Sales of alcohol in Scotland are on the rise with the equivalent of 41 bottles of vodka sold per adult in 2015, according to new figures.
Alcohol sales had been falling but the NHS Health Scotland study found this downward trend has reversed, mainly due to a greater proportion being sold through supermarkets and off-licences which hit their highest level since recording began.
The report found 10.8 litres of pure alcohol was sold per adult in Scotland in 2015 - equivalent to 41 bottles of vodka, 116 bottles of wine or 477 pints of beer in the year.
A senior health figure branded the trend "concerning" and warned it presents a "substantial public health and economic cost to Scotland".
The amount of pure alcohol sold is up slightly from 10.7 litres in 2014 and is now equivalent to 20.5 units per week, more than the new UK-wide guidelines of 14 units a week for men and women.
Almost three quarters of alcohol (74%) was sold through off-sales in 2015, which was the highest market share since recording began in 1994.
The Scottish sales were 20% higher than in England and Wales, mainly driven by higher sales of cheaper alcohol in supermarkets and off-licences, particularly spirits. More than twice as much vodka was bought through these outlets per adult in Scotland than in England and Wales.
Researchers also looked at prices and found the average price of a unit of alcohol sold through off-sales was 52p, unchanged for the past two years.
Around half (51%) of alcohol bought in off-licences and supermarkets cost under 50p per unit, the initial level proposed for minimum unit pricing, down from a high of 77% in 2013. The amount of beer sold below this price has increased by 11% in the past two years, equivalent to more than 30 million bottles.
The average price of a unit of alcohol sold in pubs, clubs and restaurants was £1.74.
Dr Mark Robinson, senior public health information manager at NHS Health Scotland, said: "It is concerning that the recent falls in population alcohol consumption have reversed and that off-trade alcohol sales have reached their highest level.
"Trends in the price of alcohol sold by supermarkets and off-licences correspond with trends in the volume of alcohol sold by these retailers. Between 2009 and 2013, the average price of alcohol increased and consumption decreased. Since 2013, average price has flattened and consumption has increased.
"Higher levels of alcohol consumption result in higher levels of alcohol-related harm and these present a substantial public health and economic cost to Scotland.
"Policies that reduce the availability of low priced, high-strength alcohol are the most effective for reducing alcohol-related harms and narrowing health inequalities."
Public Health Minister Aileen Campbell said the new figures highlight the need for minimum unit pricing for alcohol, a policy measure which the Scottish Government wants to bring in but has been blocked by a legal challenge.
Ms Campbell said: "We remain absolutely committed to introducing minimum unit pricing and this report adds to the wealth of evidence which supports this policy. We also welcome the fact that the European courts have returned this matter to the Scottish courts for a final decision."
She added: "Around 22 people a week are dying in Scotland because of alcohol and despite recent reductions, deaths have increased for the last two years. Given the link between consumption and harm, and evidence that affordability is one of the drivers of increased consumption, addressing price is essential.
"Prices in pubs, bars and restaurants are increasing, but prices in shops are staying the same. We know that more than half of the alcohol - and almost three-quarters of vodka - sold in supermarkets and off-licences cost under 50p per unit. It is that cheap, high-strength alcohol that is causing the most harm in Scotland."
That view was backed by health campaigners, with Alison Douglas, chief executive of Alcohol Focus Scotland, stating: "Scotland is now a nation of home drinkers, with more alcohol sold through supermarkets and off-licences than ever before. This has been driven by really low prices and constant promotions encouraging us to consume more.
"More than half of alcohol in supermarkets and off-licences is sold at less than 50p per unit, while a fifth costs less than 40p per unit. The very cheapest products under 30p per unit are mainly vodkas and strong ciders which are favoured by young, vulnerable and harmful drinkers.
"The more affordable alcohol is, the more we drink, and this means more alcohol-related hospital admissions, crime and deaths.
"Politicians across the Scottish Parliament understood this evidence when they passed minimum unit pricing legislation four years ago. It is really disappointing that this life-saving measure has been delayed by the Scotch Whisky Association's legal challenge. Their defence of cheap vodka and cider is somewhat at odds with the 'iconic' image of Scotch.
"Like the tobacco industry, the alcohol industry is placing profits before people's health.
"With 22 Scots dying because of alcohol every single week and sales increasing, minimum pricing is desperately needed."
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