- The Sheffield Alcohol Research Group was commissioned by the Irish and Northern Irish governments to examine the potential effects of minimum unit pricing. - Their Sheffield Alcohol Policy Model estimates that a €1/standard drink MUP in Ireland would reduce total alcohol consumption by 8.8% and alcohol-related harms like deaths and hospitalizations by 16% and 10% respectively over 20 years. - The policy is estimated to reduce costs of alcohol harm by €1.7 billion over 20 years while having a modest negative financial impact on government and a positive impact on retailers.

1. Opening statement from Dr John Holmes and Mr Colin Angus, Sheffield Alcohol Research Group,
ScHARR, University of Sheffield.
Thank you for inviting us to give evidence today. As you may know, the Sheffield Alcohol Research
Group has been conducting research into alcohol policy in general and minimum unit pricing in
particular since 2008. The Irish and Northern Irish Government commissioned us in 2013 to examine
the potential effects of minimum unit pricing in their respective countries and we will focus our
presentation today on that work. However, before coming to our own research, I would like to start
by describing some of the wider evidence on the effectiveness of using alcohol prices to reduce
alcohol-related harm.
Background evidence
A major review in 2009 examined evidence on the impact of alcohol price changes on alcohol
consumption and found that increases in alcohol prices were consistently and significantly
associated with falls in consumption. This was the case for total alcohol consumption and for
individual types of alcoholic beverage (e.g. beer, wine and spirits). Similarly, both younger and older
drinkers were responsive to price changes and so were binge drinkers. These findings have been
replicated by at least two other major reviews. An example finding is that, on average across
different times and places, a 10% increase in prices is associated with a 4.4% fall in consumption.
However, our primary interest is not whether alcohol price increases reduce alcohol consumption
but whether they reduce the harm caused by alcohol. A further review of 50 scientific studies
concluded that they do. Based on their review, the researchers estimated that doubling alcohol
taxes in the US would be associated with a 35% reduction in alcohol-related mortality, an 11%
reduction in traffic crash deaths and smaller reductions in sexually transmitted diseases, violence
and crime.
Minimum pricing is a specific form of price increase targeting the cheapest alcohol which, as you will
see later, is disproportionately purchased by the heaviest drinkers. Therefore, there is good reason
to expect it will be effective in reducing alcohol-related harm. Several Canadian provinces have
operated minimum price policies for many years and recent evaluations of those policies suggest
they have been effective. The policies are not identical to minimum unit pricing as the price
thresholds are not directly linked to the strength of the drink; however, the same principle of having
a minimum price below which alcohol cannot be sold to consumers does apply.
The Canadian evaluations have shown that, all else being equal, increases in minimum prices are
associated with falls in alcohol consumption, alcohol-related hospital admissions and deaths
attributable to alcohol. The graph in Figure 1 shows the data from one example study. The black
line is the average minimum price of all alcohol in British Columbia between 2002 and 2009. The
grey line is the rate of wholly alcohol-attributable deaths in the province (i.e. those deaths closely
associated with heavy drinking such as alcohol poisoning and alcoholic liver disease). The graph
shows that a sharp and sustained increase in minimum prices in 2006 was followed by a sharp and
sustained fall in deaths closely associated with heavy drinking. This prima facie evidence of policy
effectiveness is then supported by the statistical analysis which estimated that a 10% increase in
minimum prices in British Columbia would be associated with a 32% fall in these deaths closely
associated with heavy drinking.

2. Figure 1: Rates of deaths wholly caused by alcohol and average minimum alcohol prices in British
Columbia, 2002-20091
The Sheffield Alcohol Policy Model
Turning now to our own research; we were asked by the Irish Government to estimate the potential
impact of different levels of MUP in Ireland using our Sheffield Alcohol Policy Model (SAPM). For a
given alcohol policy, SAPM provides estimates of changes in (i) alcohol consumption, (ii) consumer
spending, (iii) revenue to retailers and Government, (iv) rates of mortality, morbidity, crime and
workplace absence due to alcohol and (v) the costs to individuals and public services associated with
those harm changes. A key feature of the model is that policy effects are modelled for population
subgroups defined by age, gender, income and alcohol consumption level.
It will be helpful at this point to define the alcohol consumption groups I will be discussing. There
are three groups: low risk drinkers, increasing risk drinkers and high risk drinkers and each is defined
by the number of standard drinks of alcohol they consume per week. Low risk drinkers are males
consuming less than 17 standard drinks per week and females consuming less than 11. High risk
drinkers are males consuming 40 or more standard drinks per week and females consuming 28 or
more. Increasing risk drinkers lie between these two groups.
The model methodology is too complex for this short presentation and we are happy to discuss the
detail during the questions if desired. The basic idea is summarised in Figure 2. SAPM works
sequentially; so we first estimate the impact of introducing MUP on prices. We estimate how these
1
Reproduced from Stockwell et al. (2013) ‘Misleading UK alcohol industry criticism of Canadian research on
minimum pricing’, Addiction, 108: 1172-5

3. price changes would affect consumption, then how those consumption changes would affect rates
of harm and finally how those changes in harm affect the costs of alcohol-related harm. Although
complex, the modelling methods are largely orthodox in scientific terms. It is the broad range of
outcomes addressed and the ability to model impacts on different groups within the population that
has made our work so influential.
Figure 2: Summary of modelling steps undertaken within the Sheffield Alcohol Policy Model
Results
First we examined the effect on consumption of different levels of minimum unit pricing. Figure 3
shows that, as the minimum price gets higher the consumption reductions also increase. This is
because higher minimum prices affect a greater proportion of the alcoholic products on sale. Above
a minimum price of 60 cents per standard drink, large reductions in consumption begin to be seen.
For example, a reduction in consumption of 1.9% at 70 cents per standard drink, 3.8% at 80 cents
per standard drink and 6.2% at 90 cents per standard drink. The remainder of our presentation will
focus on €1.00 per standard drink level as an indicative example.
Based on our modelling, we estimate that a €1.00 minimum unit price introduced in Ireland would
reduce total alcohol consumption by 8.8%. In year 20, when the health effects are being fully
realised, we estimate there would be 197 or 16% fewer deaths due to alcohol each year and 5,900 or
10% fewer hospital admissions due to alcohol. From year one, we estimate there would be
approximately 1,500 fewer alcohol-related crimes and 116,000 fewer days absent from work due to
alcohol. A cost breakdown is provided in Table 1 and the headline figure is that, over 20 years, the
policy is expected to reduce the cost of alcohol-related harm by €1.7bn Euro accounting for costs to
the police and health service and a financial valuation of improved quality of life for individuals.

4. Figure 3: Estimated reduction in population consumption under different minimum unit price levels
Table 1: Estimated effects of a €1.00 minimum unit price in Ireland

5. The impact on retailers is likely to be positive as minimum unit pricing is not a tax. We estimate that
off-trade retailers (i.e. shops and supermarkets) would receive approximately €69m extra from
alcohol sales. Although the policy does not directly affect pubs and restaurants because their prices
are already higher than the €1.00 per standard drink threshold, we would expect to see changes in
people’s consumption habits and these mean on-trade retailers may also see a small increase in
their revenue. This is because people may, for example, go to the pub more as they are buying less
alcohol in supermarkets.
Regarding tax revenue, the negative impact on the exchequer would be modest as lost duty from
falling alcohol sales would be largely offset by rising VAT revenue from higher alcohol prices.
Who would be affected by MUP?
A key feature of the policy is that minimum unit pricing does not affect all drinkers equally. The
main driver of who would be affected is how much cheap alcohol different groups buy. Figure 4
shows that low risk drinkers purchase very little alcohol for less than €1.00 per standard drink (one
or two standard drinks per week), irrespective of whether they are in poverty or not. Compare this
to high risk drinkers who purchase far more substantial quantities of cheap alcohol. Although high
risk drinkers in poverty do buy more cheap alcohol than those not in poverty (43 standard drinks per
week vs 26), it is clear that those on higher incomes are still buying these products and will be
affected by the policy.
Figure 4: Number of standard drinks purchased per week for less than €1.00

6. The Sheffield Alcohol Policy Model accounts for these different purchasing patterns and our
estimates of annual reduction in standard drinks by each group reflect this. Figure 5 shows the
annual reductions in consumption which we estimate would occur. Low risk drinkers would be
largely unaffected with those low risk drinkers in poverty estimated to reduce their consumption by
just 25 standard drinks per year (equivalent to drinking three bottles of wine less per year).
Compare this to high risk drinkers who are estimated to reduce their consumption by well over 500
standard drinks per year for those in poverty and 480 standard drinks per year for those not in
poverty. This is approximately 60-70 bottles of wine per year.
A concern for some parties has been the potential financial impact on low income drinkers. Our
modelling does not support these concerns. Figure 6 shows that we estimate spending would fall in
most groups as drinkers tend to reduce their spending and consumption to accommodate higher
prices rather than spending more and maintaining their consumption. Spending is only estimated to
increase in the higher income groups. It is worth noting that these spending changes are in the tens
of Euros. High risk drinkers spend on average over €5,000 on alcohol per year so that spending is
only changing marginally.
Figure 5: Estimated reduction in annual standard drinks consumed under a €1.00 MUP

7. Figure 6: Estimated annual changes in spending on alcohol under a €1.00 MUP
Limitations of our research
All research has limitations and our aim is to be transparent about these and help policy makers
understand their implications for using our work. Some of the key limitations of SAPM include our
assumption that prices of products above the MUP threshold will be unaffected. This is unlikely to
be the case as producers may not want their product to suddenly become the cheapest drink on the
market. There are likely to be price rises on more expensive products and that means we are
probably underestimating the impact of the policy. A lack of clear evidence also means we cannot
estimate the impact of minimum unit pricing on purchasing of illicit alcohol or use of non-alcohol
substitutes (e.g. illicit drugs). However, evidence of falling alcohol-related harm following price
increases suggests any substitution effects are not sufficient to outweigh benefits.
We do not ignore these limitations and, where appropriate evidence is available, we test the
sensitivity of our results to a range of alternative assumptions, datasets and analytical techniques.
While the numerical results change, these sensitivity analyses consistently show that our conclusions
are robust and that, in general, we have made conservative assumptions. Further, when we created
a Canadian version of our model for work we undertook in British Columbia, we found our estimated
policy impacts were smaller than the real world impacts seen in the evaluations of minimum pricing.
Again, this suggests that we have made conservative assumptions within SAPM which mean we are
likely to be underestimating the impact of MUP in Ireland.

8. Conclusions
To summarise: there is strong and consistent evidence that price increases reduce alcohol
consumption and related harm. Minimum pricing is a targeted form of price increase as it tackles
the cheap alcohol disproportionately purchased by heavier drinkers. We estimate it would not
penalise low risk drinkers irrespective of income because they buy little of this cheap alcohol. High
risk drinkers would, however, be substantially affected as they buy large quantities of the alcohol
affected by the policy. Finally, these conclusions have been found to be robust to a range of
alternative assumptions, data and analytical methods.