Is harm reduction profitable? An analytical framework for corporate social responsibility based on an epidemic model of addictive consumption

Advancing public health policy making through research on the political strategies of alcohol industry actors

Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.

Research Protocol to Evaluate the Effects of Alcohol Policy Changes in Lithuania

Aims

To point out the importance for public health to evaluate the past policy changes (2016-2018) in Lithuania. To present a research protocol to conduct this evaluation.

Short summary

The staggered implementation of key alcohol policies in Lithuania over the past two years offers the possibility to evaluate 'best buys' for alcohol policies for this country. Lithuania is the only country where all 'best buys' were implemented over a short period of time, so this evaluation will be unique.

Methods

Quasi-experimental design based on interrupted time-series analysis of monthly routine statistics of morbidity and mortality indicators as well as key variables on the pathway between alcohol exposure and health outcomes.

Conclusions

For the public health community, results of the evaluation of these policy changes will be of critical importance.

Is the alcohol industry doing well by 'doing good'? Findings from a content analysis of the alcohol industry's actions to reduce harmful drinking

OBJECTIVES

The aims of this study were to: (1) describe alcohol industry corporate social responsibility (CSR) actions conducted across six global geographic regions; (2) identify the benefits accruing to the industry ('doing well'); and (3) estimate the public health impact of the actions ('doing good').

SETTING

Actions from six global geographic regions.

PARTICIPANTS

A web-based compendium of 3551 industry actions, representing the efforts of the alcohol industry to reduce harmful alcohol use, was issued in 2012. The compendium consisted of short descriptions of each action, plus other information about the sponsorship, content and evaluation of the activities. Public health professionals (n=19) rated a sample (n=1046) of the actions using a reliable content rating procedure.

OUTCOME MEASURES

WHO Global strategy target area, estimated population reach, risk of harm, advertising potential, policy impact potential and other aspects of the activity.

RESULTS

The industry actions were conducted disproportionately in regions with high-income countries (Europe and North America), with lower proportions in Latin America, Africa and Asia. Only 27% conformed to recommended WHO target areas for global action to reduce the harmful use of alcohol. The overwhelming majority (96.8%) of industry actions lacked scientific support (p<0.01) and 11.0% had the potential for doing harm. The benefits accruing to the industry ('doing well') included brand marketing and the use of CSR to manage risk and achieve strategic goals.

CONCLUSION

Alcohol industry CSR activities are unlikely to reduce harmful alcohol use but they do provide commercial strategic advantage while at the same time appearing to have a public health purpose.

The post-2015 landscape: vested interests, corporate social responsibility and public health advocacy

This paper explores the tensions between UN calls for private sector engagement in the post-2015 landscape and public health opposition to those 'harm industries' that are 'corporate vectors of disease' for the mounting global non-communicable disease burden. The UN's support for public-private partnership has provided industries with 'vested interests' in the propagation of unhealthy behaviours with new opportunities for the strategic alignment of their corporate social responsibility (CSR) endeavours with the post-2015 sustainable development agenda. This has galvanised public health advocates to place pressure on the World Health Organisation to formalise their ambiguous stance towards private sector involvement in public policy formation and the resultant 'conflicts of interest'. This paper critically examines the 'gathering storm' between this 'anti-corporate movement' and the alcohol industry in the increasingly politicised domain of CSR. Drawing on the example of SABMiller's Tavern Intervention Program, the paper argues that CSR represents a profound threat to the sanctity and moral authority of the public health worldview. Questions therefore need to be asked about whether the public health-led path of industry non-association will necessarily result in health improvements or just a further retrenchment of the ideological faultlines explored in the paper.

Alcoholism risk reduction in France: a modernised approach related to alcohol misuse disorders

During many years in France, risk reduction strategies for substance abuse concerned prevention strategies in the general population or interventions near users of illicit substances. In this spirit, the reduction of consumption only concerned opiate addicts. With regard to alcohol, the prevention messages relative to controlled consumption were difficult to transmit because of the importance of this product in the culture of the country. In addition, methods of treatment of alcoholism rested on the dogma of abstinence. Several factors have recently led to an evolution in the treatment of alcohol use disorders integrating the reduction of consumption in strategies. Strategies for reducing consumption should aim for consumption below recommended thresholds (two drinks per day for women, three for the men) or, at least, in that direction. It must also be supported by pharmacotherapy and psychotherapy, which offer possibilities. Failure to manage reduction will allow the goals to be revisited and to reconsider abstinence. Finally this evolution or revolution is a new paradigm carried in particular by a pragmatic approach of the disease and new treatments. The aims of this article are to give elements of comprehension relating to the evolution of the practices in France in prevention and treatment of alcohol use disorders and in particular with regard to the reduction of consumption.