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O'Brien P, Dwyer R, Gleeson D, Cook M, Room R. Influencing the global governance of alcohol: Alcohol industry views in submissions to the WHO consultation for the Alcohol Action Plan 2022-2030. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 119:104115. [PMID: 37549594 DOI: 10.1016/j.drugpo.2023.104115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND In 2020, the Secretariat of the World Health Organization (WHO) conducted an open consultation, with public submissions, for the purpose of developing an Alcohol Action Plan to "strengthen implementation" of the WHO's 2010 Global Strategy to Reduce the Harmful Use of Alcohol. The consultation process and public submissions provided an opportunity to critically examine alcohol industry perspectives and arguments in relation to the global governance of alcohol. METHODS 48 alcohol industry submissions to the WHO's 2020 consultation were included for analysis. Directed content analysis was used to examine the policy positions and arguments made by industry actors. Thematic analysis was employed to further explore the framing of industry arguments. RESULTS In framing their arguments, alcohol industry actors positioned themselves as important stakeholders in policy debates; differentiated "normal" drinking from consumption that merits intervention; argued that alcohol policy should be made at the national, rather than global, level; and supported industry self-regulation or co-regulation rather than cost-effective public health measures to prevent harms from alcohol. CONCLUSION The alcohol industry's submissions to the WHO's 2020 consultation could be seen as efforts to stymie improvements in the global governance of alcohol, and repeats several framing strategies that the industry has used in other forums, both national and global. However, their arguments appear to have had little traction in the creation of the Alcohol Action Plan. Changes from the Working Document to the adopted Action Plan show little acceptance by WHO of industry arguments.
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Affiliation(s)
- Paula O'Brien
- Melbourne Law School, University of Melbourne, Parkville, Victoria, 3010, Australia.
| | - Robyn Dwyer
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Deborah Gleeson
- School of Psychology and Public Health, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Megan Cook
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Bundoora, Victoria, 3083, Australia; Centre for Social Research on Alcohol & Drugs, Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
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Gilmore AB, Fabbri A, Baum F, Bertscher A, Bondy K, Chang HJ, Demaio S, Erzse A, Freudenberg N, Friel S, Hofman KJ, Johns P, Abdool Karim S, Lacy-Nichols J, de Carvalho CMP, Marten R, McKee M, Petticrew M, Robertson L, Tangcharoensathien V, Thow AM. Defining and conceptualising the commercial determinants of health. Lancet 2023; 401:1194-1213. [PMID: 36966782 DOI: 10.1016/s0140-6736(23)00013-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 126.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 10/13/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
Although commercial entities can contribute positively to health and society there is growing evidence that the products and practices of some commercial actors-notably the largest transnational corporations-are responsible for escalating rates of avoidable ill health, planetary damage, and social and health inequity; these problems are increasingly referred to as the commercial determinants of health. The climate emergency, the non-communicable disease epidemic, and that just four industry sectors (ie, tobacco, ultra-processed food, fossil fuel, and alcohol) already account for at least a third of global deaths illustrate the scale and huge economic cost of the problem. This paper, the first in a Series on the commercial determinants of health, explains how the shift towards market fundamentalism and increasingly powerful transnational corporations has created a pathological system in which commercial actors are increasingly enabled to cause harm and externalise the costs of doing so. Consequently, as harms to human and planetary health increase, commercial sector wealth and power increase, whereas the countervailing forces having to meet these costs (notably individuals, governments, and civil society organisations) become correspondingly impoverished and disempowered or captured by commercial interests. This power imbalance leads to policy inertia; although many policy solutions are available, they are not being implemented. Health harms are escalating, leaving health-care systems increasingly unable to cope. Governments can and must act to improve, rather than continue to threaten, the wellbeing of future generations, development, and economic growth.
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Affiliation(s)
| | - Alice Fabbri
- Department for Health, University of Bath, Bath, UK
| | - Fran Baum
- Stretton Health Institute, University of Adelaide, Adelaide, SA, Australia
| | | | - Krista Bondy
- Stirling Management School, University of Stirling, Stirling, UK
| | - Ha-Joon Chang
- Department of Economics, School of Oriental and African Studies University of London, London, UK
| | - Sandro Demaio
- Victorian Health Promotion Foundation, Melbourne, VIC, Australia
| | - Agnes Erzse
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Nicholas Freudenberg
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Acton, ACT, Australia
| | - Karen J Hofman
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Brazil
| | - Safura Abdool Karim
- South African Medical Research Council/Wits Centre for Health Economics and Decision Science, Wits School of Public Health, University of Witwatersrand, Johannesburg, South Africa
| | - Jennifer Lacy-Nichols
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, VIC, Australia
| | | | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Lindsay Robertson
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, NSW, Australia
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McGill E, Marks D, Petticrew M, Egan M. Addressing alcohol-related harms in the local night-time economy: a qualitative process evaluation from a complex systems perspective. BMJ Open 2022; 12:e050913. [PMID: 36008081 PMCID: PMC9422880 DOI: 10.1136/bmjopen-2021-050913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES English local authorities (LAs) are interested in reducing alcohol-related harms and may use discretionary powers such as the Late Night Levy (LNL) to do so. This study aims to describe how system stakeholders hypothesise the levy may generate changes and to explore how the system, its actors and the intervention adapt and co-evolve over time. DESIGN A process evaluation from a complex systems perspective, using qualitative methods. SETTING A London LA with high densities of residential and commercial properties, which implemented the LNL in 2014. PARTICIPANTS Data were generated through interviews with LNL implementers and alcohol consumers, observations in bars and during LNL patrols and documentary review. INTERVENTION The LNL allows LAs to charge late-night alcohol retailers an annual fee (£299-£4440) to manage and police the night-time economy (NTE). RESULTS When the LNL was being considered, stakeholders from different interest groups advanced diverse opinions about its likely impacts while rarely referencing supporting research evidence. Proponents of the levy argued it could reduce crime and anti-social behaviour by providing additional funds to police and manage the NTE. Critics of the levy hypothesised adverse consequences linked to claims that the intervention would force venues to vary their hours or close, cluster closing times, reduce NTE diversity and undermine public-private partnerships. In the first 2 years, levy-funded patrols developed relationships with the licensed trade and the public. The LNL did not undermine public-private partnerships and while some premises varied their hours, these changes did not undermine the intervention's viability, nor significantly cluster venue closing times, nor obviously damage the area's reputation for having a diverse NTE. CONCLUSIONS This study applies a framework for process evaluation from a complex systems perspective. The evaluation could be extended to measure alcohol-related outcomes and to consider the interplay between the national and local systems.
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Affiliation(s)
- Elizabeth McGill
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Dalya Marks
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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Gray HM, Wiley RC, Williams PM, Shaffer HJ. Understanding Responsible Drinking Is in the Service of Evidence-based Public Health: A Response to Petticrew et al. (2020). HEALTH COMMUNICATION 2021; 36:260-262. [PMID: 32998596 DOI: 10.1080/10410236.2020.1827542] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Heather M Gray
- Division on Addiction, Cambridge Health Alliance
- Department of Psychiatry, Harvard Medical School
| | | | | | - Howard J Shaffer
- Division on Addiction, Cambridge Health Alliance
- Department of Psychiatry, Harvard Medical School
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SIM FIONA, CHICK JONATHAN, JARVIS SARAH, LESLIE HELENE, LIDINGTON IONA, NEIDLE STEPHEN, OGDEN GRAHAM. Comment on "Dark Nudges and Sludge in Big Alcohol: Behavioral Economics, Cognitive Biases, and Alcohol Industry Corporate Social Responsibility". Milbank Q 2020; 98:E1-E4. [PMID: 33377287 PMCID: PMC7772641 DOI: 10.1111/1468-0009.12489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- FIONA SIM
- Medical Advisory Panel to DrinkawareUK
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Conde K, Peltzer RI, Pantani D, Pinsky I, Cremonte M. Alcohol industry, corporate social responsibility and country features in Latin America. Drug Alcohol Rev 2020; 40:423-430. [PMID: 33156567 DOI: 10.1111/dar.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Research on corporate behaviour can contribute to the understanding of the possible adverse impacts of alcohol-industry corporate social responsibility (CSR) initiatives and their potential influence on policymaking. This study explores the association between alcohol-industry CSR activities and selected country features in Latin America and the Caribbean. DESIGN AND METHODS Nine health experts evaluated 148 CSR activities using a standardised protocol; activities were classified into the categories risk management CSR (rmCSR), that is, to avoid/rectify externalities (n = 67), and strategic CSR, that is, to fulfill philanthropic responsibilities (n = 81). We evaluated the associations, separately, between the number of rmCSR and of strategic CSR actions in each country with threats from public health measures (specifically, the level of research into alcohol consumption and harms, the existence of an alcohol surveillance system and the number of governmental alcohol policy actions) and per capita alcohol consumption; we adjusted by economic indices (country income level and the gross domestic product) and population size. RESULTS Multivariate analyses showed that the higher the level of alcohol research within a country and its per capita consumption, the more likely rmSCR activities were to occur, independently of the country's economic development or population. DISCUSSION AND CONCLUSIONS Results suggest rmSCR actions could be implemented as a way to preserve markets by counteracting scientific evidence about alcohol related harms. This evidence could serve as a starting point to future research, contributing to the understanding of alcohol industry behaviour and the advancement of effective public policies.
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Affiliation(s)
- Karina Conde
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
| | - Raquel Inés Peltzer
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
| | - Daniela Pantani
- Department of Preventive Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Ilana Pinsky
- School of Public Health, City University of New York, New York, USA
| | - Mariana Cremonte
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
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