Will minimum prices work to minimize harm?

The recent changes to pricing rules in alcohol-serving establishments across BC have been met by applause, discontentment, indifference — and confusion. In effect, two changes were announced: the fact that restaurants and bars can now have happy hour drink specials, allowing them to change the price of alcoholic drinks throughout the day, and the introduction of province-wide minimum drink prices, which apply at all times, not just during happy hour.

BC's new minimum prices for standard alcoholic drinks in booze-serving establishments.
BC’s new minimum prices for standard alcoholic drinks in booze-serving establishments.

Minimum unit pricing is not a new concept. All provinces, except Alberta and Quebec, have some type of minimum pricing policy. Even prior to these new changes, BC had minimum pricing policies in place in liquor stores, though prices were much lower than many other provinces. These new requirements will bring the rest of the province in line with municipalities such as Victoria, which have had minimum unit pricing policies and bylaws in bars and restaurants for quite some time to reduce violence and other late-night order problems.

While the new requirement to charge at least $3 per standard drink may cause prices to increase at some establishments, many British Columbians will likely not notice the implementation of the minimum unit pricing—and in some instances, happy-hour specials will make booze cheaper than it was before. I can’t remember a time when I paid less than $5 for a beer at an establishment; $3 sounds like a steal. But minimum pricing isn’t really about getting “a good deal;” this bold move by the BC government is a step towards reducing alcohol-related harms in our province.

Every year in BC, there are more than 80,000 alcohol-related crimes, 1,800 alcohol-related deaths, and 18,000 alcohol-related hospitalizations. While many of us enjoy alcohol without incident, these staggering numbers remind us of how many of our fellow British Columbians are negatively affected by alcohol use. The introduction of minimum prices could reduce these numbers.

There is strong evidence that minimum alcohol pricing avoids punishing the majority of responsible drinkers while having the greatest impact on the behaviour and health of those most at-risk. Using BC hospital data, a recent study published in the American Journal Public Health found that for every 10 percent increase in minimum prices there was an immediate 9 percent reduction in hospital admissions for injuries and poisonings ‒ and a similar reduction in serious illnesses caused by alcohol (such as liver cirrhosis and cancers) two to three years later. Similarly, we have found immediate and delayed effects from minimum price increases on alcohol-related deaths. Is $3 really such a steep cost for reducing harm?

The BC government has listened to the strong research evidence supporting minimum prices and has taken a step in the right direction by implementing these prices for bars, restaurants and other establishments that serve alcohol. It is refreshing to see decisions being made will protect British Columbians while also respecting that alcohol is an important part of our culture and economy. However, in order to fully realize the harm-reduction potential of minimum pricing policies and offset the potential impact of happy hours, government needs to follow through on updating and overhauling minimum pricing in liquor stores. According to our research, this will have a much larger impact on high-risk consumption and related harms.

Kara Thompson, CARBC

Author: Kara Thompson, Centre for Addictions Research of BC

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC

21st century drinking in BC: more convenience, more government revenue and reduced harms?

On Friday January 31, 2014 the BC government endorsed all 73 recommendations contained in John Yap’s landmark review of liquor laws with the stated goal of modernizing BC’s approach to managing alcohol. Modern drinking in British Columbia will mean consumers are able to purchase and consume more types of alcohol and in more places. Bars, nightclubs and restaurants will be able to compete aggressively on price by offering happy hours; Canucks fans will be able to consume hard liquor while watching a game; festivalgoers will be able to purchase alcohol and wander freely as they drink it; shoppers will be able to buy alcohol with their groceries and parents will be allowed to bring their children into pubs.

The government heralds these and other measures as a way to free businesses and charities from cumbersome, out of date regulations. Interestingly, the media release is relatively silent on an encouraging swathe of other recommendations in the report that, while less politically appealing, make BC’s approach to alcohol also more responsive to health concerns. Mr Yap clearly heard the messages delivered during the review by individuals and groups concerned with health and safety, including those summarised in the CARBC submission.

We congratulate Mr Yap on his acknowledgement that alcohol is a major health issue and not just a matter for the economy, for tourism and government revenue. His very first recommendations concern the need to communicate the serious health effects of alcohol more effectively to British Columbians along with active promotion of the national drinking guidelines. The report even mentions the word “cancer”. This is critically important: at the present time the BC Liquor Distribution Branch has absolutely no mandate to acknowledge, address or monitor the health and safety consequences of the product it so efficiently distributes across our province. It will now be required to collaborate with health experts to design educational materials and, more importantly, consider how to price the many thousands of its alcoholic products so that: a) they are not too cheap and b) their price reflects their degree of potential harmfulness i.e. alcoholic strength.

Perhaps wisely, the government press release has not trumpeted the recommendations on alcohol pricing. It has used only cautious language stating rather timidly that the BC Liquor Distribution Branch should “consider” setting minimum prices according to the ethanol content of drinks and whether they are at “an appropriate level”. Such policies, while possibly the most effective available to government to reduce alcohol-related harm, are undoubtedly not quite as popular as the introduction of happy hours and less red tape for small business.

For the past eight years CARBC has been collecting and reporting indicators of alcohol consumption and related harms across 89 local areas of the province as part of the Alcohol and Other Drug (AOD) Monitoring Project. When Mr Yap’s report asserts that in 2011 there were 20,542 alcohol-related hospital admissions and 1191 alcohol-related deaths, those estimates were calculated by the AOD project team. They were also the basis of research published in the American Journal of Public Health identifying the significant positive impacts of minimum alcohol prices on BC hospital admissions. This same paper also identified negative but smaller impacts on hospital admissions from the increased availability of alcohol associated with the large increase in private liquor outlets that occurred between 2002 and 2006.

On the basis both of local and international research, if the government proceeds with only the more popular recommendations in the report, the net effect will be upward pressure on levels of alcohol consumption and increased harms. If the key recommendations for higher minimum prices based on ethanol content are fully implemented, the net effect will be reduced alcohol-related harms and increased government revenues. Maybe this is what 21st century drinking should be: more choices, more responsibility, more convenience and more financial incentives to produce, promote and consume less harmful products. Perhaps also more funds for treatment and prevention. We at CARBC will continue to watch and hope that the easier and popular policy changes will not be implemented in advance of those which are less popular but more effective in terms of protecting health and safety. Either way, we will observe and report the outcomes as they unfold.

Image  Image

Image   ImageImage

 

Authors (left to right): Tim Stockwell, Dan Reist, Kara Thompson, Gerald Thomas, & Kate Vallance