Minimum Unit Pricing for Alcohol: A Document Analysis of Evidence Submissions to the Scottish Parliament

Abstract Background Minimum unit pricing (MUP) of alcohol is a novel policy intervention aimed at increasing the price of the cheapest forms of alcohol to reduce alcohol consumption and associated harms. In Scotland, alcohol-related harms have increased exponentially during the past few decades and Scotland currently experiences the greatest level of alcohol-related mortality within the UK. Scotland would be the first country in the world to introduce the measure and therefore both advocates and critics have seized the opportunity to put forward the different arguments in the case of MUP. This study examines the evidence submitted to the Scottish Parliament with the aim of examining how arguments for and against MUP have been framed and to consider what forms of evidence have been drawn upon by different policy stakeholders to debate MUP. Methods The Scottish Parliament received evidence submissions from a wide variety of stakeholders in its first consideration of MUP as part of the Stage 1 scrutiny process for the Alcohol (etc.) Bill 2010. Sixty-five documents submitted by 47 different stakeholders (including politicians, health professionals, industry representatives, supermarkets and researchers) considered within meetings of the Select Committee were analysed. Data management was assisted using Nvivo 9, framework matrices, and thematically analysed using constant comparative methods. Results Arguments around alcohol policy have been actively constructed as a health issue by advocates for MUP in comparison to critics who highlight economic, ideological, and social aspects. Constructions of alcohol overconsumption as a population health issue, rather than an individual-level health problem, were contested. Alcohol epidemiology was drawn upon by advocates (to support a whole population approach) but also by critics (to argue alcohol harms are reducing). Issues raised in opposition include important potential secondary impacts such as exacerbating inequalities, increasing cross-border and illicit trade and perverse incentives (such as increases in profitability driving retailers to encourage increased sales). Conclusion Framing of alcohol policy as a health (rather than, for example, trade or justice) issue that requires a whole population approach has been important in creating conditions amenable to MUP being seriously considered by policymakers. The initial framing of an issue in different ways can lead to similar sources of evidence, such as routine epidemiological data, being used to suggest different actions are appropriate. Public health researchers and practitioners should be aware of the active construction process occurring in policy definition and adapt research and advocacy accordingly