In August 2023, the UK government will overhaul alcohol taxes and raise rates by 10.1%, just as the cost-of-living crisis squeezes household budgets—and this project will track what happens next. The new tax system changes how different drinks are priced, meaning some households will face steeper price hikes than others, depending on what they buy. At the same time, falling real incomes may make alcohol less affordable overall, but could also push vulnerable groups—such as people with alcohol dependence living in deprivation—toward cheaper, higher-strength drinks. Current evidence cannot predict how these overlapping pressures will play out across England, Scotland, and Wales. The research treats the tax reforms, rate increases, and cost-of-living crisis as a single complex intervention. It combines market data, focus groups, interviews, and mathematical modelling to measure short-term changes in consumption, hospitalisations, and deaths, and to project long-term health and inequality impacts. A stakeholder forum and public involvement panels will co-produce findings. If successful, the work will give government and public health agencies concrete evidence on whether the new tax system reduces harm or inadvertently worsens inequalities—information that could shape future alcohol pricing policy across Britain.
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AIM: To evaluate the impact of reforms to the UK alcohol tax system, increases to alcohol tax rates, and the current cost-of-living crisis on alcohol consumption, associated harms and health inequalities. BACKGROUND: Alcohol pricing is a key commercial determinant of health and alcohol taxes are the main way that governments influence pricing. The UK Government will introduce a new alcohol tax system in August 2023 that aims to address flaws in the current system. The Government will also raise alcohol taxes rates by 10.1% while the current cost-of-living crisis is reducing households’ real-terms disposable incomes. The overall impact of these changes is uncertain as households will face different price changes depending on the drinks they buy and these may be more or less affordable depending on their social circumstances. There may also be adverse impacts in vulnerable groups who face additional stressors. RESEARCH DESIGN: The project will treat the new alcohol tax system, increased tax rates and cost-of-living crisis as three components of a complex intervention. It will use natural experiment, observational and qualitative methods, alongside mathematical modelling, to understand the intervention’s contribution to changes in short- and long-term outcomes across England, Scotland and Wales, including changes in alcohol consumption, health outcomes and inequalities, METHODS: The project has five work packages (WPs): WP1 will characterise market responses to the intervention using several data sources. It will: (i) work with PPI panels and stakeholders to identify population subgroups to focus on across all WPs; (ii) estimate potential and actual price changes faced by those subgroups and specific alcohol producers; (iii) estimate how alcohol affordability changes during the intervention relative to other goods and household incomes; (iv) analyse how prices of lower and higher cost drinks change and (v) identify wider product changes (e.g. in size or strength). WP2 will use time series and panel analyses of market research data to estimate the intervention’s short-term impact on alcohol consumption overall and by beverage type, trade sector, nation and population subgroup. WP3 will explore how different population subgroups experience and respond to the intervention via (i) focus groups with the subgroups from WP1; (ii) interviews with people with alcohol dependence living in deprivation and (iii) analyses of survey data to examine associations between attempts to drink less, financial well-being and mental health. WP4 will use time series analyses of administrative data to estimate the short-term impact of the intervention on hospitalisations, mortality and health inequalities, and how this varies by nation. WP5 will use an established policy analysis tool, alongside workshops and interviews with stakeholders, to: (i) estimate the long-term impacts of the intervention on alcohol-related health, inequality and health economic outcomes and (ii) appraise the potential impact of further alcohol pricing policy options on these outcomes. IMPACT AND DISSEMINATION: The project will deliver actionable evidence for stakeholders in government, public health agencies, third sector organisations and the public. We will establish and work closely with a Stakeholder Forum and Public Involvement Panels to co-produce elements of the research, share emerging findings, respond to emerging evidence needs and develop our dissemination strategy.
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