Since 2020, deaths from alcohol have increased in England, particularly amongst men and people living in more deprived areas. In 2023, there were 10,473 deaths from alcohol-specific causes, which is the highest on record and has accelerated since the pandemic.
Alcohol is normalised in British culture, with approximately 21% of the adult population in England drinks at a harmful level, which the Chief Medical Officer defines as more than 14 units of alcohol per week.
Low and alcohol-free drinks have become increasingly popular, with over a third of drinkers in the UK consuming them semi-regularly. Currently, uptake varies across populations, with young people, women and people with higher incomes being more likely to consume them. With the increasing popularity of low alcohol drinks, governments, charities and researchers have stated their potential to reduce harmful drinking.
A recent study assessed trends in the use of low and alcohol-free drinks and other types of support to reduce alcohol consumption amongst people who drink at a higher risk that may harm their health. From 2020-2024, participants’ use of other evidence-based support remained at 10%, whereas their use of low and alcohol-free drinks to cut alcohol consumption increased from 26% to 39%.
Women and people with higher incomes had the highest use of low-alcohol drinks to reduce alcohol consumption, compared to men and people with lower incomes. The biggest gap was by income, whereby from 2020-2024, the use of low-alcohol drinks to cut alcohol increased from 28% to 42% amongst higher-income groups, compared to a smaller rise from 21% to 28% amongst lower-income groups.
Low and alcohol-free drinks could become a promising intervention to address harmful drinking, especially as they are increasing in popularity. However, this must be in addition to other preventative and evidence-based policies that make alcohol less affordable and desirable.
Population-level policies like minimum unit pricing for alcohol are one of the most effective policies for reducing alcohol harms and have been implemented effectively in Scotland, Wales and the Republic of Ireland. Introduced in 2018, every alcoholic drink in Scotland has a minimum unit price, which increased from 50p to 65p per unit in 2024.
Research found minimum unit pricing has reduced alcohol sales by 3% and led to a 13% reduction in deaths and 4% reduction in hospitalisations, completely attributed to alcohol. Importantly, reductions in deaths and hospitalisations were greatest amongst men and people living in the most deprived areas, demonstrating its power in reducing harm for the heaviest drinkers and narrowing health gaps.
The evidence for minimum-unit pricing is clear, but hesitations to implement this policy are strongly influenced by the alcohol industry and misinformation about how this impacts pubs. In fact, minimum-unit pricing does not increase the price of all alcohol. It only increases the cost of the strongest and cheapest alcohol sold in supermarkets or corner shops, which heavy drinkers are more likely to consume. The policy has no effect on prices in pubs, bars or restaurants as their drinks are more expensive than the minimum unit pricing.
Other effective interventions include reducing the serving size of the imperial pint in the UK (568ml), which is considerably larger than other countries, such as the US (437ml), Belgium (250ml) and Germany (500ml). One study found that reducing the serving size of a pint of beer to a two-thirds of a pint led to a 10% reduction in volume of beer, but only a 5% reduction in sales. Despite appearing unpopular, venues reported few complaints, suggesting that regulating serving sizes may shift social norms and reduce alcohol harm.
The Government has committed to reducing alcohol harms and in the recent Ten-Year Health Plan for England they have highlighted the importance of low-alcohol drinks in addressing harmful alcohol consumption. Whilst low-alcohol drinks may reduce alcohol harm, it is unlikely that they will reduce harm amongst the heaviest drinkers, meaning their impact may be limited.
Worryingly, the Government has failed to commit to other effective policies, such as minimum pricing for alcohol and restricting advertising and availability of alcohol due to lobbying from the alcohol industry. Conversely, the Government is considering changing licensing laws to allow pubs to open for longer, which may exacerbate alcohol harm.
Ultimately, tackling alcohol harm requires a multi-faceted approach, which must include population-level policies like minimum pricing for alcohol and policies that have the greatest public health impact, whilst also reducing health inequalities.