Adapting existing behaviour: Perceptions of substance switching and implementation of minimum pricing for alcohol in Wales

Abstract

Aim: Minimum Pricing for Alcohol (MPA) was enacted in Wales on March 2nd 2020. During the legislative process (i.e. consultation and parliamentary discussion), concern was expressed about the possibility of some drinkers switching to using other substances in response to any rise in the cost of alcohol. This paper reports on findings from a study which explored these pre-implementation concerns and how the policy was shaped. Method: The research involved surveys (n=193) and interviews (n=87) with drinkers (predominantly harmful or treatment seeking) and providers of services. Survey responses were detailed, thus when combined with the interviews, provided a wealth of qualitative data, which are drawn upon in this paper. Results: The findings highlight an expectation that most drinkers would respond to the new policy with adaptations of their coping mechanisms to maintain alcohol use at pre-legislative levels. This was either by switching alcohol products and adjusting their lifestyle to maintain an affordable drinking habit or developing new behaviours to manage additional costs. A small group of those with previous experience of drug use were identified as likely to switch from using alcohol to some other substances. Conclusions: Prior to the legislation being implemented awareness of the detail of the policy was found to be low, and the perceptions of increased potential harm for certain groups, including switching, were linked to concern about a lack of treatment capacity.

Views on minimum unit pricing for alcohol before its introduction among people with alcohol dependence in Scotland: A qualitative interview study

“…The number of people reporting use of drugs as a substitute for alcohol or increased criminal activity were uniformly small across all studies. This aligns with the findings of a recent study examining potential substance-switching in people presenting to alcohol services before the introduction of MUP in Wales [27,28]. However, unlike the permanent price increase caused by MUP, much of the previous research literature is based on temporary experiences of alcohol unaffordability.…”

“…In 2012, it was estimated that only 25% of Scottish adults with possible alcohol dependence had ever accessed treatment services [34]. People with particularly complex vulnerabilities, such as the homeless and other marginalised groups may also have different experiences and perspectives it would be important to understand, although previous studies, including within the MUP evaluation program, have specifically targeted these populations [20][21][22][23][24][25][26][27][28]35].…”

Policy communities, devolution and policy transfer: The case of alcohol pricing in Wales

“…4 Yet some public health experts and government lawyers also saw the impending change as a potential opportunity for action. The provisions of the Wales Act did not take effect immediately and so this provided a fleeting “window of opportunity” to introduce enabling legislation (Livingston et al 2020 , 2). Despite the potential risk of a legal challenge by the UK government, the Welsh government followed this advice and introduced the legislation.…”

“…There are some marginal differences in the operation of the two policies. The Scottish legislation includes broader restrictions on alcohol retail promotions (Livingston et al 2020 ) and the enforcement protocols vary in each country (Government of Scotland 2018 , 2020 ). The overall similarities in approaches to alcohol pricing, however, would seem to suggest that Wales copied Scotland.…”

Participatory action research (PAR) research: critical methodological considerations

“…Service user involvement has tended to primarily focus on the active participation of “users” within treatment policy and provision agendas, rather than all users and ex-users and including evaluation and research activities. In a recently completed review of the Welsh Governments 10-year alcohol (and drug) strategy, there was no PAR material amongst the relevant data sets and evaluations (Livingston et al , 2017).…”