Minimum unit pricing for alcohol saves lives, so why is it not implemented more widely?

Minimum unit pricing (MUP) for alcohol sets a price below which alcohol cannot be legally sold based on alcohol content. In Scotland, the price was set in 2018 at 50p per unit (8 g of alcohol)1 and will increase to 65p in September 2024.2 A major justification for MUP is to target cheaper, high strength alcohol, which is disproportionately purchased by people who drink heavily.1 MUP is one of a suite of alcohol pricing policies, including excise taxes,3 endorsed for implementation by all member states of the World Health Organization.4

Minimum pricing for alcohol was introduced in Ontario, Canada, soon after prohibition was repealed in the 1920s.5 Minimum prices were used to stabilise alcohol markets that were operated by government alcohol monopolies, an important source of government revenue.5 Widespread adoption across all Canadian provinces began in the 1990s,6 with evidence of public health benefits.7 Some countries have MUP for spirits, but not for all alcohol (Armenia, Belarus, Kazakhstan, Kyrgyzstan, and Russia), for which it has been difficult to evaluate a unique effect, owing to multiple policies being implemented at the same time.8

There has been considerable interest in evaluating the effects of MUP in Scotland. …