SHAAP's 20th anniversary: lessons from two decades of alcohol policy reformSHAAP's 20th anniversary: lessons from two decades of alcohol policy reform
Alcohol Alert Podcast
SHAAP chair Dr Alastair MacGilchrist and founding member Dr Lesley Graham look back over two decades of Scottish alcohol policy, from rising death rates to minimum unit pricing and beyond. Their conversation links evidence, politics and treatment to show how policy decisions affect people living with alcohol harm.
42:57•31 Jul 2026
Twenty Years of SHAAP: How Scotland Put Health at the Heart of Alcohol Policy
Episode Overview
- Robust national statistics exposed a sharp rise in alcohol deaths in Scotland, prompting the creation of SHAAP as a strong clinical and public health voice.
- SHAAP identified price, availability, marketing and brief interventions as key levers, leading to early and sustained support for minimum unit pricing.
- Six years of legal resistance from the alcohol industry delayed MUP, but also harmed the industry’s reputation and strengthened the evidence base for the policy.
- Drinking has shifted heavily into the home, especially for people with the highest levels of harm, making cheap off-trade alcohol a central concern.
- Future priorities include automatic uprating of MUP, restrictions on alcohol marketing (particularly to protect children), and better alcohol treatment and justice system responses.
“We realised that we'd been sleepwalking into this alcohol epidemic, and alcohol deaths had really taken off about the beginning of the 1990s.”
How do individuals from all walks of life battle addiction when the biggest player in the story is public policy? This Alcohol Alert episode turns the spotlight on 20 years of Scottish Health Action on Alcohol Problems (SHAAP), with chair Dr Alastair MacGilchrist and founding member Dr Lesley Graham sharing how a small medical advocacy group helped change Scotland’s drinking landscape.
You’ll hear how, in the early 2000s, Scotland realised it had been “sleepwalking into this alcohol epidemic”, with deaths soaring and no coherent statistics. Lesley explains how building a solid data picture, then focusing on price, availability, marketing and brief interventions, led SHAAP to champion minimum unit pricing (MUP) as a core public health measure. The conversation strips back the politics too.
MacGilchrist talks through the “David and Goliath” feel of taking on the alcohol industry, and how six years of legal challenges from the Scotch Whisky Association delayed MUP but badly damaged industry credibility. As he puts it, doctors start “with that sort of kudos of trust”, while industry conflicts of interest are plain to the public. For anyone interested in recovery or harm reduction, there’s plenty that connects policy and personal lives.
The episode digs into why cheap supermarket alcohol fuels the heaviest drinking, why pubs may actually be closer allies to public health than enemies, and how most problem drinkers now consume almost all their alcohol at home. Looking ahead, SHAAP’s priorities include keeping MUP effective through regular price updates, clamping down on marketing that targets children, and rebuilding alcohol treatment, brief interventions, and support in hospitals and the justice system.
As Lesley puts it, one big lesson is “the power of evidence” – and the need to hang on to it when the storms hit. If you care about fewer families losing loved ones to alcohol, this conversation might make you ask: what should fair and effective alcohol policy look like where you live?
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