The Impact Of Alcohol Minimum Unit Pricing On People with experience of Homelessness: Qualitative Study

Abstract

ABSTRACTBACKGROUNDAlcohol Minimum Unit Pricing (MUP) was introduced in Scotland in May 2018. Existing evidence suggests MUP can reduce alcohol consumption in the general population, but there is little research about its impact on vulnerable groups. This qualitative study aimed to explore experiences of MUP among people with experience of homelessness.METHODSWe conducted qualitative semi-structured interviews with a purposive sample of 46 people with current or recent experience of homelessness who were current drinkers when MUP was introduced. Participants (30 men and 16 women) were aged 21 to 73 years. Interviews focused on views and experiences of MUP. Data were analysed using thematic analysis.RESULTSPeople with experience of homelessness were aware of MUP but it was accorded low priority in their hierarchy of concerns. Reported impacts varied. Some participants reduced their drinking, or moved away from drinking strong white cider in line with policy intentions. Others were unaffected because the cost of their preferred drink (usually wine, vodka or beer) did not change substantially. A minority reported increased involvement in begging. Wider personal, relational and social factors also played an important role in participant responses to MUP.CONCLUSIONOur findings suggest that MUP worked as intended for some people with experience of homelessness, while a minority reported negative consequences. Our findings highlight the importance of considering the impact of population level health policies on marginalised groups. Policymakers in Scotland, and elsewhere, need to consider wider contextual factors that affect responses to MUP in people with experience of homelessness. It is important to invest further in secure housing and appropriate support services for people with experience of homelessness who consume alcohol, and implement and evaluate harm reduction initiatives such as managed alcohol programmes.