also comprise aspects of female consumption, particularly in relation to its impact on reproduction. She has been recently funded by the Chief Scientist’s Office in Scotland and Alcohol Research UK. This work was designed to contribute to the evidence base informing policy changes which propose a minimum unit price for alcohol. The three year study documented, using a mixed method approach, drink choices and prices paid by heavy consumers of alcohol who attended Scottish NHS settings.

Professor Jonathan Chick and Dr Jan Gill

Potential strategies to address alcohol misuse remain contentious. Our presentation aims to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. Additionally we contrast our findings with national sales data and explore the impact of socioeconomic status on purchasing behaviour.

Study Design: Cross sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012.

Methods: 639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week’s or a ‘typical’ weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status.

Results: Median consumption was 184.8 (IQR=162.2) UK units /week paying a mean of 39.7 pence per alcohol unit (£0.397). Off–sales accounted for 95% of purchases with 85% of those <50 pence (£0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived.

Conclusions: Heavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multi-buys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Nonetheless, drinkers were able to off-set higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing accordingly.

This study was supported financially by the Chief Scientist Office, Scotland (CZH/4/645); Alcohol Research UK (R2011/01); NHS Health Scotland; NHS Lothian Foundation Trust and in kind by the Scottish Mental Health Research Network.

Download the presentation slides here.