title: Understanding the development of minimum unit pricing of alcohol in Scotland: a qualitative study of the policy process.
abstract: BACKGROUND
  Minimum unit pricing of alcohol is a novel public health policy with the potential to improve population health and reduce health inequalities. Theories of the policy process may help to understand the development of policy innovation and in turn identify lessons for future public health research and practice. This study aims to explain minimum unit pricing's development by taking a 'multiple-lenses' approach to understanding the policy process. In particular, we apply three perspectives of the policy process (Kingdon's multiple streams, Punctuated-Equilibrium Theory, Multi-Level Governance) to understand how and why minimum unit pricing has developed in Scotland and describe implications for efforts to develop evidence-informed policymaking.
  
  
  METHODS
  Semi-structured interviews were conducted with policy actors (politicians, civil servants, academics, advocates, industry representatives) involved in the development of MUP (n = 36). Interviewees were asked about the policy process and the role of evidence in policy development. Data from two other sources (a review of policy documents and an analysis of evidence submission documents to the Scottish Parliament) were used for triangulation.
  
  
  RESULTS
  The three perspectives provide complementary understandings of the policy process. Evidence has played an important role in presenting the policy issue of alcohol as a problem requiring action. Scotland-specific data and a change in the policy 'image' to a population-based problem contributed to making alcohol-related harms a priority for action. The limited powers of Scottish Government help explain the type of price intervention pursued while distinct aspects of the Scottish political climate favoured the pursuit of price-based interventions.
  
  
  CONCLUSIONS
  Evidence has played a crucial but complex role in the development of an innovative policy. Utilising different political science theories helps explain different aspects of the policy process, with Multi-Level Governance particularly useful for highlighting important lessons for the future of public health policy.
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom; Department of Public Health and Policy, NHS Lothian, Edinburgh, United Kingdom.
authors.forename: Srinivasa Vittal
authors.initials: SV
authors.lastname: Katikireddi
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Shona
authors.initials: S
authors.lastname: Hilton
authors.affiliation: Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom.
authors.forename: Chris
authors.initials: C
authors.lastname: Bonell
authors.affiliation: MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom; Centre of Excellence in Intervention and Prevention Science, Melbourne, Australia.
authors.forename: Lyndal
authors.initials: L
authors.lastname: Bond
mesh_terms: D000438:Alcohols / Q000191:economics*; D003132:Commerce / Q000331:legislation & jurisprudence*; D006291:Health Policy; D011050:Policy Making; D012606:Scotland; D013997:Time Factors
chemical_list: D000438:Alcohols