Lower Prices Associated With Greater Alcohol-Related Harm and Risky Drinking Among Vulnerable Groups: Findings From...

Minimum unit pricing (MUP) reduces use of cheap, high strength alcoholic beverages that drive harm, yet concerns remain about inequitable effects for structurally vulnerable groups. As part of the Consumption, Harms, Expenditures and Alcohol Prices (CHEAP) study, we linked individual-level, product-specific alcohol consumption survey data with provincial retail price data to estimate prices per standard drink (PPSD) and examine their association with alcohol-related outcomes across sociodemographic groups.

A cross-sectional survey of people who consumed alcohol in the past week in British Columbia, Canada, was linked to provincial product-level alcohol sales data. The population weighted sample included 1,217 adults ≥ 19 years (716 men; mean age 49.34, SD 16.98). Participants reported product-specific consumption, which was matched to retail prices to calculate individual-level PPSD. Survey weighted quasibinomial models examined associations between PPSD and three outcomes: (1) causing harm to self or others in the past year, (2) scoring ≥ 8 on the Alcohol Use Disorder Identification Test, and (3) consuming ≥ 15 standard drinks per week. Analyses were stratified by income, education, subjective social status, and race/ethnicity.

Lower price per standard drink was associated with higher odds of harm (OR 3.05, 95% CI 1.25-7.40) and an AUDIT score ≥ 8 (OR 2.34, 95% CI 1.37-3.99). Associations were generally stronger among structurally disadvantaged groups, including low-income and Indigenous participants.

Lower alcohol prices are linked to risky alcohol use, with the strongest effects among structurally disadvantaged groups. MUP is likely to reduce this risk and promote health equity.