Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study

Vivian So; Andrew D. Millard; Srinivasa Vittal Katikireddi; Paolo Deluca; Colin Drummond; Douglas Eadie; Niamh Fitzgerald; Allison Ford; Ross Forsyth; Lesley Graham; Shona Hilton; Anne Ludbrook; Gerry McCartney; Oarabile Molaodi; Michele Open; Lynn Owens; Samantha Perry; Thomas Phillips; Martine Stead; Chris Yap; Lyndal Bond; Alastair Leyland

doi:10.2139/ssrn.3697993

Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study

Vivian So, Andrew D. Millard, Srinivasa Vittal Katikireddi, Paolo Deluca, Colin Drummond, Douglas Eadie, Niamh Fitzgerald, Allison Ford, Ross Forsyth, Lesley Graham, Shona Hilton, Anne Ludbrook, Gerry McCartney, Oarabile Molaodi, Michele Open, Lynn Owens, Samantha Perry, Thomas Phillips, Martine Stead, Chris YapLyndal Bond, Alastair Leyland

Faculty Of Humanities And Social Sciences

Research output: Working paper/Preprint/Pre-registration › Working paper

Abstract

Background: Minimum Unit Pricing (MUP) was introduced in Scotland at 50p per unit (8g) of alcohol on 1st May 2018 to reduce alcohol consumption and associated harms. We assessed its impact on alcohol-related emergency department (ED) attendances, drinking patterns, and having an alcohol-related diagnosis amongst ED attendees.

Methods: We used a natural experiment approach to compare outcomes between Scotland (intervention group) and England (comparison group). Two EDs in Scotland and two in England were recruited for one baseline and two post-intervention waves. Research nurses considered all attendees for interview, and recorded reasons for not interviewing attendees. The primary outcome was alcohol-related attendances among all recorded attendees. Secondary outcomes included alcohol-related diagnosis, binge drinking and high-risk drinking, and tested for differential effects across socioeconomic groups. Difference-in-difference regression models adjusted for age, sex and baseline covariates.

Findings: 12,207 participants were recruited in Scotland and 11,248 in England. The odds ratio for an alcohol-related attendance was 1.14 (95% CI 0.90-1.44) after the introduction of MUP in Scotland relative to England, after controlling for covariates. It is estimated that an additional 1.0% (95% CI -0.7% to 2.7%) of the ED attendances were alcohol-related than would have been the case in the absence of MUP. Meanwhile, the odds for an attendee having at least one alcohol-related diagnosis increased after MUP (OR=1.25, 95%CI 1.00-1.57). There was no evidence of substantive differences in the majority of other secondary outcomes after the introduction of MUP in Scotland, or of differential effects across socioeconomic groups.

Interpretation: We found no evidence that MUP impacted on alcohol-related ED attendances.

Original language	English
DOIs	https://doi.org/10.2139/ssrn.3697993
Publication status	Published - 28 Oct 2020

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

public health
minimum unit price
alcohol policy
difference-in-difference
natural experiment

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10.2139/ssrn.3697993

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So, V., Millard, A. D., Katikireddi, S. V., Deluca, P., Drummond, C., Eadie, D., Fitzgerald, N., Ford, A., Forsyth, R., Graham, L., Hilton, S., Ludbrook, A., McCartney, G., Molaodi, O., Open, M., Owens, L., Perry, S., Phillips, T., Stead, M., ... Leyland, A. (2020). Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study. https://doi.org/10.2139/ssrn.3697993

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title = "Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study",

abstract = "Background: Minimum Unit Pricing (MUP) was introduced in Scotland at 50p per unit (8g) of alcohol on 1st May 2018 to reduce alcohol consumption and associated harms. We assessed its impact on alcohol-related emergency department (ED) attendances, drinking patterns, and having an alcohol-related diagnosis amongst ED attendees. Methods: We used a natural experiment approach to compare outcomes between Scotland (intervention group) and England (comparison group). Two EDs in Scotland and two in England were recruited for one baseline and two post-intervention waves. Research nurses considered all attendees for interview, and recorded reasons for not interviewing attendees. The primary outcome was alcohol-related attendances among all recorded attendees. Secondary outcomes included alcohol-related diagnosis, binge drinking and high-risk drinking, and tested for differential effects across socioeconomic groups. Difference-in-difference regression models adjusted for age, sex and baseline covariates. Findings: 12,207 participants were recruited in Scotland and 11,248 in England. The odds ratio for an alcohol-related attendance was 1.14 (95\% CI 0.90-1.44) after the introduction of MUP in Scotland relative to England, after controlling for covariates. It is estimated that an additional 1.0\% (95\% CI -0.7\% to 2.7\%) of the ED attendances were alcohol-related than would have been the case in the absence of MUP. Meanwhile, the odds for an attendee having at least one alcohol-related diagnosis increased after MUP (OR=1.25, 95\%CI 1.00-1.57). There was no evidence of substantive differences in the majority of other secondary outcomes after the introduction of MUP in Scotland, or of differential effects across socioeconomic groups. Interpretation: We found no evidence that MUP impacted on alcohol-related ED attendances. ",

keywords = "public health, minimum unit price, alcohol policy, difference-in-difference, natural experiment",

author = "Vivian So and Millard, \{Andrew D.\} and Katikireddi, \{Srinivasa Vittal\} and Paolo Deluca and Colin Drummond and Douglas Eadie and Niamh Fitzgerald and Allison Ford and Ross Forsyth and Lesley Graham and Shona Hilton and Anne Ludbrook and Gerry McCartney and Oarabile Molaodi and Michele Open and Lynn Owens and Samantha Perry and Thomas Phillips and Martine Stead and Chris Yap and Lyndal Bond and Alastair Leyland",

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So, V, Millard, AD, Katikireddi, SV, Deluca, P, Drummond, C, Eadie, D, Fitzgerald, N, Ford, A, Forsyth, R, Graham, L, Hilton, S, Ludbrook, A, McCartney, G, Molaodi, O, Open, M, Owens, L, Perry, S, Phillips, T, Stead, M, Yap, C, Bond, L & Leyland, A 2020 'Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study'. https://doi.org/10.2139/ssrn.3697993

TY - UNPB

T1 - Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland

T2 - a natural experiment study

AU - So, Vivian

AU - Millard, Andrew D.

AU - Katikireddi, Srinivasa Vittal

AU - Deluca, Paolo

AU - Drummond, Colin

AU - Eadie, Douglas

AU - Fitzgerald, Niamh

AU - Ford, Allison

AU - Forsyth, Ross

AU - Graham, Lesley

AU - Hilton, Shona

AU - Ludbrook, Anne

AU - McCartney, Gerry

AU - Molaodi, Oarabile

AU - Open, Michele

AU - Owens, Lynn

AU - Perry, Samantha

AU - Phillips, Thomas

AU - Stead, Martine

AU - Yap, Chris

AU - Bond, Lyndal

AU - Leyland, Alastair

PY - 2020/10/28

Y1 - 2020/10/28

N2 - Background: Minimum Unit Pricing (MUP) was introduced in Scotland at 50p per unit (8g) of alcohol on 1st May 2018 to reduce alcohol consumption and associated harms. We assessed its impact on alcohol-related emergency department (ED) attendances, drinking patterns, and having an alcohol-related diagnosis amongst ED attendees. Methods: We used a natural experiment approach to compare outcomes between Scotland (intervention group) and England (comparison group). Two EDs in Scotland and two in England were recruited for one baseline and two post-intervention waves. Research nurses considered all attendees for interview, and recorded reasons for not interviewing attendees. The primary outcome was alcohol-related attendances among all recorded attendees. Secondary outcomes included alcohol-related diagnosis, binge drinking and high-risk drinking, and tested for differential effects across socioeconomic groups. Difference-in-difference regression models adjusted for age, sex and baseline covariates. Findings: 12,207 participants were recruited in Scotland and 11,248 in England. The odds ratio for an alcohol-related attendance was 1.14 (95% CI 0.90-1.44) after the introduction of MUP in Scotland relative to England, after controlling for covariates. It is estimated that an additional 1.0% (95% CI -0.7% to 2.7%) of the ED attendances were alcohol-related than would have been the case in the absence of MUP. Meanwhile, the odds for an attendee having at least one alcohol-related diagnosis increased after MUP (OR=1.25, 95%CI 1.00-1.57). There was no evidence of substantive differences in the majority of other secondary outcomes after the introduction of MUP in Scotland, or of differential effects across socioeconomic groups. Interpretation: We found no evidence that MUP impacted on alcohol-related ED attendances.

AB - Background: Minimum Unit Pricing (MUP) was introduced in Scotland at 50p per unit (8g) of alcohol on 1st May 2018 to reduce alcohol consumption and associated harms. We assessed its impact on alcohol-related emergency department (ED) attendances, drinking patterns, and having an alcohol-related diagnosis amongst ED attendees. Methods: We used a natural experiment approach to compare outcomes between Scotland (intervention group) and England (comparison group). Two EDs in Scotland and two in England were recruited for one baseline and two post-intervention waves. Research nurses considered all attendees for interview, and recorded reasons for not interviewing attendees. The primary outcome was alcohol-related attendances among all recorded attendees. Secondary outcomes included alcohol-related diagnosis, binge drinking and high-risk drinking, and tested for differential effects across socioeconomic groups. Difference-in-difference regression models adjusted for age, sex and baseline covariates. Findings: 12,207 participants were recruited in Scotland and 11,248 in England. The odds ratio for an alcohol-related attendance was 1.14 (95% CI 0.90-1.44) after the introduction of MUP in Scotland relative to England, after controlling for covariates. It is estimated that an additional 1.0% (95% CI -0.7% to 2.7%) of the ED attendances were alcohol-related than would have been the case in the absence of MUP. Meanwhile, the odds for an attendee having at least one alcohol-related diagnosis increased after MUP (OR=1.25, 95%CI 1.00-1.57). There was no evidence of substantive differences in the majority of other secondary outcomes after the introduction of MUP in Scotland, or of differential effects across socioeconomic groups. Interpretation: We found no evidence that MUP impacted on alcohol-related ED attendances.

KW - public health

KW - minimum unit price

KW - alcohol policy

KW - difference-in-difference

KW - natural experiment

U2 - 10.2139/ssrn.3697993

DO - 10.2139/ssrn.3697993

M3 - Working paper

BT - Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland

ER -

Impact of minimum unit pricing on alcohol-related emergency department attendances in Scotland: a natural experiment study

Abstract

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Keywords

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