MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Evaluating Scotland’s Alcohol Minimum Unit Pricing (MUP): a natural experiment
A project funded by the National Institute for Health Research (NIHR)
Andrew Millard, BA, MSc, MPH, PhD.
Researcher, MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Scotland.
Faculty of Public Health (Scotland) 28-29 November 2019
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
The Minimum Unit Price policy in Scotland
• The price
• Groups most likely to be affected
• Potential effects
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
CompliancePrice change.
No alcohol <50ppu
ReducedPurchasing (in off-trade)
Reducedconsumption
Reducedharm
Economic impacton alcohol industry
Substitution:industrial alcohol
or drugs
Displacement of spending
Product and marketing changes
Theory of change for MUP
Change in Social norms and Attitudes to MUP
MUPimplemented
Influence of factors external to the strategye.g: other influences on alcohol price and/or disposable income
Impact on demand for
services
Slide by kind permission of Clare Beeston, NHS Health Scotland
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Evaluation Outcome Areas covered by our study
• Implementation and compliance • qualitative component (not a natural experiment)
• Alcohol Market • not covered
• Alcohol Consumption • Sexual Health Clinics and Emergency Departments components
• Health and Social harm• Sexual Health Clinics and Emergency Departments
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Research Aims for our quantitative components
• Emergency Departments (EDs) component:To determine the impact on alcohol-related harms and drinking patterns overall and by age, sex and deprivation.
• Sexual Health Clinics (SHCs) component:‘To determine the impact on non-alcohol substance use overall and by subgroups of interest.’
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Design and Methodology – EDs
Four Emergency Departments, natural experiment, three waves (snapshots)
iPad interviews for consenting eligible attendees
Reasons for not approaching and for ineligibility
Participant flow:
Response rates by wave: 79%, 72%, 66% of eligible attendees
Consented?Approachable? Interviewable? Eligible?
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Outcome measures for EDs
Primary Outcome:
• Alcohol-related attendances
Secondary Outcomes:
• alcohol misuse (FAST score >3 (range 0-16)
• mean FAST score
• binge drinking in the past week
• self-reported reason for attendance.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Design and Methodology – SHCs
Six sexual health clinics, natural experiment three waves (snapshots)
Self completion surveys
Additional data from clinic systems
Response rates by wave: 60%, 55%, 54%
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Outcome measures for SHCs
Primary Outcome
• Psychoactive substances other than alcohol in the last month.
Secondary outcomes:
• drug-specific rates of use within the last month,
• sources of alcohol,
• rates of higher risk drinking (FAST),
• binge-drinking.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Challenges to our quantitative projects
• Both ED and SHCs• Time pressures
• Ensuring consistency
• Maximising response rate
• Staffing
• Generalisability – additional data for all attendees
• ED only• Weather
• Diagnostic analysis – additional data for interviewees
• Equipment
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Conclusions so far
We must wait for our statistically adjusted results before drawing conclusions on our hypotheses.
Disclaimer:
This study/project is funded by the National Institute for Health Research (NIHR) Public Health Research programme (project reference 11/3005/40). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
More information
SPHSU MUP NIHR funded project website:
http://mup.sphsu.gla.ac.uk
Andrew Millard (SPHSU) [email protected]
MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
Steering committee members and co-investigators
Professor John Frank (SC)
Professor Sally Haw (SC
Professor Tim Stockwell (SC)
Professor Petra Meier (SC)
Dr John Holmes (SC)
Professor Iain Crombie (SC)
Ms Julie Breslin (SC)
Mr Kenneth Crawford (SC)
Professor Alastair Leyland(SC, PI)
Dr Vittal Katikireddi (SC CoI)
Ms Clare Beeston (SC, CoI)
Professor Lyndal Bond (CoI)
Dr Oarabile Moloadi (CoI)
Dr Gerry McCartney (CoI)
Dr Lesley Graham (CoI)
Mr Douglas Eadie (CoI)
Ms Martine Stead (CoI)
Dr Allison Ford (CoI)
Professor Anne Ludbrook (CoI)
Professor Colin Drummond (CoI)
Dr Paolo DeLuca (CoI)
Professor Shona Hilton (CoI)
Dr Andrew Millard (CoI)
Mr Ross Forsyth (CoI)
Professor Tom Philips (CoI)
Dr Vivian So (CoI)
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