Presentation to Committee on Justice, Defence and Equality, Dublin, March 25, 2014

1. Tim Stockwell, PhD
Director, Centre for Addictions Research of BC
Professor, Department of Psychology, University of Victoria
Minimum alcohol price policies
in action:
A report from Canada
Presentation to Committee on Justice, Defence and Equality,
Dublin, March 25, 2014

2. All of Canada's 10 provinces set minimum prices
for alcohol in liquor stores and/or bars

3. British Columbia
legally prohibited alcohol
between 1913 and 1917
A liquor control
officer destroys
brewing equipment

4. Minimum Pricing:
Measures to set a floor price for alcohol
In approximate order of potential effectiveness
(low to high):
1. Bans on below-cost alcohol (UK)
2. Fixing a minimum profit margin (US)
3. Setting a minimum retail price per litre of
beverage (Canada)
4. Setting a minimum price per unit of
alcohol (Scotland)

5. Despite popular beliefs to the
contrary…
Increased alcohol prices lead to
reduced rates of illnesses and
injuries associated with heavy
drinking patterns
Rationale
for Alcohol Price Policies

6. Alcohol price and tax strategies have
strong scientific evidence for effectiveness
Summary analyses of all high quality published studies
indicate
1. A 10% increase in price leads on average to a 5%
reduction in consumption
2. Price increases lead to reductions in drinking by heavy
and problem drinkers
3. Price increases also lead to reductions in serious
alcohol-related injuries and illnesses
Minimum pricing is just one variation - theory and
evidence to date suggests it is particularly well targeted
towards heavy drinkers and should be effective

8. 1. Heavy drinkers prefer cheap alcohol: e.g.
Top 10% of US drinkers by volume spend on
average 79c per standard drink versus $4.75
for lowest 50% ie light drinkers
Kerr and Greenfield (2007)
2. Greater responsiveness to price changes
near lower end of “price-quality spectrum”
favoured by higher volume drinkers
Gruenewald et al (2006)
In theory, minimum pricing might be a particularly
well targeted and effective alcohol pricing strategy
Why is cheap alcohol
important for public health policy?

9. Do increases in minimum
alcohol prices lead to
reduced consumption?

10. Case Study: Saskatchewan
• Evaluation of a public health inspired proposal to increase
all minimum prices SIMULTANEOUSLY with higher prices
for higher strength beverages [ie similar to MUP]
• Four strength categories for beer (<6.5% to >8.5%) with
minimum prices set between the equivalent of $1.58 and
$2.48 per standard drink
• Two strength categories for wine, 2 for coolers and 3 for
spirits

11. Impacts on Consumption II
Stockwell, Zhao et al, American J Public Health, 2012
80
85
90
95
100
105
110
115
120
1 2 3 4 5 6 7 8 9 10111213 1 2 3 4 5 6 7 8 9 10111213 1 2 3 4 5 6 7 8 9 10111213 1 2 3 4 5 6 7 8 9 10111213
2008/09 2009/10 2010/11 2011/12
Age15+percapitaalcoholconsumption
Fiscal period, April 2008 to March 2012
Consumption of alcoholic beverages in Saskatchewan
before and after a major Minimum Price policy change
Total Ethanol
Beer
Spirits
Wine
Coolers
Cocktails
Liqueur

12. Findings
• A 10% increase in minimum prices significantly reduced
consumption of beer by 10.1%, spirits by 5.9%, wine by
4.6%, and all beverages combined by 8.4%
• Significantly greater reductions for government liquor
stores where minimum prices most affected retail prices
and for beverages with most products affected
• There was a significant shift away from high to low
strength beers and wines
• Increase in government revenue from liquor – approx.
$40m per annum
• Increase in profits to alcohol wholesalers

13. Informal reports of benefits
“Higher prices for cheap booze cuts binge drinking, Sask. Finds” -
Saskatoon Star Phoenix July 5, 2010
“Saskatchewan one of first jurisdictions in the world to implement
across the board minimum pricing…linked to a formula
accounting for the amount of pure alcohol in each product”
"The concept is to discourage excess consumption through binge
drinking,” - Saskatchewan Liquor and Gaming Authority
Police calls per month related to intoxication or disturbances
halved - local police inspector
Late night violence and vandalism in public places dramatically
reduced – Saskatoon Police Chief

14. Do increases in the
minimum alcohol prices
lead to reduced alcohol-
related harm?
Case Study of British
Columbia

15. Acute Alcohol
Attributable Hospital Admissions
Unintentional injuries
Motor vehicle accidents
Poisonings
Accidental poisoning & exposure to alcohol
Falls
Fires
Drowning
Other unintentional injuries
Intentional injuries
Self-inflicted injuries
Violence-related injuries
Intentional self-poisoning by and exposure to alcohol
Other intentional injuries

17. Estimated impacts on alcohol
attributable hospital admissions
Stockwell, Zhao et al (2013) American Journal of Public Health (Open Access)
% Change in alcohol attributed admissions with a
10% increase in average minimum price:
Type of hospital
admission
Immediate
impact
Delayed
impact after 2
years
Acute -8.95% ** -1.67%
Chronic -5.31% -9.22% *
*P<0.05 **P<0.01.

18. Forthcoming Analysis of Crime Impact
• 9 years of crime data for 89 local health areas in BC
• Controls for season, cost of living, density of liquor
outlets, household income, demographic profiles
• 10% increase in average minimum price associated with
decreases of 19.5% in alcohol-related traffic offences,
18.5% in property crimes and of 10.4% violent crimes
• No significant effect on non-alcohol related traffic
violations
• Much larger effects than Sheffield Model predicts

19. Sheffield Model is supported but
gives conservative estimates of health and
crime outcomes for British Columbia
Comparative estimates of health and crime outcomes from an increase in
the average Minimum Price in BC from CA$1.15 to CA$1.50/Standard Drink
[Equivalent to £0.43p to £0.55p per UK Unit]
Immediate Delayed
Category of Alcohol
Attributable Harm
Sheffield
Model
CARBC
Studies
Sheffield
Model
[10 years]
CARBC
Studies
[2 years]
Deaths (N)
39 100 56 276
Hospital Admissions (N)
244 1432 610 1893
Crimes (N) 1346 7600 n/a n/a

20. Some Conclusions
• Most hypotheses regarding associations with alcohol
consumption and related harm were confirmed
• Gruenewald et al’s theory is likely correct and minimum
pricing per standard drink is well targeted to heavy
drinkers – and is a more feasible pricing policy
• The Sheffield Model underestimates the health benefits of
Minimum Unit Pricing for the UK
• Replication studies in other jurisdictions are required
See: Stockwell and Thomas (2013) Is alcohol too cheap in the
UK? Institute for Alcohol Studies, London, UK, 24 April.
Visit: www.carbc.ca and www.ias.uk.org for copies of papers

21. THANK YOU!
Thank you!