Dr. John Holmes:

Yes, I refer to text messages and not graphics. They change people's intentions but they do not necessarily affect behaviour. It comes down again to the point that in a very liberalised alcohol market with relatively little regulation on how alcohol is marketed, the prices at which it can be sold and the level of overall availability in shops, simple messaging might not be enough on its own to change behaviour. Nonetheless, there are impacts, just not necessarily on behaviour.

There were questions on how to choose minimum price and increase it over time. In terms of choosing it, one must balance the impact on moderate drinkers against the impact of bigger health benefits. Clearly, the higher one goes with a minimum price, the bigger the health effects, although if one goes so high, it may result in a big restructuring of the alcohol market. The industry might fundamentally decide this is not the way to should sell certain products any more and make other products. In that case our estimates would start to become rather less robust.

One trades off in terms of the bigger health impact. It is obvious that the greater the level of alcohol consumed by low risk drinkers that is affected, the bigger the effects one will have on them. The question for the committee and the Government is how much impact they are willing to accept on low-risk drinkers to get the bigger health effects. That is not a question we can answer. We could make a recommendation but it would just be our personal view that is based on our personal values, so I am not sure that is especially helpful.

In terms of how one increases minimum pricing over time, the Scottish Government has faced this question as well but has not answered it, as far as I am aware. It said that it needed a mechanism and needed to think about what that mechanism would be, but it has not made a decision yet. Some obvious things to think about are inflation. We talk a lot in alcohol research about affordability, which is inflation adjusted to take account of household and personal incomes. The committee and Government may want to look at whether one can set a threshold that stays the same in order that a minimum price keeps cheap alcohol equally affordable over time. Within that, one might like to think about equally affordable for whom. One might find one is making it increasingly unaffordable because the metric is from the population and not from low-income people. If the metric is based on affordability generated by a population average and not from the low-income people, one might find that one changes affordability for certain groups more than others over time. There are some quite complex things to think about. We hope to start research on this issue in the near future.