Abstract

Alcohol’s estimated contribution to cancer incidence is likely to increase, as causal relationships with additional cancers (e.g. prostate, melanoma, pancreas) become accepted and downward biases in cohort studies are corrected. Strategies are needed to reduce population exposure to alcohol, the most efficient and cost-effective being strategies that influence the cost of purchasing the carcinogenic ingredient in alcoholic beverages: ethanol. Among pricing policies, those that target the cheapest alcohol appear to be the most efficient as the heaviest drinkers tend to select the cheapest alcohol. Cheap alcohol also has a high price elasticity. Other advantages of minimum pricing include greater public acceptability than across the board price increases, increased revenues for some governments and support from some sectors of the alcohol industry. Canada is one of a handful of countries where minimum alcohol pricing in some form is evident in all of its 10 provinces. Evaluations of the public health impacts of Canadian minimum pricing indicate delayed effects on chronic alcohol-related diseases two to three years after a price increase. The size of the observed effects on alcohol-related morbidity and mortality tend to be much larger than has been predicted by highly conservative UK modelling studies. Given that minimum pricing is also associated with increased revenues in Canada, a case can be made that this strategies has the potential to be the most cost-effective of all available strategies for cancer prevention. Finally, recommendations are made for implementing minimum pricing so as to maximise public health benefits.