Alcohol purchasing by ill heavy drinkers; cheap alcohol is no single commodity

Abstract

ObjectivesPotential strategies to address alcohol misuse remain contentious. We aim to characterise the drink purchases of one population group: heavy drinkers in contact with Scottish health services. We contrast our findings with national sales data and explore the impact of socio-economic status on purchasing behaviour.Study designCross-sectional study comparing alcohol purchasing and consumption by heavy drinkers in Edinburgh and Glasgow during 2012.Methods639 patients with serious health problems linked to alcohol (recruited within NHS hospital clinics (in- and out-patient settings) 345 in Glasgow, 294 in Edinburgh) responded to a questionnaire documenting demographic data and last week's or a ‘typical’ weekly consumption (type, brand, volume, price, place of purchase). Scottish Index of Multiple Deprivation quintile was derived as proxy of sociodemographic status.ResultsMedian consumption was 184.8 (IQR = 162.2) UK units/week paying a mean of 39.7 pence per alcohol unit (£0.397). Off-sales accounted for 95% of purchases with 85% of those <50 pence (£0.5 UK) per alcohol unit. Corresponding figures for the Scottish population are 69% and 60%. The most popular low-priced drinks were white cider, beer and vodka with the most common off-sales outlet being the corner shop, despite supermarkets offering cheaper options. Consumption levels of the cheapest drink (white cider) were similar across all quintiles apart from the least deprived.ConclusionsHeavy drinkers from all quintiles purchase the majority of their drinks from off-sale settings seeking the cheapest drinks, often favouring local suppliers. While beer was popular, recent legislation impacting on the sale of multibuys may prevent the heaviest drinkers benefiting from the lower beer prices available in supermarkets. Non-etheless, drinkers were able to offset higher unit prices with cheaper drink types and maintain high levels of consumption. Whilst price is key, heavy drinkers are influenced by other factors and adapt their purchasing as necessary.

The effect of price increases on predicted alcohol purchasing decisions and choice to substitute

“…Those who drank at levels which put them at high risk for short-term harms appeared to be more likely to substitute in response to a 50% price increase than those at low risk of short-term harms, across all beverage types examined. This concurs with research by Gill et al (2015) which showed that, among very heavy drinkers, reduction in affordability was associated with substitution for a cheaper beverage rather than reduction in consumption levels. Higher price increases may be more effective at reducing overall consumption among those who drink at levels which put them at low risk for short-term harm (i.e.…”

“…Furthermore, this study did not take into account the potential effects of other substances, such as tobacco and illicit drugs, the consumption of which may alter in response to changes in alcohol affordability if intoxication is the primary goal of consumers (Moore, 2010). Very heavy drinkers (who drink quantities considerably above the consumption levels putting them the risk of harms) may respond differently to other drinkers, but the number of drinkers in this group was too small to allow sub-analysis in this study (Falkner, Christie, Zhou, & King, 2015;Gill et al, 2015).…”

Potential Impact of Minimum Unit Pricing for Alcohol in Ireland: Evidence from the National Alcohol Diary Survey

“…Consistent with our findings, they also found high risk drinking to be greatest among men (Crawford et al, 2012). While the results from the UK studies are not directly comparable, as they tested the effects of a MUP of <50p/unit which is approximately €0.70 per 8 grammes of alcohol, similar to our findings all studies revealed that high risk drinkers are most likely to purchase off-sales alcohol at less than the MUP (Crawford et al, 2012;Sheron et al, 2014;Gill et al, 2015). Unsurprisingly, the proportion of respondents purchasing cheap alcohol was higher in studies of F o r P e e r R e v i e w 12 people with serious alcohol-related problems in a hospital setting, compared to our study (Black et al, 2011;Sheron et al, 2014;Gill et al, 2015).…”

“…While a number of studies have examined individual level data regarding minimum unit pricing and the price people pay for alcohol for their own consumption, previous studies have focussed on people with serious alcohol-related problems in a hospital setting (Black et al, 2011;Sheron et al, 2014;Black et al, 2014;Gill et al, 2015) or a convenience sample of members of the public (Crawford et al, 2012). This is the first study to investigate the potential impact of minimum unit pricing by examining the relationship between harmful alcohol consumption, personal income, place of purchase and price paid for alcohol at a population level.…”

Heavy Drinkers’ Perspectives on Minimum Unit Pricing for Alcohol in Scotland

“…They had not understood that they would be paying a minimum of 50 pence for each unit of alcohol (8g ethanol) contained in a drink, with no option to benefit financially from, for example, bulk buying or purchasing an alternative beverage type. Our quantitative data show that the mean unit price paid for beer was slightly above 50ppu (Gill et al, 2015), but, we propose, high alcohol consumption levels of beer drinkers are supported through the availability of cheaper drinks such as cider (Black et al, 2014).…”