Alcohol harm

Alcohol harm encompasses a broad range of health, social, and financial impacts that can affect individuals, families and society as a whole. Do not type over or delete this non-printing text

The now defunct Public Health England (PHE) published a review on the evidence on the public health burden of alcohol in England in December 2016.[1] This reported that “among those aged 15 to 49 in England, alcohol is now the leading risk factor for ill-health, early mortality and disability and the fifth leading risk factor for ill-health across all age groups”.[2]

Government policy

The Government has said that it does not have plans to introduce a standalone alcohol strategy and that alcohol will be considered within a forthcoming UK wide cross-government addiction strategy.[3]

In a July 2019 Green Paper, Advancing our health: prevention in the 2020s, the Government outlined a number of measures to reduce alcohol related harm.[4] These included; increasing the availability of alcohol-free and low-alcohol products, closer working between alcohol treatment and children’s services and ensuring people are aware of the health risks through the One You campaign.

The NHS Long Term Plan, published in January 2019, highlighted the introduction of specialist Alcohol Care Teams (ACTs) at some hospitals and their success in reducing A&E attendance, bed days, readmissions and ambulance callouts.[5] The Plan said that over the next five years, the hospitals with the highest rate of alcohol dependence-related admissions would be supported to fully establish ACTs using funding from their clinical commissioning groups health inequalities funding supplement, working in partnership with local authority commissioners of drug and alcohol services.

The most recent alcohol strategy was published in 2012 and focused on targeting binge drinking culture and alcohol related violence.[6] It committed to a consultation on minimum unit pricing (MUP) on alcohol and to look at a number of other measures to tackle excessive drinking and alcohol-related crime. Responding to the consultation, the Government said that it would keep minimum-unit pricing under consideration but would not implement it at the time. [7]

Alcohol consumption during the Covid-19 pandemic

In July 2021, PHE published a report on alcohol consumption and harm during the Covid-19 pandemic.[8] The report summarised:

Taken together, all survey data measuring self-reported alcohol consumption suggests a polarisation in drinking. Most respondents reported drinking the same volume and the same frequency as they did before the pandemic. Roughly similar proportions of respondents reported drinking more or more frequently and drinking less or less frequently. Where surveys measured a respondent’s drinking before the pandemic, they suggest that people who reported drinking more during the pandemic than before tended to be heavier drinkers.[9]

PHE said that addressing alcohol consumption and harm “must be an essential part of the UK government’s Covid-19 recovery plan, given that tackling geographic health disparities are part of the government’s Build Back Better plans”.[10] PHE identified long-term, sustained action to prevent and reduce liver disease as a priority for public health.

Changes to the alcohol duty system

In the Autumn Budget and Spending Review 2021, the Government announced changes to the alcohol duty system, aimed at simplifying it.[11]

Under the new arrangements, the number of main rates would be cut from 15 to 6, and all products will be taxed in proportion to their alcohol content. This would ensure that alcohol will be taxed “in a progressive manner, ensuring higher strength products incur proportionately more duty, addressing the problem of harmful high-strength products being sold too cheaply”. New rates will be introduced for low strength drinks below 3.5% alcohol by volume (ABV), to encourage manufacturers to develop new products at lower ABVs, with all product categories set at the same rate. It is anticipated that these changes will take effect from February 2021.

The Government said that the changes had been designed to support its public health objectives, and expected the changes to have a positive impact, with the potential to reduce alcohol-related hospitalisations and deaths, as well as providing other positive health outcomes.[12]

Minimum unit pricing

Alcohol licensing is a devolved matter.

In England, a ban on selling alcohol below a “permitted price” has been in place since 28 May 2014. This was introduced through the Licensing Act 2003 (Mandatory Conditions) Order 2014. The permitted price is defined as the level of alcohol duty plus VAT.

In June 2021, the Government said there were “no plans” to introduce MUP in England. However, it would continue to “monitor the impact of MUP in Scotland and Wales as it emerges”.[13]

In Wales, the Public Health (Minimum Price for Alcohol) (Wales) Act 2018 enabled the introduction of MUP on public health grounds, an area within the Welsh Assembly’s legislative competence. A minimum unit price of 50p was introduced from 2 March 2020.

In Scotland, a minimum unit price of 50p has been in place since 1 May 2018. 

[1]      As part of a wider reorganisation of public health bodies England, Public Health England (PHE) was replaced by the UK Health Security Agency (UKHSA) and the Office for Health Improvement and Disparities (OHID) in 2021. OHID will address a range of public health issues including alcohol and tobacco.

[2]     PHE, The Public Health Burden of Alcohol and the Effectiveness and Cost Effectiveness of Alcohol Control Policies An evidence review, December 2016

[3]     PQ 41318, 7 Sep 201

[4]     Cabinet Office and DHSC, Advancing our health: prevention in the 2020s- consultation document, 22 Jul 2019

[5]     NHS, Long Term Plan, 7 Jan 2019

[6]     Home Office, Alcohol strategy, 23 Mar 2012

[7]     Home Office, Alcohol strategy consultation, published 28 Nov 2012

[8]     PHE, Monitoring alcohol consumption and harm during the Covid-19 pandemic: report, 15 Jul 2021

[9]     PHE, Monitoring alcohol consumption and harm during the Covid-19 pandemic: report, 15 Jul 2021

[10]    PHE, Monitoring alcohol consumption and harm during the Covid-19 pandemic: report, 15 Jul 2021

[11]     HM Treasury, Autumn Budget and Spending Review 2021, Oct 2021, para 2.178-82, and para 5.58-9

[12]     HL3894, 22 Nov 2021

[13]     PQ 19662 [on MUP], answered 24 June 2021