Alcohol-related deaths rose in Scotland last year

Remember last week when statistics showed a fall in alcohol consumption in Scotland in 2018 and everybody pretended that minimum pricing was responsible for the decline?

You can hardly have missed the news. It was reported everywhere and it inspired the Irish prime minister to get moving with minimum pricing... 

Ireland will move quickly to implement a minimum price below which alcoholic drink cannot be sold, the Taoiseach has said.

Mr Varadkar said the recent data in Scotland – which brought in the measure in May of last year – showed it was working well. This encouraged the Irish Government to implement the measure already contained in an alcohol control law passed by the Dáil and Seanad.

However, as I explained at the time, it's difficult to read too much into the figures for the calendar year of 2018, for a few reasons. 

First, minimum pricing didn't begin until May, so for a third of the year alcohol was sold at the market price. The figures I have seen for off-trade sales in the post-MUP period (May 2018 to April 2019) show no decline.

Second, alcohol sales have fallen in nine of the last eleven years, including a 3.7% fall in 2011, a 4.2% fall in 2012, a 2.5% fall in 2013 and a 1.9% fall in 2016. There is nothing special or unusual about the 2.95% fall recorded in 2018.

Third, if you dig into the spreadsheets of the MESAS study, you'll see that the decline in the on-trade was almost identical to that in the off-trade (2.9% and 3.1% respectively). If minimum pricing was behind the decline, you would expect it to be driven by the off-trade since that is where the price rises were experienced.

None of this was allowed to intrude on the celebrations last week. We all had to pretend that 2018 was the post-MUP period and minimum pricing was responsible for whatever happened in it.

Today, the figures for alcohol-related deaths were published. This was the moment that Alison Douglas of Alcohol Focus Scotland had been looking forward to, as she said in April:

"Really importantly, we'll get the first data on alcohol specific deaths in Scotland because that's the first indicator of what's happening to harm. Lets not forget the whole policy here is about reducing alcohol related harm and consumption is the means to improving peoples heath and lives."

This time, however, there was no press release from NHS Scotland, no comment from the Scottish Health Minister and not a peep from any of the newspapers. Why not? Perhaps because the figures show a rise in the number of alcohol-related deaths in Scotland between 2017 and 2018, from 1,120 to 1,136 (1.4%). 

Let's remember that the sainted Sheffield Model predicted exactly 58 fewer alcohol-related deaths in the first year of minimum pricing.

But 2018 was not the first year of minimum pricing. It was year in which minimum pricing was in force for eight months, as today's report makes clear...

Minimum unit pricing for alcohol was implemented in Scotland on 1 May 2018, with a minimum price of 50p per unit. The 1% increase in the number of alcohol-specific deaths between 2017 and 2018 is not conclusive evidence on whether or not the policy is working because (for example) it is well within the range of the ‘random’ year-to-year fluctuations that have been seen in many previous years and, in any case, the figure for 2018 as a whole includes deaths which were registered in four months (January to April 2018) in which there was no minimum unit price for the sale of alcohol.

This applies equally to the alcohol consumption figures. The 2.95% decline in 2018 was 'well within the range of the ‘random’ year-to-year fluctuations that have been seen in many previous years'.

All I want here is a bit of consistency. If we're going to pretend that the calendar year of 2018 was the post-MUP period and use post hoc rationale, then minimum pricing drove down alcohol consumption while failing to reduce alcohol-related deaths. Today's statistics should have received at least as much attention as the sales figures did last week ('the whole policy here is about reducing alcohol related harm', after all).

Instead, today's figures have been released to the sound of crickets and tumbleweed.

Ever get the feeling you're being played?