The Sheffield Alcohol Policy Model (SAPM)

The Sheffield Alcohol Policy Model (also known as SAPM or the Sheffield model) provides estimates of the effectiveness and cost-effectiveness of alcohol policies including pricing and availability policies as well as screening and brief interventions. It has been influential in informing public and political debate on alcohol policy and has provided a key evidence base for informing policy decisions around minimum unit pricing of alcohol. More recently, estimates from an adapted version of the model were used to inform the UK Chief Medical Officers’ lower risk drinking guidelines.

Adaptations of the model have been provided for the Scottish government and the Canadian Institutes of He alth Research. Further work has provided adaptations of the pricing model for Wales, Northern Ireland and the Republic of Ireland and we are currently adapting the model to allow estimation of policy impacts in English Local Authorities. The screening and brief intervention model has also been adapted to estimate policy impacts in several European countries.

Please see below for further information on the structure of the model and sources of further information.

Structure of the model

Version 3 of the Sheffield Alcohol Policy Model is the latest version and focuses on modelling the effectiveness of alcohol pricing policies and of screening and brief intervention policies. Previous versions of the model additionally address availability or advertising policies. The outputs of the model provide estimates of:

Changes in alcohol consumption for different population subgroups;
Changes in the incidence of various alcohol-related harms including health conditions, crime, unemployment and sickness absence;
The costs associated with changes in the incidence of harm incorporating direct costs (e.g. to the health services or police) as well as costs associated with changes in individuals’ quality of life (e.g. from alcohol-related diseases or being a victim of crime).

Analyses are carried out on population subgroups defined by age, sex, consumption level and income or socioeconomic status. This means the model is able to present results describing the impact of alcohol policies on particular subgroups of interest such as young hazardous drinkers, low income moderate drinkers or high income harmful drinking women.

The pricing model has two elements. The first element uses an econometric approach to model consumer responses to changes in the prices of alcoholic beverages. This allows appraisal of how consumers’ change consumption levels, drink in alternative settings or switch to alternative beverages following a pricing policy change. The second element uses epidemiological data on the relationship between alcohol consumption and various harms to model how those changes in consumption change the consumers’ risk of harm. This allows for estimates of the change in incidence of alcohol-related harms and the costs associated with those harms to be calculated.

The screening and brief intervention model uses a range of data from healthcare settings and published evidence on the effectiveness of brief interventions in altering consumption behaviour to model a set of possible policies. The impact of changes in consumption is modelled as in the pricing policy; however, crime and work-related harms are excluded.

The drinking guidelines model focused on the second, epidemiological, aspect of the model to examine the relationship between alcohol consumption and alcohol-related harms to health. Estimates of relative and absolute risk of alcohol-attributable mortality were produced for different consumption levels and patterns. These were then used to derive implied thresholds for lower risk drinking under different of lower risk.

Version 3 of the model was developed as part of our 3-year MRC- and ESRC-funded programme of research known as IARP (Interdisciplinary Alcohol Research Programme). For more information see the project’s webpage and the publication list at the bottom of this page which includes policy analyses and methodological reports.

Further information

For information on SAPM’s screening and brief intervention model: ODHIN and PUBLICATIONS (and below)
For detailed methodological reports and full results: PUBLICATIONS (and below)
For information about the IARP project to develop version 3 of SAPM: IARP PAGE
For adaptations of SAPM to other countries: Scotland, Canada, Wales and Ireland pages
For our response to criticisms of SAPM: SARG response to critique by Adam Smith Institute

Publications

Journal Articles – Alcohol pricing analyses

Meier PS, Holmes J, Angus C, Ally AK, Meng Y and Brennan A. (2016) ‘Estimated effects of different alcohol taxation and price policies on health inequalities: A mathematical modelling study‘, PLOS Medicine, 13 (2), e1001963.

Brennan, A., Meier, P., Purshouse, R., Rafia, R., Meng, Y., Hill-McManus, D., Angus, C. and Holmes, J. (2015) ‘The Sheffield Alcohol Policy Model: A Mathematical Description‘, Health Economics, 24 (10), pp.1368-88

Brennan, A., Meng, Y., Holmes, J., Hill-McManus, D. and Meier, P. (2014) ‘Potential benefits of minimum unit pricing for alcohol versus a ban on below cost selling in England 2014: modelling study‘, BMJ, doi: http://dx.doi.org/10.1136/bmj.g5452. See accompanying editorial.

Ally, A., Meng, Y., Chakraborty, R., Dobson, PW., Seaton, JS., Holmes, J., Angus, C., Guo, Y., Hill-McManus, D., Brennan, A. and Meier, PS. (2014) ‘Alcohol tax pass-through across the product and price range: do retailers treat cheap alcohol differently?‘, Addiction, 109 (12), pp.1994-2002

Holmes, J., Meng, Y., Meier, PS., Brennan, A., Angus, C., Campbell-Burton, A., Guo, Y., Hill-McManus, D., and Purshouse, RC. (2014) ‘Effects of minimum unit pricing for alcohol on different income and socioeconomic groups: a modelling study‘, The Lancet, 383 (9929), 1655-64. See accompanying commentary.

Meng, Y., Brennan, A., Purshouse, R., Hill-McManus, D., Angus, C., Holmes, J. and Meier, PS. (2014) ‘Estimation of own and cross price elasticities of alcohol demand in the UK: A pseudo-panel approach using the Living Costs and Food Survey 2001-2009‘, Journal of Health Economics, 34, pp.96-103

Purshouse, R.C., Meier, P.S., Brennan, A., Taylor, K.B. & Rafia, R. (2010) ‘Estimated effect of alcohol pricing policies on health and health economic outcomes in England: an epidemiological model’, The Lancet, 375 (9723), pp.1355-64. See accompanying commentary.

Meier, P.S., Brennan, A., Purshouse, R. (2010) ‘Policy Options for Alcohol Price Regulation: The Importance of Modelling Population Heterogeneity’, Addiction, 105 (3) , pp.383-93. See accompanying commentaries.

Journal articles – Screening and brief intervention analyses

Angus, C., Latimer, N., Preston, L., Li, J. and Purshouse, R. (2014) ‘What are the implications for policy makers? A systematic review of the cost-effectiveness of screening and brief interventions for alcohol misuse in primary care‘, Frontiers in Psychiatry, 5 (114), DOI: 10.3389/fpsyt.2014.00114

Struzzo, P., Angus, C., Scafato, E., Ghirini, S., Torbica, A., Ferre, F., Scafuri, F., Purshouse, R. and Brennan, A. (2014) ‘Lo screening e l’intervento breve in medicina generale: un modello di analisi economica sui bevitori a rischio‘, Politiche sanitarie, 15 (2), pp.77-83.

Angus, C., Scafato, E., Ghirini, S., Torbica, A., Ferre, F., Struzzo, P., Purshouse, R. and Brennan, A. (2014) ‘Cost-effectiveness of a programme of screening and brief interventions for alcohol in primary care in Italy‘, BMC Family Practice, 15, e26

Purshouse, R., Brennan, A., Rafia, R., Latimer, N., Archer, R., Angus, C., Preston, L. and Meier, P. (2012) ‘Modelling the Cost-Effectiveness of Alcohol Screening and Brief Interventions in Primary Care in England’. Alcohol and Alcoholism. 48 (2), pp. 180-8

Journal articles – Methodological reports

Brennan, A., Meier, P., Purshouse, R., Rafia, R., Meng, Y., and Hill-McManus, D. (2013) ‘Developing policy analytics for public health strategy and decisions – the Sheffield alcohol policy model framework‘, Annals of Operational Research, 236 (1), pp.149-76

Hill-McManus, D., Angus, C., Meng, Y., Holmes, J., Brennan, A. and Meier, P. (2014) ‘Estimation of usual occasion-based individual drinking patterns using diary data‘, Drug and Alcohol Dependence, 13 (1), pp.136-43

Meier, PS., Meng, Y., Holmes, J., Baumberg, B., Purshouse, R., Hill-McManus, D. and Brennan, A. (2013) ‘Adjusting for Unrecorded Consumption in Survey and Per Capita Sales Data: Quanification of Impact on Gender- and Age-specific Alcohol-attributable Fractions for Oral and Pharyngeal Cancers in Great Britain‘. Alcohol and Alcoholism, 48 (2), pp.241-49

Holmes, J., Meier, P., Booth, A., Guo, Y. & Brennan, A. (2012) ‘The temporal relationship between per capita alcohol consumption and harm: A systematic review of time lag specifications in aggregate time series analyses.’ Drug and Alcohol Dependence, 123 (1–3), pp.7–14

Alcohol policy modelling reports

UK-wide reports

Angus C & Henney M (2019) ‘Modelling the impact of alcohol duty policies since 2012 in England & Scotland‘, Sheffield: ScHARR, University of Sheffield.

Holmes J et al. (2016) ‘Mortality and morbidity risks from alcohol consumption in the UK: Analyses using the Sheffield Alcohol Policy Model (v.2.7) to inform the UK Chief Medical Officers’ review of the UK lower risk drinking guidelines‘, ScHARR, University of Sheffield

Hill-McManus, D., Brennan, A., Stockwell, T., Giesbrecht, N., Thomas, G., Zhao, J., Martin, G. and Wettlaufer, A. (2012) ‘Model-based appraisal of alcohol minimum pricing in Ontario and British Columbia: A Canadian adaptation of the Sheffield Alcohol Policy Model Version 2‘. Sheffield: ScHARR, University of Sheffield

Other reports, journal contributions and publications

Hill-McManus, D., Angus, C., Meng, Y., Holmes, J., Brennan, A. and Meier, P. (2014) ‘Injury alcohol-attributable fractions: Methodological issues and developments‘, HEDS Discussion Paper DP 14.02, Sheffield: ScHARR, University of Sheffield.

Ludbrook, A., Holmes, J. and Stockwell, T. (2014) ‘Gender differences in alcohol demand: A systematic review of the role of prices and taxes. Comment on conclusions by Nelson‘, Health Economics, DOI: 10.1002/hec.3096.

Purshouse, R.C et al. (2014) ‘Commentary on Nakamura et al. (2014): Alcohol policy appraisal and evaluation – to understand what is happening and why, we need better data on alcohol as a commodity‘, Addiction, 109 (4) pp.568-9

Purshouse, R.C et al. (2013) ‘Reply to Klaus Makela’s Cost-of-alcohol studies as a research programme’, Nordic Studies on Alcohol and Drugs, 30 (5) pp.445-7

Meng, Y. et al. (2013) ‘Estimation of own and cross price elasticities of alcohol demand in the UK – a pseudo-panel approach using the Living Cost and Food Survey 2001 to 2009‘. HEDS Discussion paper DP 13/11. Sheffield: ScHARR

Brennan, A. et al. (2013) ‘A public response to the Adam Smith Institute’s critique of the Sheffield Alcohol Policy Model‘. Sheffield: ScHARR. See also: ‘Response to the Appendix to Duffy and Snowdon’s report‘

Booth, A., Meier, P., Shapland. J., Wong. R. and Paisley, S. (2011) ‘Alcohol pricing and criminal harm: a rapid evidence assessment of the published research literature‘. Sheffield: ScHARR

Booth, A. et al. (2008) ‘Independent review of the effects of Alcohol Pricing and Promotion: Part A: Systematic Reviews’, Project Report for the Department of Health

News articles and other media

June 2014, ‘UK supermarkets minimise price rises for the cheapest alcohol when taxes are increased‘, blog post for Public Health Topics @ The University of Sheffield.

April 2014, ‘Minimum unit pricing: Effective and Equitable?‘, Dr John Holmes at the New Directions in the Study of Alcohol Group conference (VIDEO).

March 2014 ‘Alcohol duty cuts make the Coalition’s cheap alcohol policy even less effective‘, blog post for Public Health Topics @ The University of Sheffield.

February 2014, ‘Minimum pricing for alcohol: Reducing health inequalities without penalising responsible drinkers‘, blog post by Dr John Holmes for Public Health Topics @ The University of Sheffield.

January 2014, ‘Computer Modelling: All about the image?‘, Dr Robin Purshouse at Battle of Ideas 2013 (VIDEO)

January 2014, ‘Below Cost Alcohol Ban 40 Times Less Effective Than Minimum Pricing‘, Dr John Holmes writes for The Conversation UK

July 2013, SARG press release on the impacts of a ban on below cost selling

December 2012, ‘The impact of minimum pricing: Evidence from the Sheffield Alcohol Policy Model‘, Dr John Holmes at Alcohol Action Ireland’s annual conference

November 2012, ‘Alcohol minimum pricing ‘effective in reducing consumption’‘, Dr John Holmes speaks to BBC News