Alcohol is now the single biggest cause of preventable early death and disability among adults aged 18 to 49, with rising numbers of alcohol-related hospital admissions. The UK is facing an alcohol health crisis and it is more pressing than ever that we act.

Last month the Government considered introducing new restrictions on alcohol advertising as part of a broader public health strategy, with proposals expected to form a key element of Labour’s forthcoming 10-year health plan. Ministers are considering partial restrictions on alcohol promotion, including a potential ban on advertising before 9pm. These changes would give content-based restrictions statutory force. Dr Richard Piper, Chief Executive of Alcohol Change UK, called on the Government to seize the opportunity to “move alcohol out of the spotlight and reduce harm for millions of people.”

Alcohol overconsumption was already increasing before the 2020 pandemic and has since accelerated, posing a significant threat to public health, social wellbeing, and safety. In 2023, there were 8,274 alcohol-specific deaths in England, which was an increase of 63.8% since 2006 and 4.6% since 2022. Despite the extent of the problem, current policy is having a negligible impact on the health and social consequences of problematic alcohol consumption.

The resulting pressure of the alcohol crisis on public services is considerable. A 2024 report found approximately 27 billion pounds a year is being spent in England on the health and social harms of drinking. £14.6 billion alone is spent on crime and disorder, with more than 4 million alcohol-related crimes in 2022. £1 billion is lost as a result of unemployment due to alcohol use, and nearly £4 billion through lost productivity.

The NHS, of course, suffers most. Alcohol costs the health service £4.9 billion a year, of which more than £3bn is from alcohol-related A&E visits and hospital admissions. NHS staff see the consequences of excessive use of alcohol daily, hourly in attendances at accident and emergency and in the way people respond to health professionals. As a country we cannot afford to sit back and do nothing. The government must develop new alcohol policy to tackle this rising harm, which would have a knock-on effect of reducing the financial burden.

The most obvious reform to combat the alcohol crisis is minimum unit pricing. Despite decades of demand for this life-saving reform, current policy is limited to a ban on selling alcohol below a “permitted price”, defined as the level of alcohol duty plus VAT. Evidence from Scotland, where minimum unit pricing has been enforced since 2018, shows that MUP has reduced deaths directly caused by alcohol consumption by an estimated 13.4% and hospital admissions by 4.1%. All the available evidence suggests that MUP would have more of an impact on alcohol related harm than the ban on below cost selling, by reducing alcohol-related harm while saving health-care costs. Why aren't we implementing this essential legislation across the UK?

A second policy alternative is marketing reform. The President of the Royal College of Physicians Dr Sarah Clarke recently advocated for health warnings and nutritional information on labelling and restrictions on alcohol marketing, which will significantly improve public health and help to reduce the strain on an NHS workforce currently facing overwhelming demand. Research shows that the implementation of plain tobacco packaging with health warnings increased warning salience and reduced the appeal of smoking, with some less consistent evidence that plain packaging has helped reduce misperceptions of harm. Health warnings can increase consumer knowledge of the health risks of their purchases.

Unlike smoking, lack of alcohol-related health policy likely attributes to public ignorance of the intensely negative impact of alcohol on health. Only 13% of people understand that cancer is a health risk of alcohol. Taking inspiration from existing smoking policy, packaging and marketing reform could have a similar impact on improving customer awareness.

Finally, the government could pursue the implementation of the 10-10 selling hours policy of the Alcohol etc. (Scotland) Act 2010 across the UK. Research shows that this stipulation reduced off-trade alcohol sales in Scotland, largely driven by a statistically significant decrease in off-trade wine sales. These findings indicate that the Scottish decline was directly due to the legislation. In a medium-sized English city harmful drinkers account for 32% of alcohol-related revenue in the off-trade, compared with 17% of revenue in the on-trade. On-trade alcohol is more expensive, and the price of alcohol is a significant factor in how much alcohol is consumed. The implementation of this policy could have considerable positive impact on the overconsumption of off-trade alcohol.

Alcohol overconsumption is one of the most significant public health concerns in the UK today. Alcohol is having a detrimental impact on our NHS, our justice system, our safety and our families. We need policy to reflect the state of this emergency. With thousands of preventable deaths across the UK each year, emergency is no understatement.

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