Is the drinks industry damaging democracy as well as health?

Dr Nick Sheron, FRCPRoyal College of Physicians Representative to the EU Alcohol and Health

Forum

Calling Time on Europe's Alcohol Problem, European Parliament, Brussels,

24 April 2013

Liver deaths in my unit in Southampton, most of the increase is alcohol related

Nick Sheron, unpublished data

BulgariaFinlandHungaryRomaniaUnitedKingdom

AustriaFranceItalyPortugalSpain

GreeceIrelandNetherlandsNorwaySweden

BelgiumCroatiaCzechRepublicDenmarkGermanyPoland

WHO – HFA data

Changes in liver death rates in Europe

Linear regression of open source data, WHO-HFA

64% of the variation in EU liver mortality can be explained by differences in population level consumption of alcohol.

R 2 = 0.64

Brandish & Sheron 2010

ONS data, N Sheron Clinical Medicine 2010

Beer

Vodka

1992

Increasing wealth,Decreasing relative priceDifferent retailers

ONS data, decennial supplements 1921-2001, N Sheron

Taxation v Minimum Unit Price (MUP)

Taxation MUP

Impact on all drinks Impact only cheapest drinks

Impacts on pubs / bars No Impact on pubs / bars

Impact proportional to consumption Impact targeted to heavy drinkers

Taxation v Minimum Unit Price (MUP)

Taxation MUP

Revenue to government Revenue to industry

Impact on all drinks Impact only cheapest drinks

Impacts on pubs / bars No Impact on pubs / bars

Scotland introduced MUP because they were unable to increase taxation

The Scottish Nationalist Party did so AS A MANIFESTO POLICY COMMITMENT

and subsequently won a landslide election victory

Weekly alcohol consumption in 381 liver patients in Southampton

Median consumption in patients with

alcohol related liver disease is

equivalent of 4 bottles of vodka / week

Half drink more…

Univ of Southampton data, N Sheron

The actual impact of MUP on patients with liver disease (n= 143)

The actual impact of MUP on patients with liver disease (n= 143)

Univ of Southampton data, N Sheron

Minimum unit price is an exquisitely targeted measure

0%10%20%30%40%50%60%70%80%90%

100%

% population % alcoholconsumed

Moderate drinkersHazardous drinkersHarmful drinkers

One third of profitability comes from harmful drinkers

Three quarters of profitability comes from hazardous and harmful drinkers

UK Dept of Health data

The Pareto principle

1/5 of consumers consume 4/5 of any product

0%10%20%30%40%50%60%70%80%90%

100%

% population % alcoholconsumed

Moderate drinkersHazardous drinkersHarmful drinkers

X Minimum unit price

targeted at heavy consumers who buy the cheapest alcohols