Wednesday, 3 June 2020

Restricting the sale of high strength beer and cider doesn't work

One of the pet projects of England's overpaid public health directors is getting shops to stop selling high strength beer and cider. Alcoholics and/or street drinkers are known to favour these products and so, in the stunted imagination of paternalists, it is assumed that there will be fewer alcoholics and street drinkers if they are removed from the market. It is exactly the same logic that lies behind minimum pricing.

More worldly people argue that these people will substitute other types of drink (or drugs) and that such policies will, at best, make them even poorer.

Nevertheless, many shopkeepers have gone along with these schemes and their local implementation has created some natural experiments.

Two years ago, I mentioned a study looking at the Reduce The Strength initiative in Suffolk which concluded that 'the overall findings showed no intervention attributable impact.'

Our findings suggest that voluntary RtS [Reduce The Strength] initiatives, have little or no impact on reducing alcohol availability and purchase amongst a broader population of customers.

Brighton and Hove has a similar campaign called Sensible on Strength which has led to more than 200 off-licences (74%) no longer selling high strength beer and cider. A new study looks at the alcohol consumption and health outcomes of people admitted to hospital with liver disease in the city.

The study is called 'Does regulating the sale of high-strength beer and cider impact hospital admissions with decompensated alcohol-related liver disease?'. The answer is no. The individuals consumed less beer and cider after Sensible on Strength began but they consumed more wine, and there was no change in their overall consumption of alcohol. Nor was there any change in rates of alcohol-related liver disease (ALD) mortality after the scheme took effect.

Comparing patients admitted in both phases, there were no significant differences in liver prognostic scores, liver-related complications, length of stay and inpatient/long-term mortality (p>0.05). However, the SoS initiative was associated with a 33% move away from beer and cider consumption (36.3% vs 54.0%; p=0.034), but without a significant change in units of alcohol consumed.


Though there was a 33% reduction in the consumption of beer and cider post introduction of the SOS initiative, the total number of alcohol units consumed did not change. This might explain why the SOS initiative did not impact the number and severity of hospital admissions with ALD [alcohol-related liver disease] nor have an effect on ALD-related mortality.

D'ya think?

'Public health' academics can never fully admit defeat so they conclude by saying that their study shows that 'regulating alcohol sales can modify drinking behaviour' and conclude as follows:

Despite having no apparent impact on the clinical spectrum of local ALD admissions, it is conceivable that longer follow-up is needed to determine the true impact of this initiative.

Hmm. Since the scheme didn't lead to a decline in alcohol consumption, I wouldn't get your hopes up for that.

Beer and cider sales down, wine sales up, and no improvement in health outcomes? There are obvious parallels here with the minimum pricing flop.

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