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A health watchdog has added its voice to calls for a minimum price per unit of alcohol in England.

The recommendation from the National Institute for Health and Clinical Excellence (NICE) is in guidance on reducing the harm from excess drinking.

NICE says about one in four adults is drinking too much and damaging, or at least risking, their health.

The coalition government agrees that alcohol misuse is a problem, but does not support a minimum price.

NICE's guidance focuses on the damaging impact of excessive alcohol, and suggests ways for the government, the NHS and others to reduce the harm from misuse, based on the best available evidence.

It says in 2005 alcohol consumption caused nearly 15,000 deaths. The watchdog puts the annual cost to the NHS at over £2bn, and it concludes that misuse may be linked to 1.2 million violent incidents a year.

Tough measures

The guidance recommends a raft of measures, including banning advertising and making alcohol less easy to buy.

This could include cutting how much holidaymakers are allowed to bring into the country from abroad, and reducing the number of shops selling alcohol, as well as the days and hours it can be bought.

Councils should look at how many shops are already selling drink in an area to check if a place is "saturated" before granting new licences.

And patients could face tougher questions on their alcohol intake from GPs, doctors and pharmacists.

But NICE says the most effective approach is to make alcohol "less affordable", pushing up the cost of the cheapest drinks through a minimum price per unit of alcohol.

Professor Mike Kelly, public health director at NICE, told ���˿��� Radio 4's Today programme that minimum pricing was the "most effective way of targeting problem drinkers".

He added: "It wouldn't affect the 'on' trade by and large, because most pubs sell well above that price. It really is a measure designed to attack cheap alcohol in the 'off' trade."

One of the leading authors of the report, health economist Professor Anne Ludbrook, says this approach would target the heaviest drinkers.

"Alcohol is much more affordable now than it ever has been - and the price people pay does not reflect the cost of the health and social harms that arise.

"When it is sold at a very low price, people often buy and then consume more than they otherwise would have done."

Professor Ludbrook says there would be a big impact on the price of heavily discounted alcohol in supermarkets.

"At the example price of 50 pence, a bottle of vodka would be just over £13. Whereas in the supermarkets currently you could find vodka selling at below £8. Cheap white cider, for example, would go up to over £7 a bottle. It's currently selling at about £2."

This idea has strong backing from doctors and health campaigners, and the Scottish government is already trying to introduce a minimum price.

Wales also supports minimum pricing. A spokesperson for the Department of Health, Social Services and Public Safety in Northern Ireland said: "The issue of alcohol pricing remains an issue which is under active consideration."

Dr Robin Purshouse, of Sheffield University, did research on alcohol pricing for the Scottish Government.

He estimates that a minimum price on every unit of 40 pence would result in about 1,000 fewer premature deaths a year, about 40,000 fewer hospital admissions a year, and about 10,000 fewer violent crimes and criminal damage incidents per year.

"There's a wide range of factors that relate to people's alcohol consumption, but price is widely recognised as one of the greatest levers," he said.

"And if you look at the prices people pay, then the people who drink the most tend to pay less for the alcohol that they purchase."

But the Westminster coalition, which sets policy for England, prefers a ban on the sale of alcohol below cost price.

In a statement, Health Secretary Andrew Lansley agreed with NICE on the urgency of the problem, but he said it was not clear that a minimum price "is the best way to impact price in order to impact demand".

'Cultural issue'

The drinks industry agrees.

Simon Litherland of Diageo GB said: "Yet again it is disappointing to see continued support for minimum pricing despite no credible empirical evidence that it would be an effective measure in reducing alcohol-related harm."

Andrew Opie, food policy director at the British Retail Consortium, said: "It's too simplistic to say the UK's alcohol problems are down to price.

"Irresponsible alcohol consumption is primarily a cultural issue that needs to be addressed through education and information."

Tesco recently announced its support for a minimum price, but the Wine and Spirit Trade association remains opposed.

A spokesman, Gavin Partington, said measures in the guidance would "merely punish the majority of British consumers who drink responsibly".

He added: "Minimum pricing, self evidently, is not going to address alcohol misuse by heavy drinkers because people logic alone tells you that people who have a problem are going to go to any end to actually obtain alcohol."