Price Per Standard Drink and Alcohol-Related Outcomes Among Vulnerable Groups in British Columbia: Findings from the Costs, Harms, Expenditures and Alcohol Prices Study

Abstract Objective Minimum unit pricing (MUP) aims to reduce use of cheap, high strength alcoholic beverages that drive harm, yet concerns remain about inequitable effects for structurally vulnerable groups. As part of the Costs, Harms, Expenditures and Alcohol Prices (CHEAP) study, we linked individual-level, product-specific alcohol consumption data from a customized survey with provincial retail price data to estimate prices per standard drink (PPSD) and examine their association with alcohol-related outcomes across sociodemographic groups. Method A cross-sectional survey of past-week drinkers in British Columbia, Canada, was linked to provincial product-level alcohol sales data. The population weighted sample included 1,217 adults aged ≥ 19 years (716 men; mean age 49.34, SD 16.98). Participants reported product-specific consumption, which was matched to retail prices to calculate individual-level PPSD. Survey weighted quasibinomial models then examined associations between PPSD and three outcomes: (1) causing harm to self or others in the past year, (2) scoring ≥ 8 on the Alcohol Use Disorder Identification Test, and (3) consuming ≥ 15 standard drinks per week. Analyses were stratified by income, education, subjective social status, and race/ethnicity. Results Lower price per standard drink was associated with higher odds of harm (OR 3.05, 95% CI 1.25–7.40) and scoring ≥ 8 on the AUDIT (OR 2.34, 95% CI 1.37–3.99). Associations were stronger among structurally disadvantaged groups, including low-income respondents and Indigenous participants. Conclusions Lower alcohol affordability is linked to risky alcohol use, with the strongest effects among structurally disadvantaged groups. MUP would reduce this risk and promote health equity.