Japan is sitting at .25 deaths per 100k without any such law. [1]
Sounds like this is a case of "law of small numbers." The deaths dropped by 40 in a single year in a single city? 40 people? Does that not see drastically small to use to back something like this up?
I only thought of Japan because they sell alcohol (beer and sake) in vending machines there. Doesn't really get much easier to buy than that. And alcohol is popular there, it's not as if it's a country with prohibition.
I haven’t seen alcohol vending machines here in Tokyo in many years, however you are correct that alcohol is cheap and easily available. You can buy a 330ml can of 9% alcohol drink called Strong Zero at the supermarket for close to ¥100. Many restaurants offer ‘all you can drink’ specials for as little as ¥1200 for two hours.
I’m actually surprised that alcohol related deaths are so low.
Is it not a bit soon to be drawing conclusions? Also there are so many other factors involved. I'm a scotsman and I'm personally not a fan of this law, nor the 10am-10pm licensing laws. They're blunt instruments that fail to tackle the root causes. I'm not saying they don't work or that they're not relatively easy to implement but I wouldn't be surprised if we soon see an increase in deaths from other drugs.
How should they tackle the "root cause?" It is fine to criticize the existing solutions, but this isn't offering a counter proposal that could be used when they're scrapped (and until this proposal exists and comes on-tap, they're better than nothing).
The root causes vary, but include mental health issues and poverty in general. We should instead focus on those issues more.
The main alcohol related root cause is the culture of binge drinking. The way to tackle that is to create and encourage a culture of moderate drinking. Change licensing laws to make it easy for families to go to pubs for example.
And also have more sources of entertainment for early-20s adults than bars. I've lived in many smaller towns in the USA where the only entertainment after 8pm was a bar.
> binge drinking. The way to tackle that is to create and encourage a culture of moderate drinking
In scotland?? Drinking culture is tied in to masculinity at least in the UK midlands ('beer or queer' - that kind of shit though thankfully fadin) and I'll bet it's the same in scotland. And you've got an entire drug industry, the drinks industry, working hard to get people to abuse, NOT use, to ABUSE to excess, their product.
It's a deep problem with very difficult solutions. Externalised costs of capitalism, shitty lives, poverty, people who can't see a way out and if offered won't take it...
From what I've seen the beer is manly culture is going away. There's also a lot more awareness of drinking levels and sobriety. It's far easier and more socially acceptable to drink moderately now. These changes are mostly driven by healthy living concerns.
Educating people about lifestyle is proving effective.
My comment was to be taken as a joke and also not untrue. The current state of our Congress is that one Party controls the Senate and refuses to bring any legislation to the floor, and the other Party controls the House and refuses to hold anyone accountable for anything using the excuse that it won't make it through the Senate.
So because no one agrees on anything, nothing gets done.
Uh... I'm guessing Neoconservatives in the 60s? There have been many strategies over the years to make the Federal Government ineffective. In the 80s they did the whole Starve the Beast thing. More recently it's locking up budget talks and shutting down the government.
These days Moscow Mitch just sits on his hands and does nothing.
* I'm not blaming Republicans, Nancy Pelosi and her buddies have been doing similar shenanigans in the House. Currently she refuses to address any serious legislation in the House using the fact that it will never make it through the Senate as an excuse.
Honestly the behavior of both leaders has the same net effect and makes you wonder if they're both working towards the same goal.
Jordan Peterson had a really good point when asked about alcohol and drugs, and he said the question should be why aren't we all doing them? His proposed solution to that was that people had to have some specific thing in their lives, that was powerful enough that it was more important to them than alcohol.
It is like societies response to suicide prevention: put up a fence, don't make the people who want to jump not want to jump.
I actually support anything that makes alcohol harder to get, but I agree it's too soon to draw a conclusion.
I would be interested in seeing if there's been a decline in domestic violence and other forms of crime that have a strong historical relation with alcohol consumption.
My bet is that there's no such evidence.
I'm also curious to see how much variation in deaths there are year over year. Maybe 20% changes aren't uncommon, in which case this study is just picking up noise and no signal.
I'm also curious why they just don't implement a tax instead of minimum pricing, that way they could take that revenue and dedicate it to alcohol-related problems, at least somewhat offsetting the alcohol's cost to society.
But it also has benefits that raising alcohol duty doesn't: supermarkets etc can't absorb it by selling for a lower price or below-cost, pubs become more competitive with supermarkets, and the highest amount of alcohol for lowest price value pack disappears in theory.
I didn't know this was a thing until going to Edinburgh for the first time a couple of years ago. The queue and item makeup at 9.45 made me see the flaw in this plan quite quickly.
Agreed, correlation is not equal to causation. I think alcohol, drugs, mental illness and suicide should all be looked at together (at the very least). I suspect they might be just moving the problem elsewhere. Of course their statistics on drugs abuse will be approximations because people won't want to share their illegal habits.
I was told a funny story from my Russian friend where they introduced some law to prevent people buying hard liquor after 10pm to curb alcoholism. He was quite amused to see people running into the shop at 9:55pm with a trolley and back out just before 10pm with a trolley full of hard liquor.
That's been the experience among my circle of friends (cash strapped students). Why spend a fortune on beer when you can get a strong pill for a fiver?
Minimum unit pricing doesn't really affect beer - certainly not in a way that makes it cost a "fortune". It makes cans cost a few pence more than ones that you could get on a special offer in England. And people have been taking pills forever - it's not something people have started resorting to now they have to pay fifty pence more to get pissed on lager.
To put some numbers on this, Stella Artois is 4.8%, so a 568 ml can contains 27.264 ml of alcohol, or 2.7264 units. A minimum price of 50p a unit establishes a minimum price of £1.3632 per can, or £5.4528 per four-pack. Tesco currently sells four-packs in England for £5.50:
Nearly all grocers in England (Asda, Tesco, Sainsburys, Morrions) will have a weekly offer on crates, you can nearly always find 20 crates of stella for 20 quid (20x400mlx2). I guess these aren't available in Scotland? You only really pay over a fiver a four pack when you're in a rush at the co-op or tesco express, if you're in the big store you'll change 4 stella to four kroneberg for 3.29 or whatever similar, on mainstream lagers anyway
I thought the minimum pricing was to price out special brew/ strong ciders. If Stella is on the cusp of getting caught in the net, that must surely include most Alcohol.
I wonder if home brew is getting more popular in Scotland?
I've also heard this proposed as a risk of vaping. You get hooked on nicotine, can no longer afford expensive e-juice and switch to cigarettes. I think it's too early to know if this is the case, but the complete opposite of what vaping promoters try to sell
"Minimum unit pricing" Just means making alcohol more expensive. Headline from 6-19-2019 "Alcohol sales in Scotland hit 25 year low after minimum unit pricing introduced." Here's their governments website: https://www2.gov.scot/Topics/Health/Services/Alcohol/minimum...
Unfortunately not something that's within the power of the Scottish Government to enact, as it is a "reserved" matter - a legal power not devolved to the Scottish executive.
There is a strong desire for "shooting galleries" in Scotland (safe spaces to take drugs where help and clean needles are available) but the UK government and the Scottish government have very different policies on drugs.
I wonder if there's a startup (or multiple) here? If you take GABA supplements it has some minor version of the affect of alcohol, and if I remember correctly alcohol is a GABA inhibitor. Is there a way to engineer a better, safer, equally or more enjoyable alcohol, maybe with less judgement impairment?
But getting a recreational drug « approved » for sale is difficult. But maybe not impossible.
And chances are the attributes that make it relatively safe in 500mL-beer-equivalents probably make it possible to consume 10x amounts for 10x pleasure but still 5x worse negative effects than that 500mL beer.
Alcohol’s side effects contribute to its self-limiting self-administration for a good chunk of the population.
A "unit" of alcohol is 1cL. This amount is commonly used in the UK -- the amount of alcohol in a drink is often printed on the label in "units", and people have some ideas around how many "units" one can drink safely. It's used in personal health education at school.
The minimum price was set to 50p per unit / centilitre of alcohol.
(Keeping easy metric amounts for simplicity. In bars beer and cider is sold in 568mL glasses, though wine and spirits are nice round metric amounts.)
A 1L bottle of vodka, at 40% ABV, contains 40cL of alcohol. The shop or bar must sell it for at least 40×£0.50 = £20. In England, Tesco's cheapest 1L bottle of vodka is £15, so this has increased the price by £5 in Scotland. A fancy vodka which costs £22 in England is unaffected.
A 2L bottle of cheap cider at 5% ABV must cost at least £5. At Tesco in England, this is available for about £2.
5% is considered weak for that kind of cheap cider too, white lightning was far stronger than that for a similar price. (And if I remember correctly usually came in 3L bottles)
The higher end makers are probably glad the price curve is flattening. They can make a bit more profit and still be minimally more expensive than the cheap competition.
Stronger drinks that contain more units of alcohol have a higher minimum price than drinks that contain less alcohol. Drinks that have been most affected include strong white cider, own brand vodka and gin, and super strength lager.
A bottle of wine containing 10 units of alcohol has to be sold for at least £5, and a can of lager containing 2 units of alcohol has to cost at least £1.
Unlike supermarkets and off-licences, most drinks sold in pubs, clubs and restaurants already cost more than 50p per unit so there is no real difference under minimum pricing.
Minimum pricing is an effective policy because it targets the drinkers causing the most harm to themselves and society, whilst having almost no effect on moderate drinkers.
All alcohol sold is marked with the number of "units" it contains. Multiply that by the minimum unit price (currently £0.50) to get a minimum total price.
Christ, that's terribly written. Legalese is not a good way to communicate even very basic scientific concepts.
> The minimum price of alcohol is to be calculated according to the following formula—
> MPU × S × V × 100
> where—
> MPU is the minimum price per unit,
> S is the strength of the alcohol, and
> V is the volume of the alcohol in litres.
It's hard to figure out, but I think "alcohol" actually means "alcoholic beverage" and "strength" means "percentage of alcohol in the alcoholic beverage". So with a MPU of £0.50 and pint (0.56 litres) of 3% alcohol cider, you'd have £.5 × .03 × .56L × 100 = £0.84. So it looks like the "unit" in "minimum price per unit" is "centiliters", although this unit is mentioned literally nowhere in the law.
It's a minimum price per centiliter of pure alcohol in the beverage. That's it.
UK drinkers are generally familiar with the "unit" system - although I had no idea how much a "unit" actually was, the rule of thumb of it being roughly one standard measure of spirits or half a pint of beer is easy to remember.
s.147 defines strength: "strength", in relation to alcohol, is to be determined in accordance with section 2 of the Alcoholic Liquor Duties Act 1979 (c. 4), thus "the alcoholic strength of any liquor is the ratio of the volume of the alcohol contained in the liquor to the volume of the liquor (inclusive of the alcohol contained in it)".
It's defined in such terms as that makes it easy to calculate - both strength and volume can be looked up from the label of the alcohol. The average person wouldn't know where to start with centiliters of pure alcohol in the beverage. You don't actually need to know what a unit is to calculate it, but it's 10ml of pure alcohol, or 25ml of a 40% spirit (standard sales amount). It'll be familiar to most UK drinkers.
> strength is taken to be the alcoholic strength by volume as indicated by the mark or label
This phrasing frustrates me quite a bit. I assume they're referring to "% concentration of ethanol by volume", but they chose to express it in this obtuse "units" and "strength" nomenclature. (Or is this referring to the "proof" as the strength in their formula? Is that metric used in Scotland?)
As Symbiote explains above, units are just (volume * %ABV) expressed in a standard unit -- centiliters. It seems like a great system... it's like "standard drinks" in the US but actually printed on bottles. I imagine removing the need for people to do multiplication in order to figure out how much they are drinking is probably a good thing.
It's absolutely effective. Much of the public aren't as educated as we might like, and communication needs to be as simple as possible. Using units of measure will only serve to confuse, because it adds additional complexity in interpreting the advice.
"Units" reduce the complexity to a single number. For most drinks it will be 1, 2 or 3 units. Simple numbers, single digits.
General health advice will state that n units are the maximum recommended per week or day for men or for women. It's a single number to remember. Make sure the drinks you have total less than that maximum number, and you'll be following the recommendations.
The aim here isn't to be scientifically accurate. It's to reduce the problem to its essentials so that the message is clear and simple, and everyone in the entire population can understand it and follow it. By that measure, it's wildly successful.
> Using units of measure will only serve to confuse, because it adds additional complexity in interpreting the advice.
Units are an unit of measure. It's literally a different name for a centilitre.
> "Units" reduce the complexity to a single number. For most drinks it will be 1, 2 or 3 units. Simple numbers, single digits.
Centilitres reduce the complexity to a single number. For most drinks it would be 1, 2, or 3 centilitres. Simple numbers, single digits.
> General health advice will state that n units are the maximum recommended per week or day for men or for women. It's a single number to remember. Make sure the drinks you have total less than that maximum number, and you'll be following the recommendations.
General health advice will state that n centilitres are the maximum recommended per week or day for men or for women. It's a single number to remember. Make sure the drinks you have total less than that maximum number, and you'll be following the recommendations.
A "unit" is a specific amount of alcohol though. Not very obtuse if you are familiar with it, and know that, for example, a pint of session ale is around a couple of units. The minimum price is applied per alcohol unit.
A 'unit' in Scotland/UK is 1cl of pure alcohol. So to get the number of 'units' of alcohol you multiply the the 'strength', in % ethanol by volum, by the volume of the container it is sold in. So a 1 liter bottle of vodka is 1l x 40% = 40 units and a bottle of wine in 0.75 x 13% = 9.75 units.
You must pay at least a certain amount of money for a certain mass of ethanol.
The minimum price of any container of ethanol is determined by how much ethanol is in that container.
In Ontario, Canada, it works differently. They attempt to apply different minimum prices to various broad categories of alcoholic drink (beer vs wine vs liquor).
Yes - per liter of pure ethanol. If you buy a pint of regular lager beer you are buying basically 0.56L times 5.2% alcohol which is 2.9 cl pure ethanol, or as a brit would some times say "about 3 units". So a minimum proce per unit is the same as a minimum price per litre of pure ethanol. The minimum price per liter of ethanol is 100x the minimum price per unit (since one unit is 1 cl pure ethanol).
The reason this is so fantastically confusing is because sometimes even regulators use "alcohol" to refer to the drink, and not the ethanol.
Basically. There is a minimum price set of 0.50 per unit. This means a bottle of whisky, 70cl at 37.5% ABV cannot retail for less than £14 whereas previously these would be on promotion sometimes at £11/£12/£13.
By setting it per unit instead of quantity of drink the government targets super strength cheap cider etc that were linked to lots of anti-social behaviour and crime.
Apologies for some domestic political comment on HN - but surely the Scotsman isn't about to give the terrible SNP credit for something?!
Was there not a more negative spin they could've used, e.g. "deaths fall by smaller percent than promised/hoped"?
I note this policy is being mooted UK wide - good. Overuse - and outright abuse - of alcohol is so prevalent and "normal" in the UK it's shocking.
Impact to prices in bars and supermarkets has been totally negligible to anyone enjoying e.g. a pretty cheap £6 bottle of wine or four-beers-for-£5 bundles. It's the supercheap £3 for 2L of strong cider this policy's targeted at and it looks like it might be helping.
> I note this policy is being mooted UK wide - good.
To moot is to argue, but then your next statement seems to suggest you want the policy to be rolled out across the UK? Are you for or against rolling this policy out across the UK?
I currently live in New Zealand where alcohol is relatively expensive and it has a massive drinking problem for young persons. When I go back to the UK, the problem is about the same, but the young people aren't going broke buying alcohol. I don't think it works. Increasing the price of Tobacco didn't do much to stop smoking, but vaping and preventing smoking in public areas did. Changing social attitudes to smoking is fundamentally what reduced it.
Personally, I think it's better to use the carrot and not the stick. It shouldn't be the responsibility of the state to raise people's children correctly.
I think this works in my experience. As a child, my parents would let me have a small drink with a meal. As I grew up I never felt the need to drink to excess, I knew how alcohol worked. My sibling had the same experience and doesn't drink. My younger sibling still, was prevented from drinking anything and then went crazy when they legally could.
"mooted" here means "considered". The authorities are considering extending this policy from Scotland to the whole of the UK. brianmcc is in favour of this.
IIRC, it depends on your study period. Increasing the price of tobacco has been found to have diminishing effects. It was very effective when they first started doing it, but now the price is so high in some countries that price-sensitive smokers have already stopped and further increases do little.
Agree with you on using a carrot. Iceland dealt with its youth drinking problem very effectively by building youth centres and sports/activities programs.
Our country has been starved of resources for young people since the short sighted 80s idea to sell off school sports facilities.
By comparison the community facilities in Iceland are wonderful.
I'm surprised that Iceland had a youth drinking problem though. Not that kids everywhere don't find ways to rebel but alcohol seemed very expensive when I was last there. Far in excess of the minimum prices alcohol in Scotland.
I'm meaning "the policy is being considered" as others mention.
Yeah I'm generally for it, but along with the wealth of consultation materials it's recognised as not being a panacea, it's a factor to help a country with a serious recognised problem.
It could be overdone - I'm not in favour of prohibitive pricing across the board - but it feels a sensible pragmatic starting point to me.
I'm going to propose that your having a drink when you were a child and "knowing how alcohol worked" has absolutely nothing to do with your lack of a drinking problem..
One year with numbers that small doesn't prove it yet though. Maybe they're just exited about the possibility of another referendum on Scottish independence. Who knows, with this data.
England doesn't have this policy. The rate of alcohol-related deaths is half of that in Scotland. And alcohol is only one issue among many. Increasing the cost of alcohol may reduce the number of alcohol-related deaths but what is actually doing for people who need help? Either they have less money or they go somewhere else.
The meta of this policy is kind of interesting too. This kind of price tinkering, control freakery is very New Labour (and probably Conservatives now too, although to a lesser extent). It feels sophisticated, and it is usually accompanied by research from very serious civil servants who model the impact down to the decimal point.
The problem is that these policies always has unintended consequences, you use your blunt instrument to achieve your primary aim...but then other stuff happens. I get that we need to give economists jobs...but can't they just do it somewhere else?
Rather than tinkering with prices, why not focus on exactly why these people are making these choices? The govt has had long enough. And, from what I have read, NHS Scotland just whine about poverty (and now austerity the bogeyman de jour). We have known for years (over a decade iirc) that these effects still exist after income (rich people in Scotland die faster than in England too). Maybe that is a link worth examining: doctors playing politics and patients with poor life expectancy? Ineffective policy-makers (there is little evidence that the govt are particularly competent in anything other than railing against "Westminster")? Ineffective managers in the NHS?
Serious question: what if the answer to "why these people are making these choices" turns out to be "culture"? As in, this is the way lots of big Scottish people have behaved in front of lots of little Scottish people for generations, and absent any opprobrium from the rest of society (which is something this law provides, in addition to its purely economic effect), it will continue that way for the foreseeable?
At that point would it be reasonable for Scotland, as a society, to decide to put its thumb in the scale through a measure like the one discussed in the article to try to reduce the harm?
Note: I've never been to Scotland, don't know any Scottish people, and certainly don't have my finger on the beating pulse of Scottish culture, so the above is purely a hypothetical! I'm just always curious to see how people who emphasize the economic causes of problems think about possible non-economic factors.
Culture, and also despair. Perhaps similar to the US opiate crisis.
There are a lot of people in the UK who drink "too much", and a general distribution of people genetically predisposed to addiction. To drink yourself to death requires something more, usually falling off the edge of society. People who feel economically and socially unwanted, growing up in a "hard" culture.
Glasgow and Dundee in particular were cities of the Empire. When that came to an end in 1950 onwards there was a huge spike in unemployment, and a lot of the traditional heavy industries gradually left. This left a huge scar across both the physical infrastructure of Scotland (run down housing) and its culture. Trainspotting isn't exactly a documentary but it's a culturally appropriate portrait of how things were.
This is gradually changing as the country acquires 21st century industries (satellites, biosciences, video games, banking), but that on its own doesn't do a lot for the old drunks.
Just a note... Trainspotting was set mostly in Edinburgh, not Glasgow. Glasgow is worse off - it's a larger city that historically had a larger reliance on industry.
Rough stats... Glawgow's life expectancy is one of the lowest in the UK and lower than Edinburgh by 2+ years for both men and women. Its employment rate is nearly 10% lower than Edinburgh.
For Americans: comparing Glasgow to Edinburgh is a bit like Baltimore vs Washington DC. Not a perfect comparison, but close enough to get the general idea.
I am not emphasising the economic causes. I am saying precisely the opposite: this is a public health issue being solved by a civil servant like it is a problem in an economics textbook.
And yes, the issue is cultural. But that doesn't really matter either way (and if the issue is cultural then you can't solve it by increasing costs any way...you are just taxing people who have a problem).
Fair enough, I see that now on a re-read. Sorry for mischaracterizing your position.
But I still think taxing a thing, especially in this particular way where the policy is very clearly saying "we want to address this particular behavior" is a way for a society to indicate that it wishes to change. Stigma can be very powerful and useful for changing behavior and, through attrition, culture. Though obviously it can go overboard.
Wut? That makes no sense. What we know is: higher prices of a certain product will cause consumption of that product to fall. Will it happen every time? No. And you don't necessarily know if it is going to change behaviour in the way you want (again, that is the kind of policy control freakery that has, generally, not worked very well but was so beloved of New Labour/Cameron). And it may have unintended consequences. There is no stone tablet inscribed with "price is everything" that the world must obey (although that stone tablet may certainly exist at the UoC).
And you missed the point. If England doesn't have this, and alcohol-related deaths are lower is it reasonable to conclude that other stuff is going on (the fact that Scotland has much lower life expectancy would suggest that this is a reasonable conclusion).
There is no "increased revenue" (apart from a one-time duty gain...presumably). It is just minimum pricing.
Hypothecation isn't a tricky topic, it hasn't been commonly used in govt finance globally since the late 19th century (and this term usually means hypothecating govt revenues to a creditor). If you mean reserving the proceeds of a tax for a certain use though, that happens very commonly in the UK (the reason people, usually, talk about this in the UK is because some edgelords have a problem that national insurance is allocated to the NHS whilst the NI "fund", there is no fund in a financial sense, says that the money can't be spent that way).
I'm not sure that's true. Charges for e.g. plastic bags in supermarkets had a dramatic effect across the entire country. Even if you can afford an expense, people don't like paying for things if they don't have to. When saving money is easy--like bringing some old bags to the supermarket, people do adapt their behaviour. It adds up over time to be a decent saving.
That said, the problems with alcoholism often affect the less well off, so if it did materially affect them more, then that's probably not a particularly bad thing in terms of satisfying the objectives for the change. This law is primarily affecting the purchase of low quality and high alcohol beverages, like really cheap ciders and lagers. I occasionally buy bottled real ale, and the price has not changed at all. It's around £1.65-£1.80 per bottle in a supermarket. Still much cheaper than at the pub, but several times more what a multipack of cheap cans cost. If the objective is to improve public health by making binge drinking harder, then I think the pricing will actually be effective. It worked for smoking. The pricing of the cheap booze in supermarkets was ridiculously cheap, and I personally think that while it might have benefitted the drinks companies and the supermarkets, it's a net negative for society at large, and overall many people and their families will have their quality of life improved by the change. The change is not stopping purchase of alcohol, or even raising the price of most drinks, but it is raising the price of the stuff people binge on. If you're a moderate and responsible drinker, then you'll not even notice the difference.
Correct. I make a fair bit of money and I honestly don’t even look at prices at the grocery store unless it’s specialty item (like a nice Champagne or something, but even then I barely glance at the price.) These little sin taxes are more about raising government revenue than actually changing behavior. For example, if we really thought the government should intervene with smoking, why not just ban cigarettes? It’s because government has gotten addicted to the taxes collected.
Sounds like this is a case of "law of small numbers." The deaths dropped by 40 in a single year in a single city? 40 people? Does that not see drastically small to use to back something like this up?
I only thought of Japan because they sell alcohol (beer and sake) in vending machines there. Doesn't really get much easier to buy than that. And alcohol is popular there, it's not as if it's a country with prohibition.
[1] https://www.worldlifeexpectancy.com/cause-of-death/alcohol/b...