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ideasIdea

Evaluate alcohol minimum unit pricing against cancer incidence

Scotland and Wales put a floor under the price of alcohol. Deaths from liver disease have already fallen. Cancer takes longer to show, so someone has to keep measuring for a decade.

Minimum unit pricing (Scotland 2018, Wales 2020, Ireland 2022) reduced alcohol sales by about 3% and alcohol-specific deaths by about 13% within three years. Alcohol-attributable cancers (oral, oesophageal, liver, colorectal, breast) have latencies of 10-20 years, so the cancer benefit, which is a large part of the policy's justification, will only be visible if a pre-registered evaluation with cancer registry linkage is funded for the long term. Natural-experiment designs comparing Scotland with England, and dose-response by deprivation, are feasible because registries are complete.

Hypothesis
Within 10-15 years of introduction, minimum unit pricing reduces incidence of alcohol-attributable cancers by 3-5% relative to England, with the largest reductions in the most deprived quintile, and the effect is dose-dependent on price level.
Rationale
Cancer is the largest alcohol-attributable cause of death in the long run, but policy evaluations stop at 3-5 years. A pre-registered, decade-long registry analysis protects against both premature declarations of success and industry claims of failure.
What would test it
Pre-registered interrupted time-series and synthetic-control analysis using national cancer registries for Scotland, Wales, Ireland and comparators, stratified by deprivation and sex, with annual reporting; funded by public health agencies for 15 years.
Maturity
being tested at scale
Who has to act
policy
Cost to try
Small (under $1M)
Years to first evidence
10
Bottlenecks it attacks

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