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van Schalkwyk MC, Hawkins B, Eisenkraft Klein D, Koon AD. The role of metaphor in the corporate political strategies of health harming industries: Comparing the concept of balance in the gambling and opioid industry discourses. Soc Sci Med 2024; 356:117158. [PMID: 39094389 DOI: 10.1016/j.socscimed.2024.117158] [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: 10/09/2023] [Revised: 06/07/2024] [Accepted: 07/21/2024] [Indexed: 08/04/2024]
Abstract
Scholars have identified notable similarities between the political strategies employed by health-harming industries. This includes similarities in the narratives employed by industry actors seeking to oppose public health regulations that threaten their commercial interests. This study seeks to examine the use of a specific concept - the balance metaphor - in the policy discourses of two health-harming industries. Namely, the pharmaceutical industry implicated in the prescription opioid crisis in the US, and the UK gambling industry, whose products and practices are associated with a serious, but largely neglected, series of harms. We first review research on metaphors, demonstrating how this provides additional theoretically-informed concepts with which to understand how industry discourse circumscribes the terrain of policy debates in ways amenable to commercial interests. Building from these insights, we conducted a rhetorical analysis, examining how the concept of balance is employed by different actors in distinct contexts to shape understandings of the social and policy problems associated with gambling and opioid products and to promote industry-favourable regulatory responses to these. This brings a micro-level of analysis to supplement previous meso- and macro-level scholarship in this space. We use our findings to argue that the depoliticization of the policy process and objectivization of the policy space - in ways that obscure its contingent and political nature - through discourses of balance is itself an arch political act. Examining the metaphors used in policy debates and their functions provides important insights that can be used to inform the construction of counter-narratives to industry-favourable discourses, including the creative use of novel metaphors in the service of public health goals.
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Affiliation(s)
- May Ci van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK.
| | | | | | - Adam D Koon
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, USA; Georgetown University, USA
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Farkouh EK, Vallance K, Wettlaufer A, Giesbrecht N, Asbridge M, Farrell-Low AM, Gagnon M, Price TR, Priore I, Shelley J, Sherk A, Shield KD, Solomon R, Stockwell TR, Thompson K, Vishnevsky N, Naimi TS. An assessment of federal alcohol policies in Canada and priority recommendations: Results from the 3rd Canadian Alcohol Policy Evaluation Project. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:640-653. [PMID: 38739320 PMCID: PMC11303602 DOI: 10.17269/s41997-024-00889-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To systematically assess the Canadian federal government's current alcohol policies in relation to public health best practices. METHODS The 2022 Canadian Alcohol Policy Evaluation (CAPE) Project assessed federal alcohol policies across 10 domains. Policy domains were weighted according to evidence for their relative impact, including effectiveness and scope. A detailed scoring rubric of best practices was developed and externally reviewed by international experts. Policy data were collected between June and December 2022, using official legislation, government websites, and data sources identified from previous iterations of CAPE as sources. Contacts within relevant government departments provided any additional data sources, reviewed the accuracy and completeness of the data, and provided amendments as needed. Data were scored independently by members of the research team. Final policy scores were tabulated and presented as a weighted overall average score and as unweighted domain-specific scores. RESULTS Compared to public health best practices, the federal government of Canada scored 37% overall. The three most impactful domains-(1) pricing and taxation, (2) marketing and advertising controls, and (3) impaired driving countermeasures-received some of the lowest scores (39%, 10%, and 40%, respectively). Domain-specific scores varied considerably from 0% for minimum legal age policies to 100% for controls on physical availability of alcohol. CONCLUSION Many evidence-informed alcohol policies have not been adopted, or been adopted only partially, by the Canadian federal government. Urgent adoption of the recommended policies is needed to prevent and reduce the enormous health, social, and economic costs of alcohol use in Canada.
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Affiliation(s)
- Elizabeth K Farkouh
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada.
- Mayo Clinic Alix School of Medicine, Rochester, MN, USA.
| | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Ashley Wettlaufer
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
| | - Norman Giesbrecht
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Amanda M Farrell-Low
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Marilou Gagnon
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tina R Price
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Isabella Priore
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Jacob Shelley
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kevin D Shield
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Robert Solomon
- Faculty of Law, University of Western Ontario, London, ON, Canada
| | - Tim R Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Kara Thompson
- St. Francis Xavier University, Antigonish, NS, Canada
| | - Nicole Vishnevsky
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Timothy S Naimi
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
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Baumann S, Leão T. Industries, citizens, and non-governmental organizations' positioning and arguments used in European Union initiatives for alcohol taxation and cross-border regulation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 129:104475. [PMID: 38971018 DOI: 10.1016/j.drugpo.2024.104475] [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: 01/21/2024] [Revised: 04/13/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The European region has the highest daily alcohol consumption per capita and a high alcohol-related burden of disease. Policymaking at the European Union level is open to participation by interest groups, from public health organizations to alcohol industry representatives. This study aimed to map the interest groups present in the alcohol taxation and cross-border regulation initiatives and identify which arguments were used to support positions in favor or against them. METHODS We used qualitative content analysis on the comments submitted on the official European Commission website during the 2017, 2018, 2020, and 2022 participation periods. Interest groups were characterized considering their positioning, and arguments were identified and compared by position and type of initiative. RESULTS Opponents of changes to the structures of alcohol excise duties and cross-border regulations were mostly representatives of the alcohol and agricultural industries, and the proponents were mostly health-related nongovernmental organizations. Opponents of these initiatives used a wide variety of arguments, from economic and trade to health arguments, while proponents focused mainly on health arguments, such as the effectiveness of alcohol taxation in preventing alcohol-related morbidity and mortality. CONCLUSION This study highlights the wide range of arguments used by opponents around alcohol control policies, contrasting with the health-centered arguments of proponents. It further shows that there is a lobbying network at the European Union level, combining national and international representatives of industry and non-governmental organizations. These findings provide an opportunity for better preparation for upcoming discussions on alcohol control at national and regional levels.
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Affiliation(s)
- Selina Baumann
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal
| | - Teresa Leão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal.
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Lesch M, Golder S, McCambridge J. Corporate social responsibility, policy framing and strategic marketing: understanding the alcohol industry's use of social media in Uganda. Subst Abuse Treat Prev Policy 2024; 19:31. [PMID: 38902800 PMCID: PMC11188496 DOI: 10.1186/s13011-024-00611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/15/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Sub-Saharan Africa is important to the future of alcohol and global health because the alcohol market there is expanding rapidly in a relatively young population. This entails a corresponding contest about whether the policy measures adopted will be shaped by scientific evidence or by industry interference in alcohol policy. This study examines how alcohol industry actors use social media. METHODS Uganda was selected for study because of high levels of alcohol harm and recent alcohol policy debates. Data on the X (formerly Twitter) activity of the Ugandan companies of AB InBev and Diageo, who are the two main brewers, and the trade association including both, were collected, coded and thematically analysed. RESULTS X is used overwhelmingly by alcohol industry actors in Uganda to promote corporate social responsibility (CSR) and alcohol policy framing content. There is little direct product marketing. The framing of policy problems and solutions, and of the actors involved in policymaking and CSR resembles that used elsewhere in the political strategies of the transnational alcohol corporations. Content which appears more emphasised in Uganda includes material on farmers, illicit trade and contribution to the economy. As elsewhere, it avoids giving attention to the policy measures which would make a difference to the levels of alcohol harms endured by Uganda. Rhetorically, X is thus used to create a parallel universe, in which the actual harms and what is known about how to reduce them are conspicuous by their absence. CONCLUSIONS The alcohol industry presents itself as indispensable to Uganda's future and appears to have developed relationships with politicians, partnerships with government, and built a coalition with farmers. This means the alcohol industry may be well positioned to oppose public health policy measures, even though their arguments lack substance and are at odds with the evidence.
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Affiliation(s)
- Matthew Lesch
- Department of Politics and International Relations, Derwent College, University of York, York, YO10 5DD, UK.
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, York, YO10 5DD, UK
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, York, YO10 5DD, UK
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Lesch M, McCambridge J. Continuities and change in alcohol policy at the global level: a documentary analysis of the 2010 Global Strategy for Reducing the Harmful Use of Alcohol and the Global Alcohol Action Plan 2022-2030. Global Health 2024; 20:47. [PMID: 38877515 PMCID: PMC11179290 DOI: 10.1186/s12992-024-01034-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/23/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND There are only two major statements which define alcohol policy development at the global level. There has not been any comparative analysis of the details of these key texts, published in 2010 and 2022 respectively, including how far they constitute similar or evolving approaches to alcohol harm. METHODS Preparatory data collection involved examination of documents associated with the final policy statements. A thematic analysis across the two policy documents was performed to generate understanding of continuity and change based on comparative study. Study findings are interpreted in the contexts of the evolving conceptual and empirical literatures. RESULTS Both documents exhibit shared guiding principles and identify similar governance challenges, albeit with varying priority levels. There is more emphasis on the high-impact interventions on price, availability and marketing in 2022, and more stringent targets have been set for 2030 in declaring alcohol as a public health priority therein, reflecting the action-oriented nature of the Plan. The identified roles of policy actors have largely remained unchanged, albeit with greater specificity in the more recent statement, appropriately so because it is concerned with implementation. The major exception, and the key difference in the documents, regards the alcohol industry, which is perceived primarily as a threat to public health in 2022 due to commercial activities harmful to health and because policy interference has slowed progress. CONCLUSIONS The adoption of the Global Alcohol Action Plan 2022-30 potentially marks a pivotal moment in global alcohol policy development, though it is unclear how fully it may be implemented. Perhaps, the key advances lie in advancing the ambitions of alcohol policy and clearly identifying that the alcohol industry should not be seen as any kind of partner in public health policymaking, which will permit progress to the extent that this influences what actually happens in alcohol policy at the national level.
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Affiliation(s)
- Matthew Lesch
- Department of Politics and International Relations, Derwent College, University of York, D/N/126, Heslington, York, YO10 5DD, UK.
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Eisenkraft Klein D, Shawanda A. Bridging the commercial determinants of Indigenous health and the legacies of colonization: A critical analysis. Glob Health Promot 2024; 31:15-22. [PMID: 37522186 DOI: 10.1177/17579759231187614] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
To date, there has been scarce effort to consider the intertwining of colonization and the commercial determinants of Indigenous health. This is a vital omission, and one that this paper proposes to address. We propose how four losses of tradition borne out of colonialism are intertwined with four respective commercial determinants of Indigenous health: 1) loss of traditional diets and the ultra-processed food industry; 2) loss of traditional ceremony and the tobacco industry; 3) loss of traditional knowledge and the infant formula industry; and 4) loss of traditional support networks and the alcohol industry. Building on Indigenous efforts to decolonize spaces and assert control over their own lives, we argue that analyzing the mechanisms through which industry activities intersect with colonial legacies will improve broader understandings of Indigenous health disparities.
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Affiliation(s)
| | - Amy Shawanda
- Waakebiness Institute for Indigenous Health, Dalla Lana School of Public Health, University of Toronto, Canada
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Backholer K, Huse O, Brooks R, Martino F, Chung A, Zorbas C, Driessen C, Sartori A, Browne J. The rise and fall of the Queensland Government policy to restrict unhealthy food and alcohol advertising on publicly owned assets. Aust N Z J Public Health 2024; 48:100148. [PMID: 38839474 DOI: 10.1016/j.anzjph.2024.100148] [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: 11/12/2023] [Revised: 03/25/2024] [Accepted: 04/02/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE To examine the strategies employed by opponents of the Queensland Government's policy to restrict unhealthy food and alcohol advertising on publicly owned assets and identify which of the opposing arguments appeared to influence the policy outcomes. METHODS Retrospective qualitative policy analysis case study informed by the Policy Dystopia Model of corporate political activity. We used qualitative content analysis to examine data from stakeholder submissions to the 'Advertising content on Queensland Government advertising spaces' policies (v1 and 2), and Minister for Health's diaries. RESULTS Stakeholders from the food, beverage, alcohol and advertising industries and several not-for-profit health organisations opposed the policy. Industry actors used discursive strategies, coalition management (including co-option of not-for-profit health organisations), information management and direct involvement with policy makers to communicate their arguments against the policy. The second version of the policy was weaker regarding scope and key policy provisions, reflecting the arguments of industry actors. CONCLUSIONS Influence from industries with a clear conflict of interest should be minimised throughout policy development to ensure public health is prioritised over corporate gain. IMPLICATIONS FOR PUBLIC HEALTH Our findings can support other jurisdictions to prepare for industry opposition when designing policies to restrict unhealthy food and alcohol marketing.
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Affiliation(s)
- Kathryn Backholer
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia.
| | - Oliver Huse
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
| | - Ruby Brooks
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
| | - Florentine Martino
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
| | - Alexandra Chung
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Christina Zorbas
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
| | - Christine Driessen
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
| | | | - Jennifer Browne
- Deakin University, Global Centre for Preventive Health and Nutrition, Institute for Health Transformation, Geelong, Australia
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Coles CE, Earl H, Anderson BO, Barrios CH, Bienz M, Bliss JM, Cameron DA, Cardoso F, Cui W, Francis PA, Jagsi R, Knaul FM, McIntosh SA, Phillips KA, Radbruch L, Thompson MK, André F, Abraham JE, Bhattacharya IS, Franzoi MA, Drewett L, Fulton A, Kazmi F, Inbah Rajah D, Mutebi M, Ng D, Ng S, Olopade OI, Rosa WE, Rubasingham J, Spence D, Stobart H, Vargas Enciso V, Vaz-Luis I, Villarreal-Garza C. The Lancet Breast Cancer Commission. Lancet 2024; 403:1895-1950. [PMID: 38636533 DOI: 10.1016/s0140-6736(24)00747-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/18/2023] [Accepted: 04/09/2024] [Indexed: 04/20/2024]
Affiliation(s)
| | - Helena Earl
- Department of Oncology, University of Cambridge, Cambridge, UK
| | - Benjamin O Anderson
- Global Breast Cancer Initiative, World Health Organisation and Departments of Surgery and Global Health Medicine, University of Washington, Seattle, WA, USA
| | - Carlos H Barrios
- Oncology Research Center, Hospital São Lucas, Porto Alegre, Brazil
| | - Maya Bienz
- Mount Vernon Cancer Centre, East and North Hertfordshire NHS Trust, London, UK; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - David A Cameron
- Institute of Genetics and Cancer and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Fatima Cardoso
- Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal
| | - Wanda Cui
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Prudence A Francis
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Reshma Jagsi
- Emory University School of Medicine, Atlanta, GA, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Miami, FL, USA; Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA; Tómatelo a Pecho, Mexico City, Mexico
| | - Stuart A McIntosh
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Kelly-Anne Phillips
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
| | - Lukas Radbruch
- Department of Palliative Medicine, University Hospital Bonn, Bonn, Germany
| | | | | | - Jean E Abraham
- Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | - Lynsey Drewett
- Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | | | - Farasat Kazmi
- Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK
| | | | | | - Dianna Ng
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | - Szeyi Ng
- The Institute of Cancer Research, London, UK
| | | | - William E Rosa
- Memorial Sloan Kettering Cancer Center, New York City, NY, USA
| | | | | | | | | | | | - Cynthia Villarreal-Garza
- Breast Cancer Center, Hospital Zambrano Hellion TecSalud, Tecnologico de Monterrey, Monterrey, Mexico
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Dumbili EW. Alcohol industry-sponsored music festivals, alcohol marketing and drinking practices among young Nigerians: Implications for policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104384. [PMID: 38492330 DOI: 10.1016/j.drugpo.2024.104384] [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: 11/21/2023] [Revised: 02/17/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The global alcohol industry sponsors social/music events targeting young people; however, existing literature focuses on Westernised contexts. Given the decline in young people's drinking in many Western countries, it appears that multinational alcohol companies are importing the strategies they have used in high-income countries to the Global South countries like Nigeria to recoup profits. This study aims to examine the Guinness Show- a free one-month annual music festival, alcohol marketing at the festival and the extent to which the event encourages diverse drinking practices among its attendees. METHODS We observed the music festival before collecting data through 53 interviews and 3 focus groups (N = 26). Data were analysed to generate themes with the aid of NVivo 12 software. FINDINGS Over 6000 participants attend the Guinness Show daily, and participants gave detailed descriptions of the music festival, alcohol marketing activities that occur in it and the drinking practices of attendees, indicating that they were highly knowledgeable of the event. The Guinness Show attracts famous music artistes and other entertainers. Therefore, young people attend to see them perform free of charge. However, diverse alcohol promotions (e.g., quantity deals, low prices, giveaways) that happen daily, the strategic use of young women as 'beer promoters', and the pleasure the event induces by fusing music/entertainment into alcogenic environments, encourage drinking and drunkenness. All the attendees drank alcohol, and some engaged in impulse buying, while many consumed excessively due to promotions (e.g., buy-two-get-one free), which facilitated intoxication and the loss of control. CONCLUSIONS Guinness Nigeria organises the event for strategic brand communication, generating brand capital, and encouraging alcohol purchases and consumption among young people. Policymakers should reconsider self-regulation and implement national alcohol control policies and other public health interventions to restrain the alcohol industry from sponsoring such events.
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Affiliation(s)
- Emeka W Dumbili
- School of Sociology, College of Social Sciences and Law, University College Dublin, Belfield, Dublin 4, Ireland.
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10
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Carlini BH, Kellum LB, Garrett SB, Nims LN. Threaten, Distract, and Discredit: Cannabis Industry Rhetoric to Defeat Regulation of High-THC Cannabis Products in Washington State. J Stud Alcohol Drugs 2024; 85:322-329. [PMID: 38270913 PMCID: PMC11218453 DOI: 10.15288/jsad.23-00277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE Washington State legislators have attempted to regulate high delta-9-tetrahydrocannabinol (THC) cannabis to reduce cannabis-related harms. Historically, industry actors of other health-compromising products have influenced governments' adoption of evidence-based regulation policies. A better understanding of the industry rhetoric can be used by public health advocates to develop counterarguments and disseminate alternative narratives that protect the public's health. We analyzed the arguments used by cannabis industry actors opposing regulations to de-incentivize the availability and use of high-THC products in Washington State. METHOD We analyzed 41 testimonies transcribed from 33 cannabis industry actors in 3 public bill hearings and one legislative work session that occurred between 2020 and 2023. Using a deductive thematic analysis, informed by industry actors' arguments opposing regulation of alcohol, tobacco, and high-sugar beverages, we developed a codebook to analyze and identify themes within cannabis industry rhetorical strategies. RESULTS We identified three main rhetorical strategies used by cannabis industry actors to oppose THC content regulation: threaten, distract, discredit. The most frequently used rhetorical strategy was threats to economic benefits, public health, and the will of the people. The other two most apparent strategies were distracting from the bill's focus by introducing a tangential topic and discrediting the science that supported regulation of cannabis products with high THC concentration or its advocates. CONCLUSIONS Cannabis industry actors have leveraged several arguments used by industry actors of other health-compromising products to undermine initiatives to advance public health. They have also adapted rhetoric from other industries to the unique conditions of the cannabis regulatory landscape.
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Affiliation(s)
- Beatriz H. Carlini
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lyndsey B. Kellum
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Sharon B. Garrett
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
| | - Lexi N. Nims
- Addictions, Drug, & Alcohol Institute, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington
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Stewart D, Madden M, McCambridge J. Brief interventions 2.0: a new agenda for alcohol policy, practice and research. Global Health 2024; 20:34. [PMID: 38641840 PMCID: PMC11031858 DOI: 10.1186/s12992-024-01031-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/20/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Alcohol problems are increasing across the world and becoming more complex. Limitations to international evidence and practice mean that the screening and brief intervention paradigm forged in the 1980s is no longer fit for the purpose of informing how conversations about alcohol should take place in healthcare and other services. A new paradigm for brief interventions has been called for. BRIEF INTERVENTIONS 2.0: We must start with a re-appraisal of the roles of alcohol in society now and the damage it does to individual and population health. Industry marketing and older unresolved ideas about alcohol continue to impede honest and thoughtful conversations and perpetuate stigma, stereotypes, and outright fictions. This makes it harder to think about and talk about how alcohol affects health, well-being, and other aspects of life, and how we as a society should respond. To progress, brief interventions should not be restricted only to the self-regulation of one's own drinking. Content can be orientated to the properties of the drug itself and the overlooked problems it causes, the policy issues and the politics of a powerful globalised industry. This entails challenging and reframing stigmatising notions of alcohol problems, and incorporating wider alcohol policy measures and issues that are relevant to how people think about their own and others' drinking. We draw on recent empirical work to examine the implications of this agenda for practitioners and for changing the public conversation on alcohol. CONCLUSION Against a backdrop of continued financial pressures on health service delivery, this analysis provokes debate and invites new thinking on alcohol. We suggest that the case for advancing brief interventions version 2.0 is both compelling and urgent.
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Affiliation(s)
- Duncan Stewart
- School of Social Sciences and Professions, London Metropolitan University, London, N7 8DB, UK.
| | - Mary Madden
- Department of Health Sciences, University of York, York, YO10 5DD, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, YO10 5DD, UK
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McCambridge J, Golder S. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of epidemiological studies. Addict Behav 2024; 151:107932. [PMID: 38103279 DOI: 10.1016/j.addbeh.2023.107932] [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: 06/15/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Alcohol's effects on cardiovascular disease (CVD) are controversial. Alcohol industry actors have shown particular interest in this subject, and been extensively involved through research funding, and in other ways, generating concerns about bias, particularly in reviews. MATERIAL & METHODS We conducted a co-authorship network analysis of the primary studies included within a previous co-authorship study of 60 systematic reviews on the impact of alcohol on CVD. Additionally, we examined the relationships between declared alcohol industry funding and network structure. RESULTS There were 713 unique primary studies with 2832 authors published between 1969 and 2019 located within 229 co-authorship subnetworks. There was industry funding across subnetworks and approximately 8% of all papers declared industry funding. The largest subnetwork dominated, comprising 43% of all authors, with sparse evidence of substantial industry funding. The second largest subnetwork contained approximately 4% of all authors, with largely different industry funders involved. Harvard affiliated authors who at the review level formed co-authorship subnetworks with industry funded authors were seen at the primary study level to belong to the largest epidemiological subnetwork. A small number of key authors make extensive alcohol industry funding declarations. CONCLUSIONS There was no straightforward relationship between co-authorship network formation and alcohol industry funding of epidemiological studies on alcohol and CVD. More fine-grained attention to patterns of alcohol industry funding and to key nodes may shed further light on how far industry funding may be responsible for conflicting findings on alcohol and CVD.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom.
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom
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13
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Sherk A, Churchill S, Cukier S, Grant SC, Shield K, Stockwell T. Distributions of alcohol use and alcohol-caused death and disability in Canada: Defining alcohol harm density functions and new perspectives on the prevention paradox. Addiction 2024; 119:696-705. [PMID: 38237919 DOI: 10.1111/add.16414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/15/2023] [Indexed: 03/05/2024]
Abstract
AIMS The aims of this study were to examine the distribution of alcohol use and to define 'harm density functions' representing distributions of alcohol-caused health harm in Canada, by sex, towards better understanding which groups of drinkers experience the highest aggregate harms. DESIGN This was an epidemiological modeling study using survey and administrative data on alcohol exposure, death and disability and risk relationships from epidemiological meta-analyses. SETTING This work took place in Canada, 2019. PARTICIPANTS Canadians aged 15 years or older participated. MEASUREMENTS Measures included modeled life-time mean daily alcohol use in grams of pure alcohol (ethanol) per day, alcohol-caused deaths and alcohol-caused disability-adjusted life-years. FINDINGS As a life-time average, more than half of Canadians aged 15+ (62.8% females, 46.9% males) use fewer than 10 g of pure alcohol per day (g/day). By volume, the top 10% of the population consume 45.9% of the total ethanol among males and 47.1% of the total ethanol among females. The remaining 90% of the population experience a slim majority of alcohol-caused deaths (males 55.3%, females 46.9%). Alcohol harm density functions compose the size of the using population and the risk experienced at each volume level to show that the population-level harm experienced is highest for males at 25 g/day and females at 13 g/day. CONCLUSIONS Almost 50% of alcohol use in Canada is concentrated among the highest 10% of drinkers, but more than half of the alcohol-caused deaths in Canada in 2019 were experienced by the bottom 90% of the population by average volume, providing evidence for the prevention paradox. New alcohol harm density functions provide insight into the aggregate health harm experienced across the mean alcohol use spectrum and may therefore be used to help determine where alcohol policies should be targeted for highest efficacy.
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Affiliation(s)
- Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Samuel Churchill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Samantha Cukier
- School of Health Sciences, Dalhousie University, Halifax, Canada
| | - Sierra C Grant
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
| | - Kevin Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, Canada
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Klingemann H, Lesch M. The confluence of legacy, corporate social responsibility, and public health: The case of Migros and alcohol-free retailing in Switzerland. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 125:104333. [PMID: 38350167 DOI: 10.1016/j.drugpo.2024.104333] [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: 07/13/2023] [Revised: 01/10/2024] [Accepted: 01/17/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Alcohol policy studies have traditionally focused on formal policymaking processes. Retail cooperatives, however, have rarely been studied as sites of public health interventions. Migros, a cooperatively owned chain of supermarkets in Switzerland, has long forbidden alcohol sales in its supermarkets. Focusing on processes of framing, this study explores a recent unsuccessful attempt to reverse the long-standing ban via membership vote in 2022. METHODS The study draws on a range of data sources, including company documents, a televised debate, and the results of a large online survey among the general population conducted ahead of the referendum. Using thematic analysis, it investigates various campaign-related arguments, including those made by Migros management, NGOs, and other key campaign participants. RESULTS Proponents and opponents used a combination of public health, economic/market-oriented, and corporate social responsibility (CSR) frames. Migros's longstanding dedication to CSR, its participatory governance structure, and the regional political dynamics in the Swiss context are essential in understanding the nature and impact of framing. CONCLUSIONS Alcohol-related harm arises from a complex interaction between different social, political, and economic factors. Reducing harm requires approaches that consider the range of contexts and measures that can shape alcohol availability.
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Affiliation(s)
- Harald Klingemann
- Bern University of Applied Sciences, Bern Academy of the Arts (HKB), Institute of Design Research (IDR) Bern Switzerland, Fellerstrasse 11, Bern, CH-3027, Switzerland.
| | - Matthew Lesch
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, United Kingdom
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Rodriguez AML, Adams PJ, Sayes E, Kypri K. The role of gifts in building influence with politicians: Thematic analysis of interviews with current and former parliamentarians. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 125:104332. [PMID: 38422916 DOI: 10.1016/j.drugpo.2024.104332] [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: 10/15/2023] [Revised: 01/14/2024] [Accepted: 01/15/2024] [Indexed: 03/02/2024]
Abstract
Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building.
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Affiliation(s)
- Ara Marie Leal Rodriguez
- School of Population Health, and Centre for Addiction Research, University of Auckland, Private Bag 92019, Auckland 1142, Aotearoa New Zealand
| | - Peter J Adams
- School of Population Health, and Centre for Addiction Research, University of Auckland, Private Bag 92019, Auckland 1142, Aotearoa New Zealand.
| | - Edwin Sayes
- School of Population Health, and Centre for Addiction Research, University of Auckland, Private Bag 92019, Auckland 1142, Aotearoa New Zealand
| | - Kypros Kypri
- Department of Preventive and Social Medicine, University of Otago, Dunedin 9016, Aotearoa New Zealand
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16
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McCambridge J, Lesch M. Are we moving into a new era for alcohol policy globally? An analysis of the Global Alcohol Action Plan 2022-30. BMJ Glob Health 2024; 9:e014246. [PMID: 38388164 PMCID: PMC10895216 DOI: 10.1136/bmjgh-2023-014246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/17/2023] [Indexed: 02/24/2024] Open
Abstract
The Global Alcohol Action Plan 2022-30 (GAAP) represents an important milestone in policy implementation at the global level on alcohol and health. There has, however, been little attention paid to the GAAP in the research literature. With a focus on the alcohol industry, this analysis examines the content of, and prospects for, the GAAP. It is clear why stronger action on alcohol and health is needed. The health harming nature of alcohol and policy interference by industry are now clearly understood. The alcohol industry is now thus regarded primarily as a key part of the problem. The GAAP calls for action in six areas with specific roles for public health actors, and invites powerful industry actors to desist from harmful activities, within each area. The broad outline of what is expected of the alcohol industry is now clear. It remains unclear, however, how far countries will continue to face formidable opposition from the major alcohol companies and their surrogates, in adopting and implementing evidence-based measures. Governments must now act at speed, and it is unclear if the targets set for 2030 will be met. If this long-running public health policy failure continues, this will have dire consequences for low and middle income countries where the alcohol market is expanding. Stronger actions may also be needed.
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Affiliation(s)
| | - Matthew Lesch
- Department of Health Sciences, University of York, York, UK
- Department of Politics and International Relations, University of York, York, UK
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17
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Adams PJ, Gregan MJ. Moral jeopardy, conflicts of interest and the integrity of public health research. Int J Epidemiol 2024; 53:dyae023. [PMID: 38374718 PMCID: PMC10877091 DOI: 10.1093/ije/dyae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Affiliation(s)
- Peter J Adams
- Centre for Addiction Research, School of Population Health, The University of Auckland, Auckland, Aotearoa New Zealand
| | - Melissa-Jade Gregan
- Centre for Addiction Research, School of Population Health, The University of Auckland, Auckland, Aotearoa New Zealand
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18
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Gage R, Connor J, Jackson N, McKerchar C, Signal L. Generating political priority for alcohol policy reform: A framework to guide advocacy and research. Drug Alcohol Rev 2024; 43:381-392. [PMID: 38017702 DOI: 10.1111/dar.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/26/2023] [Accepted: 10/28/2023] [Indexed: 11/30/2023]
Abstract
INTRODUCTION While effective policies exist to reduce alcohol-related harm, political will to enact them is low in many jurisdictions. We aimed to identify key barriers and strategies for strengthening political priority for alcohol policy reform. METHODS A framework synthesis was conducted, incorporating relevant theory, key informant interviews (n = 37) and a scoping review. Thematic analysis informed the development of a framework for understanding and influencing political priority for alcohol policy. RESULTS Twelve barriers and 14 strategies were identified at multiple levels (global, national and local). Major barriers included neoliberal or free trade ideology, the globalised alcohol industry, limited advocate capacity and the normalisation of alcohol harms. Strategies fell into two categories: sector-specific and system change initiatives. Sector-specific strategies primarily focus on influencing policymakers and mobilising civil society. Examples include developing a clear, unified solution, coalition building and effective framing. System change initiatives target structural change to reduce the power imbalance between industry and civil society, such as restricting industry involvement in policymaking and securing sustainable funding for advocacy. A key example is establishing an international treaty, similar to the Framework Convention on Tobacco Control, to support domestic policymaking. DISCUSSION AND CONCLUSIONS Our findings provide a framework for understanding and advancing political priority for alcohol policy. The framework highlights that progress can be achieved at various levels and through diverse groups of actors. The importance of upstream drivers of policymaking was a key finding, presenting challenges for time-poor advocates, but offering potential facilitation through effective global leadership.
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Affiliation(s)
- Ryan Gage
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
| | - Jennie Connor
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | | | - Christina McKerchar
- Department of Population Health, University of Otago Christchurch, Christchurch, New Zealand
| | - Louise Signal
- Department of Public Health, University of Otago Wellington, Wellington, New Zealand
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Severi K, Hawkins B. Policy Actors' Perceptions of Conflicts of Interest and Alcohol Industry Engagement in UK Policy Processes. Int J Health Policy Manag 2024; 13:8068. [PMID: 38618829 PMCID: PMC11016281 DOI: 10.34172/ijhpm.2024.8068] [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: 04/04/2023] [Accepted: 01/14/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Alcohol industry organisations occupy a prominent position in UK alcohol policy, but their involvement has been contested by public health bodies on the basis that a conflict of interest (COI) exists between their economic objectives and those of public health. There are ongoing debates in the research literature about how to conceptualise COI and mitigate this in health research and practise. However, less attention has been paid to these issues in relation to the alcohol industry specifically. This article explores similarities and differences in beliefs among alcohol policy actors regarding COI and the implications of engagement with the alcohol industry in the context of UK public health policy. METHODS Semi-structured interviews with a range of policy actors (n=26) including medical professionals, parliamentarians, civil servants, academic researchers, health campaigners, and alcohol industry representatives. Interviews with alcohol industry representatives were supplemented with an analysis of industry responses to a public consultation. All data was thematically coded using NVivo software. RESULTS Two competing "coalitions" were identified, expressing beliefs about COI linked to alcohol industry engagement. Both divergent and convergent beliefs were expressed by the two coalitions in relation to the type of industry actor, form of engagement, the policy issue under discussion and the stage of policy process. CONCLUSION Alcohol policy is a complex and contested space in which policy actors have differing, nuanced and contingent understandings of COI and identify varying risks associated with alcohol industry engagement. In identifying the areas of convergence and diversion in both understanding and evaluation of COI in alcohol-specific settings, these findings will assist both decision-makers and non-governmental actors in developing policies and guidelines to manage potential COI in future.
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20
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Madden M, Bartlett A, McCambridge J. Constructing public-private partnerships to undermine the public interest: critical discourse analysis of Working Together published by the International Alliance for Responsible Drinking. Global Health 2023; 19:103. [PMID: 38104100 PMCID: PMC10725627 DOI: 10.1186/s12992-023-01000-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The global burden of alcohol harm has increased and is forecast to grow further without effective policy implementation. Public-private partnerships aiming to address global health, and other societal challenges, are a burgeoning feature of neoliberal governance. Rhetorically distancing themselves from tobacco, the major alcohol companies are committed to tackling 'harmful drinking' and have created a distinct type of public relations organization for this purpose. The activities of such organizations are increasingly recognized as an impediment to the implementation of policies to reduce alcohol harm, including in low- and middle-income countries where markets are expanding. METHODS The approach of critical discourse analysis is used to examine the discursive tactics and strategies used in Working Together; a 'toolkit' published by the key global level alcohol industry public relations organization, the International Alliance for Responsible Drinking (IARD). This study considers how it works discursively to set the terms of, and overcome skepticism about partnerships, to define aims and position various actors by constructing their roles. The construction of prospective partners provides insights into the alcohol industry itself. RESULTS The toolkit operates as an ideological resource for forming public-private partnerships across the world based on the accumulated know-how of the major companies through IARD. This allows the largest alcohol companies to exercise leadership of the industry, while remaining off-stage. The toolkit relies on a form of rhetorical work which creates distance from obvious corporate interests and the harms caused to population health and society. This is accomplished by working against evidence-informed population level approaches, and thus avoiding policies that will make any significant difference to overall alcohol harm. Unspecific "complexity" affords opportunity for preferred types of "actions", and "partnership" provides opportunity to gain credibility by association, further minimizing the likelihood of any material harm being reduced. CONCLUSIONS The toolkit is designed to not only legitimate the inclusion of alcohol industry actors as initiating 'partners', but also assigns them roles as managers of a set of carefully constructed relationships. This vision of public-private partnership reproduces the hegemonic narrative that has successfully blocked policy advances for decades and led to growing alcohol harm globally.
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Affiliation(s)
- Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England.
| | - Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
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21
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Maani N, CI van Schalkwyk M, Petticrew M. Under the influence: system-level effects of alcohol industry-funded health information organizations. Health Promot Int 2023; 38:daad167. [PMID: 38097395 PMCID: PMC10721437 DOI: 10.1093/heapro/daad167] [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] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Abstract
There is now an established body of evidence that the alcohol industry seeks to obstruct public health policies that could affect the availability, affordability or marketing of alcohol. In parallel, the alcohol industry is active in funding corporate social responsibility initiatives, with a particular focus on 'responsible drinking' campaigns, often facilitated by national-level charities established and/or funded by the alcohol industry and associated organizations. While evidence continues to grow regarding biases in the content produced by such health information organizations, they remain active in partnerships with government health departments on national health promotion campaigns and provide a range of health-related information to the public, community organizations and schools. To understand the implications of such access for policymakers, researchers and the public, there is a need to consider the wider, system-level influences of such organizations and their place in wider alcohol industry strategies. In this article, we describe evolving evidence of the direct and indirect strategic effects of such organizations and demonstrate how they serve key roles in the alcohol industry through their existence, content, partnerships and public profiles. We end by considering the implications for how we conceptualize charities established or funded (entirely or partly) by harmful commodity industries, and to what extent current conflicts of interest guidelines are sufficiently effective.
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Affiliation(s)
- Nason Maani
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, 15a George Square, Edinburgh, EH8 9LD, UK
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - May CI van Schalkwyk
- Department of Health Services Research and Policy, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
- UK PRP SPECTRUM Consortium, Usher Institute, Old Medical School, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, UK
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22
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Pitt H, McCarthy S, Keric D, Arnot G, Marko S, Martino F, Stafford J, Thomas S. The symbolic consumption processes associated with 'low-calorie' and 'low-sugar' alcohol products and Australian women. Health Promot Int 2023; 38:daad184. [PMID: 38158741 PMCID: PMC10757065 DOI: 10.1093/heapro/daad184] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
The influence of commercial actors, practices and processes on the health and wellbeing of women is still not well understood. The alcohol industry has developed a range of products to appeal to new 'health conscious' markets, such as 'low-calorie' and 'low-sugar' products. While these products may have specific appeal for women, there has been little in-depth research that has sought to understand how women conceptualize these products and the range of symbolic meanings that women associate with these products. An online qualitatively led survey was conducted with n = 497 Australian women who had consumed alcohol in the last year. Questions related to the reasons for and influences on alcohol use, the purchasing of 'low-calorie' or 'low-sugar' products and the influence that these products might have on women's alcohol use. Data were interpreted using reflexive thematic analysis. Women consumed alcohol to relax, cope with everyday stressors and because of the alignment with social practices and social connection. Women perceived that these products provided a healthier alternative to traditional alcohol products and that they aligned with women's values relating to weight and the thin ideal. Some women were concerned that these products could increase alcohol consumption by reducing the perceptions of risk associated with alcohol. Policy consideration is needed to address how product claims and attributes may influence population groups' interpretations of the risks and benefits of these alcohol products, including the illusion that these products have protective potential and are better for overall health and wellbeing.
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Affiliation(s)
- Hannah Pitt
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Simone McCarthy
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Danica Keric
- Cancer Council Western Australia, Level 1/420 Bagot Road, Subiaco, Western Australia, 6008, Australia
| | - Grace Arnot
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Sarah Marko
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Florentine Martino
- Faculty of Health, GLOBE, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
| | - Julia Stafford
- Cancer Council Western Australia, Level 1/420 Bagot Road, Subiaco, Western Australia, 6008, Australia
| | - Samantha Thomas
- Faculty of Health, Institute for Health Transformation, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia
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Reynales-Shigematsu LM, Barnoya J, Cavalcante T, Aburto TC, Romieu I, Stern MC, Barquera S, Corvalán C, Hallal PC, Canelo-Aybar C, Alvarado-Villacorta R, Espina C, Feliu A, Rivera JA. Latin America and the Caribbean Code Against Cancer 1st edition: Tobacco and nicotine-related products, secondhand smoke, and alcohol and cancer. Cancer Epidemiol 2023; 86 Suppl 1:102413. [PMID: 37852726 DOI: 10.1016/j.canep.2023.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/27/2023] [Accepted: 06/30/2023] [Indexed: 10/20/2023]
Abstract
Tobacco, secondhand smoke (SHS), and alcohol, all carcinogens, are leading preventable cancer risk factors in Latin America and the Caribbean (LAC). Since 2000, smoking and SHS exposure have significantly decreased in the region. Yet alcohol consumption remains high. The entry of nicotine-related products such as electronic cigarettes (e-cigs) threatens achievements made in tobacco control and chronic diseases prevention, including cancer. E-cigs use is likely associated with smoking initiation among adolescents who had never smoked and dual use with combustible tobacco products. Therefore, the LAC Code Against Cancer recommends to the public actions they can take to reduce their risk of cancer: 1. Don't smoke or use any type of tobacco. If you do, quitting is possible, with professional help if needed. Don't use e-cigarettes either, as they lead to tobacco use. 2. Make your home a smoke-free place. Respect and promote laws that ensure smoke-free spaces to protect our health. and 3. Avoid drinking alcoholic beverages. This helps prevent several types of cancer. The Code recommends to policymakers a package of cost-effective policies based on the MPOWER and SAFER to prevent cancer at the population level. It also recommends that primary care health professionals: 1. Ask all their patients and their families whether they smoke or vape, inform them about the harms of smoking and vaping, and promote tobacco and nicotine related products cessation strategies among users. 2. Inform about the harms of exposure to SHS, especially among children, and promote smoke-free environments, and 3. Prevent alcohol use by their patients and their families, use tools to assess use, intensity, and frequency, and apply brief counseling intervention to support alcohol abstinence in primary care.
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Affiliation(s)
- Luz Myriam Reynales-Shigematsu
- Tobacco Control and Preventive Department. Center for Population Health Research. National Institute of Public Health. Av. Universidad 655, Col. Santa María Ahuacatitlán, Cuernavaca, Morelos CP 62100, Mexico.
| | - Joaquin Barnoya
- Integra Cancer Institute, Guatemala, 9ª calle 4-52 zona 10, Guatemala, Guatemala
| | - Tania Cavalcante
- Instituto Nacional del Cáncer, INCA, Brasil.Pr. da Cruz Vermelha, 23 - Centro, Rio de Janeiro, RJ 20230-130, Brazil
| | - Tania C Aburto
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Isabelle Romieu
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
| | - Mariana C Stern
- Department of Preventive Medicine and Urology, Keck School of Medicine of USC, 90033 Los Angeles, USA
| | - Simón Barquera
- Center for Research on Nutrition and Health, National Institute of Public Health, CP 62100 Cuernavaca, Mexico
| | - Camila Corvalán
- Institute of Nutrition and Food Technology (INTA), University of Chile, Macul, Chile
| | - Pedro C Hallal
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, United States
| | - Carlos Canelo-Aybar
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Rosa Alvarado-Villacorta
- Department of Clinical Epidemiology and Public Health, Iberossssamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Carolina Espina
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Ariadna Feliu
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, 25 avenue Tony Garnier CS 90627, 69366 Lyon CEDEX 07, France
| | - Juan A Rivera
- Center for Population Health Research, National Institute of Public Health, CP 62100, Cuernavaca, Mexico
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24
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Adams J, Asiasiga L, Neville S. The alcohol industry-A commercial determinant of poor health for Rainbow communities. Health Promot J Austr 2023; 34:903-909. [PMID: 36103136 DOI: 10.1002/hpja.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/08/2022] [Accepted: 09/13/2022] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Alcohol use is an area of challenge for health promotion internationally. The alcohol industry operates as a key commercial determinant of health in that its actions contribute to alcohol misuse, resulting in a range of health and social harms to individuals, families and communities. Rainbow people (including those who identify as lesbian, gay, bisexual, transgender or gender diverse) are one group experiencing considerable harm from alcohol use. METHODS Data from 24 focus groups involving 131 people held in six cities in New Zealand during 2018, were used to explore local understandings of the ways in which the alcohol industry operates as a commercial determinant of health for Rainbow communities. The focus group discussions were analysed thematically. RESULTS Three key themes were identified. First, the alcohol industry was identified as present in the 'everyday', through targeted alcohol promotion to Rainbow people, and due to the centrality of bars to their social and cultural landscapes. Second, participants recognised the benefits of alcohol industry support for Rainbow communities. Last, an opposing view was articulated, with the alcohol industry and its commercial activities viewed negatively. CONCLUSIONS These findings highlight that alcohol as a commodity and the alcohol industry are successfully and firmly embedded within Rainbow communities. Overall, given alcohol is widely regarded in a positive way, this is likely to create difficulties for health promotion efforts to reduce alcohol related harm in these communities.
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Affiliation(s)
- Jeffery Adams
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Lanuola Asiasiga
- SHORE & Whāriki Research Centre, Massey University, Auckland, New Zealand
| | - Stephen Neville
- Department of Nursing, Auckland University of Technology, Auckland, New Zealand
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Bartlett A, Lesch M, Golder S, McCambridge J. Alcohol policy framing in South Africa during the early stages of COVID-19: using extraordinary times to make an argument for a new normal. BMC Public Health 2023; 23:1877. [PMID: 37770857 PMCID: PMC10537160 DOI: 10.1186/s12889-023-16512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/10/2023] [Indexed: 09/30/2023] Open
Abstract
INTRODUCTION Public health and alcohol industry actors compete to frame alcohol policy problems and solutions. Little is known about how sudden shifts in the political context provide moments for policy actors to re-frame alcohol-related issues. South Africa's temporary bans on alcohol sales during the COVID-19 pandemic offered an opportunity to study this phenomenon. METHODS We identified Professor Charles Parry from the South African Medical Research Council as a key policy actor. Parry uses a Twitter account primarily to comment on alcohol-related issues in South Africa. We harvested his tweets posted from March 18 to August 31, 2020, coinciding with the first two alcohol sales bans. We conducted a thematic analysis of the tweets to understand how Parry framed alcohol policy evidence and issues during these 'extraordinary times.' RESULTS Parry underlined the extent of alcohol-related harm during 'normal times' with scientific evidence and contested industry actors' efforts to re-frame relevant evidence in a coherent and well-constructed argument. Parry used the temporary sales restrictions to highlight the magnitude of the health and social harms resulting from alcohol consumption, particularly trauma, rather than the COVID-19 transmission risks. Parry portrayed the sales ban as a policy learning opportunity (or 'experiment') for South Africa and beyond. CONCLUSIONS Crisis conditions can provide new openings for public health (and industry) actors to make salient particular features of alcohol and alcohol policy evidence.
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Affiliation(s)
- Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England.
| | - Matthew Lesch
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, England
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Stumbrys D, Tamutienė I, Moskalewicz J, Sieroslawski J. Changes in attitudes toward alcohol control policies in Lithuania: findings from two representative surveys in 2015 and 2020. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2023; 49:664-674. [PMID: 37603857 DOI: 10.1080/00952990.2023.2238322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/08/2023] [Accepted: 07/15/2023] [Indexed: 08/23/2023]
Abstract
Background: A set of evidence-based alcohol control policy measures was adopted in the period 2016-2020 in Lithuania. The present study fills a knowledge gap on how changes in alcohol control policy are associated with attitudes toward different alcohol policy measures.Objective: This study aims to explore whether support for key alcohol control policy measures in Lithuania declined following implementation of alcohol control measures.Methods: Data came from the Standard European Alcohol Survey. Two representative surveys with the same questionnaire, were conducted in Lithuania in 2015 (N = 1513, 51.7% female, response rate was 38.9%) and 2020 (N = 1015, 50.6% female, response rate was 38.0%). Multi-stage stratified probability sampling was applied. Surveys were carried out using computer-assisted face-to-face interviews, descriptive statistics and multiple logistic regression analyses was applied. We used a binomial logistic regression analysis and the Pearson chi-square test.Results: There was a significant decline in a proportion of respondents who agreed that the number of alcohol selling places should be kept low (OR: 0.84, p = .032), alcohol prices should be kept high (OR: 0.83, p = .027), and the police should be allowed to randomly check whether the driver is sober (OR: 0.65, p < .001). The proportion of respondents who agree that individuals are responsible enough with their drinking significantly declined (OR: 0.76, p = .003).Conclusion: Support for restrictions on alcohol-selling points, increase in alcohol price, and random alcohol testing of drivers declined following the adoption of new alcohol control policy measures. Our findings might be beneficial for policy-makers planning alcohol control policies and information campaigns.
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Affiliation(s)
- Daumantas Stumbrys
- Department of Public Administration, Faculty of Political Science and Diplomacy, Vytautas Magnus University, Kaunas, Lithuania
| | - Ilona Tamutienė
- Department of Public Administration, Faculty of Political Science and Diplomacy, Vytautas Magnus University, Kaunas, Lithuania
| | - Jacek Moskalewicz
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Janusz Sieroslawski
- Department of Studies on Alcoholism and Drug Dependence, Institute of Psychiatry and Neurology, Warsaw, Poland
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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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Haley SJ, Peddireddy S, El-Harakeh A, Akasreku B, Riibe D. Qualitative study of states' capacity to support alcohol prevention policies during the COVID-19 pandemic in the USA. Drug Alcohol Rev 2023; 42:1358-1374. [PMID: 37452762 PMCID: PMC11002955 DOI: 10.1111/dar.13714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION The onset of the COVID-19 pandemic accelerated rates of alcohol purchasing and related harms in the USA. The increases followed governors' emergency orders that increased alcohol availability, including the allowance of alcohol home delivery, alcohol to-go from restaurants and bars, and curbside pickup from retailers. METHODS Semi-structured interviews were conducted with 53 participants involved in state-level alcohol prevention policy across 48 states. Interviewees' perspectives on changes to alcohol prevention policies during the COVID-19 pandemic, including capacity to respond to alcohol-focused executive and legislative changes to alcohol availability, were explored. Initial codes were developed collectively and refined through successive readings of transcripts using a phenomenological, action-oriented research approach. Themes were identified semantically after all transcripts were coded and reviewed. RESULTS Four themes were developed including: (i) alcohol prevention policies and capacity during COVID-19; (ii) industry-related challenges during COVID-19; (iii) limited pre-COVID-19 alcohol prevention capacity; and (iv) needs to strengthen alcohol prevention capacity. DISCUSSION AND CONCLUSIONS The pandemic exacerbated states' capacity limitations for alcohol prevention efforts and created additional impediments to public health messaging about alcohol health risks related to greater alcohol availability. Participants offered a myriad of strategies to improve alcohol prevention and to reduce alcohol-related harms. Recommendations included dedicated federal and state prioritisation, more funding for community organisations, greater coordination, consistent high-quality trainings, stronger surveillance and widespread prevention messaging. States' alcohol prevention efforts require dedicated leadership, additional funding and support to strengthen population-based strategies to reduce sustained alcohol-related harms associated with increases in alcohol availability.
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Affiliation(s)
- Sean J. Haley
- Department of Health Policy and Management, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Snigdha Peddireddy
- Department of Behavioral, Social, and Health Education Sciences, Emory University Rollins School of Public Health, Atlanta, USA
| | - Amena El-Harakeh
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
| | - Bridget Akasreku
- Departments of Health Policy and Management and Community Health and Social Sciences, City University of New York’s Graduate School of Public Health and Health Policy, New York, USA
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Miller M, Livingston M, Maganja D, Wright CCJ. Unpacking assertions made by the alcohol industry and how they make them: An analysis of submissions into Australia's National Alcohol Strategy. Drug Alcohol Rev 2023; 42:1312-1321. [PMID: 37210731 DOI: 10.1111/dar.13682] [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: 07/01/2022] [Revised: 04/11/2023] [Accepted: 04/11/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Alcohol is a leading cause of morbidity and mortality globally. One significant barrier to the implementation of evidence-based alcohol policy is alcohol industry opposition. Making submissions to national policy processes is one way in which the industry exert influence. The aim of this study was to analyse alcohol industry submissions into Australia's National Alcohol Strategy to determine key assertions made by the alcohol industry and the ways in which they use evidence and refute the effectiveness of public health policies to make their claims. METHODS Submissions made by alcohol industry actors (n = 12) were analysed using content analysis to determine key industry assertions. A pre-existing framework on alcohol industry use of evidence was then applied to analyse the evidentiary practices used to make these assertions. RESULTS Five common industry assertions were identified: 'Drinking alcohol in moderation has health benefits'; 'Alcohol isn't the cause of violence'; 'Targeted initiatives, not population level alcohol policies, are needed'; 'Strong alcohol advertising regulations are not necessary'; and 'Minimum unit price and pricing and taxation policies more broadly are not needed'. The industry systematically manipulated, misused and ignored evidence throughout their submissions. DISCUSSION AND CONCLUSIONS The alcohol industry is misusing evidence in their submissions to government consultations to make their assertions about alcohol policy. It is therefore essential that industry submissions are scrutinised and not accepted on face value. Additionally, it is suggested that the alcohol industry requires a distinct model of governance similarly to that which regulates the tobacco industry to prevent their attempts to undermine evidence-based public health policy.
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Affiliation(s)
- Mia Miller
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Michael Livingston
- National Drug Research Institute, Melbourne, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Department of Clinical Neurosciences, Karolinska Instituet, Stockholm, Sweden
| | - Damian Maganja
- The George Institute for Global Health, Sydney, Australia
| | - Cassandra C J Wright
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- Burnet Institute, Melbourne, Australia
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Bartlett A, McCambridge J. The international center for alcohol policies (ICAP) book series: a key resource globally for alcohol industry political strategies. Subst Abuse Treat Prev Policy 2023; 18:49. [PMID: 37596661 PMCID: PMC10436666 DOI: 10.1186/s13011-023-00556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/14/2023] [Indexed: 08/20/2023] Open
Abstract
This study examines the functions and purposes of the International Center for Alcohol Policies (ICAP) book series, published by Routledge between 1998 and 2010. The books were authored by invited academics, ICAP staffers, and alcohol industry representatives.The key data source for this paper was the framing material - forewords, introductions, conclusions - of the books. A thematic analysis positioned the contents with regard to ongoing alcohol research and public health policy issues.This was a project to 'shift the paradigm'. ICAP frames alcohol policy choices in ways which direct policy attention to sub-groups rather than the population level. Population-level approaches are caricatured as 'ideological'. The concept of 'balance' is prominent and is employed in multiple ways. Business interests are elided and industry involvement in policy making is promoted on scientific grounds. The intellectual programme is lent credibility by leading scientists and the imprimatur of an academic publisher.While this attempt to change the paradigm in alcohol science has failed, ineffective alcohol policies remain common, uninformed by scientific evidence on how harms at the societal level may be reduced. The ICAP book series continues to serve its function as a resource to support the status quo in respect of alcohol policy.
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Affiliation(s)
- Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
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Bartlett A, Garry J, McCambridge J. From the tobacco industry's uses of science for public relations purposes to the alcohol industry: Tobacco industry documents study. Drug Alcohol Rev 2023; 42:1269-1277. [PMID: 36933895 PMCID: PMC10947438 DOI: 10.1111/dar.13649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION Associates for Research in Substances of Enjoyment (ARISE) was formed by tobacco companies in the late 1980s designed to counter public health policy development. This study examines the alcohol content of ARISE and the contribution of ARISE to alcohol industry activities in a key period in the globalisation of the alcohol industry, generating insights into the inter-relationships between the tobacco and alcohol industries in their involvements in policy-oriented science. METHODS We systematically searched the UCSF Truth Tobacco Documents Library for information about ARISE, alcohol and the alcohol industry. This material was supplemented with an analysis of the contributions by ARISE associates to one volume in the International Center for Alcohol Policies (ICAP) book series on alcohol and pleasure. RESULTS ARISE placed nicotine alongside caffeine, chocolate and other foods, and alcohol as treats which brought pleasure and other benefits. Alcohol was thus intrinsic to the ARISE project for the tobacco industry. This study shows that at a formative moment in the mid-1990s the major alcohol companies took advantage of the intellectual inheritance and personnel provided by the tobacco industry when establishing ICAP. Key to this was an ICAP conference that resulted in Alcohol and pleasure: A health perspective (1999). DISCUSSION AND CONCLUSIONS Not only did ARISE use alcohol to play a supporting role in a sophisticated tobacco industry strategy, the alcohol industry engaged with ARISE as part of its own strategy. This shows the importance of careful attention to corporate activities on the fringes of peer-reviewed science.
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Affiliation(s)
- Andrew Bartlett
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
| | - Jack Garry
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
| | - Jim McCambridge
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
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Ulucanlar S, Lauber K, Fabbri A, Hawkins B, Mialon M, Hancock L, Tangcharoensathien V, Gilmore AB. Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy. Int J Health Policy Manag 2023; 12:7292. [PMID: 37579378 PMCID: PMC10462073 DOI: 10.34172/ijhpm.2023.7292] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/19/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) kill 41 million people a year. The products and services of unhealthy commodity industries (UCIs) such as tobacco, alcohol, ultra-processed foods and beverages and gambling are responsible for much of this health burden. While effective public health policies are available to address this, UCIs have consistently sought to stop governments and global organisations adopting such policies through what is known as corporate political activity (CPA). We aimed to contribute to the study of CPA and development of effective counter-measures by formulating a model and evidence-informed taxonomies of UCI political activity. METHODS We used five complementary methods: critical interpretive synthesis of the conceptual CPA literature; brief interviews; expert co-author knowledge; stakeholder workshops; testing against the literature. RESULTS We found 11 original conceptualisations of CPA; four had been used by other researchers and reported in 24 additional review papers. Combining an interpretive synthesis of all these papers and feedback from users, we developed two taxonomies - one on framing strategies and one on action strategies. The former identified three frames (policy actors, problem, and solutions) and the latter six strategies (access and influence policy-making, use the law, manufacture support for industry, shape evidence to manufacture doubt, displace, and usurp public health, manage reputations to industry's advantage). We also offer an analysis of the strengths and weaknesses of UCI strategies and a model that situates industry CPA in the wider social, political, and economic context. CONCLUSION Our work confirms the similarity of CPA across UCIs and demonstrates its extensive and multi-faceted nature, the disproportionate power of corporations in policy spaces and the unacceptable conflicts of interest that characterise their engagement with policy-making. We suggest that industry CPA is recognised as a corruption of democracy, not an element of participatory democracy. Our taxonomies and model provide a starting point for developing effective solutions.
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Affiliation(s)
- Selda Ulucanlar
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
| | - Kathrin Lauber
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Alice Fabbri
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
| | - Ben Hawkins
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
| | - Linda Hancock
- Alfred Deakin Institute, Deakin University, Melbourne, VIC, Australia
| | | | - Anna B. Gilmore
- Tobacco Control Research Group (TCRG), Department for Health, University of Bath, Bath, UK
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de Lacy-Vawdon C, Vandenberg B, Livingstone C. Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries. Int J Health Policy Manag 2023; 12:7723. [PMID: 37579379 PMCID: PMC10461899 DOI: 10.34172/ijhpm.2023.7723] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/19/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and well-being, including broader discourses materialised via these systems and institutions. METHODS Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/ or gambling industries. Interviews sought participants' perceptions of Australian food, alcohol, and gambling industries' similarities and differences, power and influence, relationships, and intervention opportunities and needs. RESULTS Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (eg, persuasive, preference-shaping) and hard (eg, coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants' backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. CONCLUSION Food, alcohol, and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and well-being. Per Wood and colleagues' framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural, and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health (PH) advocates and researchers alike.
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Affiliation(s)
- Cassandra de Lacy-Vawdon
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Brian Vandenberg
- School of Social Sciences, Monash University, Melbourne, VIC, Australia
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Lesch M, McCambridge J. Evolution of the major alcohol companies key global policy vehicle through the prism of tax records 2011-19. Global Health 2023; 19:34. [PMID: 37226209 DOI: 10.1186/s12992-023-00933-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/01/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Important insights have been generated into the nature of the activities of the International Center for Alcohol Policies (ICAP). Its successor, the International Alliance for Responsible Drinking (IARD) is less well understood. This study aims to rectify evidence limitations on the political activities of the alcohol industry at the global level. METHODS Internal Revenue Service filings were examined for ICAP and IARD each year between 2011 and 2019. Data were triangulated with other sources to establish what could be gleaned on the internal workings of these organisations. RESULTS The stated purposes of ICAP and IARD are near identical. The main declared activities were similar for both organisations and comprised public affairs/policy, corporate social responsibility, science/research and communications. Both organisations work extensively with external actors and it has become possible more recently to identify the main contractors supplying services to IARD. DISCUSSION This study sheds light on the political activities of the alcohol industry at the global level. It suggests that the evolution of ICAP into IARD has not been accompanied by shifts in the organisation and activities of the collaborative efforts of the major alcohol companies. CONCLUSION Alcohol and global health research and policy agendas should give careful attention to the sophisticated nature of industry political activities.
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Affiliation(s)
- Matthew Lesch
- Department of Health Sciences, Faculty of Sciences Area 4, A/TB/212, University of York, Seebohm Rowntree Building, Heslington, YO10 5DD, York, UK.
| | - Jim McCambridge
- Department of Health Sciences, Faculty of Sciences Area 4, A/TB/212, University of York, Seebohm Rowntree Building, Heslington, YO10 5DD, York, UK
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Sayes E, Adams PJ, Kypri K. Unpacking the differing understandings of "alcohol industry" in public health research. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 117:104056. [PMID: 37187085 DOI: 10.1016/j.drugpo.2023.104056] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/25/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Use of the term 'alcohol industry' plays an important role in discussions of alcohol and public health. In this paper, we examine how the term is currently used and explore the merits of alternative conceptualisations. METHODS We start by examining current ways of referring to 'alcohol industry' in public health and then explore the potential for organisational theory, political science, and sociology to provide alcohol research with more inclusive and nuanced conceptualizations. RESULTS We identify, and critique, three conceptualisations based on purely economic understandings of industry: literal, market, and supply-chain understandings. We then examine three alternative conceptualizations based on systemic understandings of industry: organizational, social-network, and common-interest understandings. In examining these alternatives, we also identify the extent to which they open up new ways of approaching the levels at which industry influence is understood to operate in alcohol and public health research and policy. CONCLUSIONS Each of the six understandings of 'industry' can play a role in research but their utility depends on the question being asked and the breadth and depth of the analysis being undertaken. However, for those intending to engage with a broader disciplinary base, approaches grounded in the systemic understandings of 'industry' are better positioned to study the complex nexus of relationships that contribute to alcohol industry influence.
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Affiliation(s)
- Edwin Sayes
- School of Population Health, and Centre for Addiction Research, University of Auckland, Private 92019, Auckland 1142, Aotearoa New Zealand
| | - Peter J Adams
- School of Population Health, and Centre for Addiction Research, University of Auckland, Private 92019, Auckland 1142, Aotearoa New Zealand.
| | - Kypros Kypri
- Department of Preventive and Social Medicine, University of Otago, Dunedin 9016, Aotearoa New Zealand
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Roberts SCM. Commentary on Luukkonen et al.: Policy possibilities for reducing public health harms related to pregnant people's alcohol consumption. Addiction 2023; 118:845-846. [PMID: 36843218 DOI: 10.1111/add.16164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/28/2023]
Affiliation(s)
- Sarah C M Roberts
- Advancing New Standards in Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, Oakland, CA, USA
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van Schalkwyk MCI, Collin J, Eddleston M, Petticrew M, Pearson M, Schölin L, Maani N, Konradsen F, Gunnell D, Knipe D. Conceptualising the commercial determinants of suicide: broadening the lens on suicide and self-harm prevention. Lancet Psychiatry 2023; 10:363-370. [PMID: 37019125 DOI: 10.1016/s2215-0366(23)00043-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/18/2023] [Accepted: 02/03/2023] [Indexed: 04/07/2023]
Abstract
Suicide is preventable, yet, in many settings, robust suicide prevention strategies have not been implemented. Although a commercial determinants of health lens is increasingly being applied to industries important to the field of suicide prevention, the interplay between the vested interests of commercial actors and suicide has received little attention. There is a need to shift attention to the causes of the causes, directing more focus to the ways that commercial determinants influence suicide and shape suicide prevention strategies. Such a shift in perspective, with an evidence base and precedents to draw upon, has transformative potential for research and policy agendas dedicated to understanding and addressing upstream modifiable determinants of suicide and self-harm. We propose a framework intended to help guide efforts to conceptualise, research, and address the commercial determinants of suicide and their inequitable distribution. We hope these ideas and lines of inquiry help to catalyse connections between disciplines and open further debate and discussion as to how to take such an agenda forward.
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Affiliation(s)
- May C I van Schalkwyk
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
| | - Jeff Collin
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK; Prevention Research Partnership SPECTRUM Consortium, UK
| | - Michael Eddleston
- Centre for Pesticide Suicide Prevention and Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Prevention Research Partnership SPECTRUM Consortium, UK
| | - Melissa Pearson
- Centre for Pesticide Suicide Prevention and Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Lisa Schölin
- Centre for Pesticide Suicide Prevention and Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
| | - Nason Maani
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK; Prevention Research Partnership SPECTRUM Consortium, UK
| | - Flemming Konradsen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - David Gunnell
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Duleeka Knipe
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK; South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Taylor N, Miller P, Coomber K, Livingston M, Jiang H, Buykx P, Scott D, Baldwin R, Chikritzhs T. Estimating the impact of the minimum alcohol price on consumers' alcohol expenditure in the Northern Territory, Australia. Aust N Z J Public Health 2023:100053. [PMID: 37202337 DOI: 10.1016/j.anzjph.2023.100053] [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: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE From October 2018, the Northern Territory (NT) government introduced a minimum unit price (MUP) for alcohol of $1.30 per standard drink. We assessed industry claims that the MUP penalised all drinkers by examining the alcohol expenditure of drinkers not targeted by the policy. METHODS Participants recruited by a market research company using phone sampling (n=766, 15% consent fraction) completed a survey in 2019, post-MUP. Participants reported their drinking patterns and their preferred liquor brand. Estimated annual alcohol expenditure for each participant was calculated by collating the cheapest advertised price per standard drink of their preferred brand pre-and-post-MUP. Participants were grouped as consuming within the Australian drinking guidelines ("moderate") or over them ("heavy"). RESULTS Based on post-MUP drinking patterns, moderate consumers had an average annual alcohol expenditure of AU$327.66 (CIs=325.61, 329.71) pre-MUP, which increased by AU$3.07 (0.94%) post-MUP. Heavy consumers had an estimated average annual alcohol expenditure of AU$2898.82 (CIs=2877.06, 2920.58) pre-MUP, which increased by AU$37.12 (1.28%). CONCLUSIONS The MUP policy was associated with an increase of AU$3.07 in alcohol annual expenditure for moderate consumers. IMPLICATIONS FOR PUBLIC HEALTH This article provides evidence that counters the alcohol industry's messaging, enabling an evidence-based discussion in an area dominated by vested interest.
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Affiliation(s)
- Nicholas Taylor
- National Drug Research Institute, Curtin University, Melbourne, Australia; School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia.
| | - Peter Miller
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Kerri Coomber
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Michael Livingston
- National Drug Research Institute, Curtin University, Melbourne, Australia
| | - Heng Jiang
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Penny Buykx
- The University of Newcastle, Newcastle, Australia
| | - Debbie Scott
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia
| | - Ryan Baldwin
- School of Psychology, Deakin University, Waterfront Campus, Geelong, Australia
| | - Tanya Chikritzhs
- National Drug Research Institute, Curtin University, Perth, Australia
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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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40
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JERNIGAN DAVIDH. Alcohol and Public Health: Failure and Opportunity. Milbank Q 2023; 101:552-578. [PMID: 37096612 PMCID: PMC10126957 DOI: 10.1111/1468-0009.12631] [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: 05/06/2022] [Revised: 10/01/2022] [Accepted: 01/06/2023] [Indexed: 04/26/2023] Open
Abstract
Policy Points Public health science regarding alcohol consumption and problems, alcohol's role in equity and social justice, and identification of effective policy interventions has grown steadily stronger in the past 30 years. Progress on effective alcohol policies has stalled or gone backward in the United States and much of the world. Because alcohol influences at least 14 of the 17 sustainable development goals, as well as more than 200 disease and injury conditions, reducing alcohol problems should offer a platform for collaboration across public health silos but will require that public health itself respect and follow its own science.
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Lesch M, McCambridge J. Distilling the distillers: examining the political activities of the Distilled Spirits Council of the United States. Global Health 2023; 19:22. [PMID: 36991443 PMCID: PMC10054220 DOI: 10.1186/s12992-023-00923-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Understanding of the alcohol industry's means of influencing public policy is increasingly well established. Less is known, however, about the specific organisations that lead the political strategies of the alcohol industry. To fill this gap, this paper explores the Distilled Spirits Council of the United States (DISCUS), a key trade association in the United States (US), which also operates internationally. METHODS This study explores how DISCUS is organised and the main political activities it pursues to advance its policy interests. The study triangulates data from several sources, including DISCUS documents, as well as federal lobbying and election expenditure data. RESULTS This study demonstrates that DISCUS is a key political actor in the US and global alcohol policymaking context. There are identifiable strategies used by DISCUS to shape alcohol policy debates, including framing and lobbying. We also find key synergies between these strategies and identify their operation at varying levels of policy decision-making. CONCLUSIONS Generating more secure inferences about the nature of the alcohol industry's efforts to advance its interests, and with what success and at what cost, requires researchers to investigate other trade associations in different contexts, and use other data sources.
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Affiliation(s)
- Matthew Lesch
- Department of Health Sciences, University of York, York, UK.
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42
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Friel S, Collin J, Daube M, Depoux A, Freudenberg N, Gilmore AB, Johns P, Laar A, Marten R, McKee M, Mialon M. Commercial determinants of health: future directions. Lancet 2023; 401:1229-1240. [PMID: 36966784 DOI: 10.1016/s0140-6736(23)00011-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 09/06/2022] [Accepted: 12/23/2022] [Indexed: 04/07/2023]
Abstract
This paper is about the future role of the commercial sector in global health and health equity. The discussion is not about the overthrow of capitalism nor a full-throated embrace of corporate partnerships. No single solution can eradicate the harms from the commercial determinants of health-the business models, practices, and products of market actors that damage health equity and human and planetary health and wellbeing. But evidence shows that progressive economic models, international frameworks, government regulation, compliance mechanisms for commercial entities, regenerative business types and models that incorporate health, social, and environmental goals, and strategic civil society mobilisation together offer possibilities of systemic, transformative change, reduce those harms arising from commercial forces, and foster human and planetary wellbeing. In our view, the most basic public health question is not whether the world has the resources or will to take such actions, but whether humanity can survive if society fails to make this effort.
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Affiliation(s)
- Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance, The Australian National University, Acton, ACT, Australia.
| | - Jeff Collin
- School of Political and Social Science, University of Edinburgh, Edinburgh, UK
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Anneliese Depoux
- Virchow-Villermé Public Health Centre, University of Paris, Paris, France
| | - Nicholas Freudenberg
- School of Public Health and Health Policy, City University of New York, New York, NY, USA
| | - Anna B Gilmore
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Paula Johns
- ACT Health Promotion, Rio de Janeiro, Brazil
| | - Amos Laar
- School of Public Health, University of Ghana, Legon, Ghana
| | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland
| | - Martin McKee
- London School of Hygiene & Tropical Medicine, London, UK
| | - Melissa Mialon
- Trinity Business School, Trinity College Dublin, Dublin, Ireland
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Kowalski M, Wilkinson C, Livingston M, Ritter A. Piloting a classification framework for the types of evidence used in alcohol policymaking. Drug Alcohol Rev 2023; 42:652-663. [PMID: 36698279 PMCID: PMC11240880 DOI: 10.1111/dar.13599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Most studies of alcohol policy have focussed on the role of industry. However, little is known about the evidence base used in alcohol policymaking or policymakers' actions in the field. Here, we mapped the different evidence types used in a case study to construct a classification framework of the evidence types used in alcohol policymaking. METHODS Using a case study from the state-level in Australia, we used content analysis to delineate the evidence types cited across six phases of a policymaking process. We then grouped these types into a higher-level classification framework. We used descriptive statistics to study how the different evidence types were used in the policymaking process. RESULTS Thirty-one evidence types were identified in the case study, across four classes of knowledge: person knowledge, shared knowledge, studied knowledge and practice knowledge. The participating public preferenced studied knowledge. Policymakers preferenced practice knowledge over all other types of knowledge. DISCUSSION AND CONCLUSION The classification framework expands on models of evidence and knowledge used across public health, by mapping new evidence types and proposing an inductive method of classification. The policymakers' preferences found here are in line with theories regarding the alcohol industry's influence on policymaking. The classification framework piloted here can provide a useful tool to examine the evidence base used in decision-making. Further study of evidence types used in policymaking processes can help inform research translation and advocacy efforts to produce healthier alcohol policies.
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Affiliation(s)
- Michala Kowalski
- Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
| | - Claire Wilkinson
- Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | - Michael Livingston
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
- National Drug Research Institute and enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Alison Ritter
- Drug Policy Modelling Program, Social Policy Research Centre, UNSW Sydney, Sydney, Australia
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44
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McCambridge J, Mitchell G, Lesch M, Filippou A, Golder S, Garry J, Bartlett A, Madden M. The emperor has no clothes: a synthesis of findings from the Transformative Research on the Alcohol industry, Policy and Science research programme. Addiction 2023; 118:558-566. [PMID: 36196477 PMCID: PMC10092733 DOI: 10.1111/add.16058] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 09/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS The Transformative Research on the Alcohol industry, Policy and Science (TRAPS) programme investigates the alcohol industry, with an innovative focus on public health sciences. TRAPS adds to an under-developed literature on the study of alcohol industry influence on alcohol science and policymaking. This paper provides a synthesis of TRAPS findings to inform future research. METHODS We conducted an interpretive review of TRAPS research findings across its component studies, identifying and integrating the key contributions made by individual studies to the literature on alcohol policymaking and science, and identifying areas where TRAPS progress was limited. This produced themes for consideration in future research agenda setting. RESULTS TRAPS explored the interventions of the alcohol industry in science and policymaking using various methods, including systematic reviews and qualitative interviews. These studies identified the industry's activities in several key areas, such as the debate over minimum unit pricing (MUP), cardiovascular health and alcohol research and a long-running public relations programme developed in close connection with the tobacco industry. Collectively, the research shows that alcohol policymaking has involved a contest between the research community and alcohol industry actors about whether and how science should be used to inform policy. CONCLUSIONS The TRAPS programme demonstrates the need for a transdisciplinary approach to understand the nature of corporate political activity; the crucial role industry involvement in science plays in the development of corporate political power; and how public health actors have successfully overcome industry opposition to evidence-based policies. Advances in alcohol policy should be underpinned by strong, reflexive public health sciences, alert to the role of industry in the alcohol harms under study and thorough in their investigation of the alcohol industry as an object of study in itself.
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Affiliation(s)
- Jim McCambridge
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | - Gemma Mitchell
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | - Matthew Lesch
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | | | - Su Golder
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | - Jack Garry
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | - Andrew Bartlett
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
| | - Mary Madden
- Department of Health SciencesUniversity of YorkHeslingtonYorkUK
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Santos MGR, Valente JY, Wagner GA, Sanchez ZM. Factors associated with attending "open bar" parties amongst early adolescents. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 112:103947. [PMID: 36640592 DOI: 10.1016/j.drugpo.2022.103947] [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: 08/09/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND "Open bar" parties are events where a flat fee is paid for unlimited alcohol consumption. At these events, alcohol intoxication is frequent amongst attendees. This study explored the prevalence of "open bar" attendance amongst Brazilian youth and the factors associated with this practice. METHODS Data was collected at the baseline of randomized controlled trial amongst 5,213 8th grade students in three Brazilian cities. Weighted logistic regression was performed. RESULTS Mean age was of 13.23 years (SE 0.01) and 17.1% of the students have reported attending "open bar" events in the past year. Attendees were wealthier, had higher odds to engage in binge drinking, to use marijuana, to be exposed to alcohol advertising, and to report more alcohol problems and clinical psychiatric symptoms when compared with non-attendees. CONCLUSIONS The ban on selling alcohol to minors has not been properly enforced. Legislation to restrict alcohol promotions and advertising in Brazil needs to be implemented and effectively monitored.
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Affiliation(s)
- Mariana G R Santos
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Juliana Y Valente
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriela A Wagner
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Zila M Sanchez
- Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, Brazil.
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Lacy-Nichols J, Cullerton K. A proposal for systematic monitoring of the commercial determinants of health: a pilot study assessing the feasibility of monitoring lobbying and political donations in Australia. Global Health 2023; 19:2. [PMID: 36611039 PMCID: PMC9824991 DOI: 10.1186/s12992-022-00900-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 12/08/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The commercial determinants of health include a range of practices to promote business interests, often at the expense of public health. Corporate political practices, such as lobbying and campaign donations, are used to influence policy makers and foster a political and regulatory environment conducive to business interests. Despite recognition of their public health importance, thus far there are relatively few efforts to systematically monitor commercial political practices. METHODS A pilot study was conducted to explore the feasibility of systematically monitoring two political practices - lobbying and political contributions - for 'harmful industries' (alcohol, gambling, ultra-processed food and tobacco industries) in Australia. Potential data sources were reviewed to compare data availability and detail. Two publicly available datasets were selected for the pilot: ministerial diaries for New South Wales and annual donor filings from the Australian Electoral Commission. Google Data Studio was used to analyse and visualise findings. RESULTS: The pilot study resulted in the creation of several interactive charts and dashboards that supported analysis and interrogation of the data. These charts helped to easily convey the volume of lobbying and political donations, as well as changes over time. For example, we found that between July 2014 and December 2020, NSW ministers had 20,607 meetings, of which 634 meetings were with harmful industries. And between 1998 and 2020, a total of $576,519,472 disclosed donations were made to political parties and other entities, of which $35,823,937 were from harmful industries. CONCLUSIONS Opportunities to develop a program to monitor commercial political practices face several challenges including access barriers arising from poor availability and detail of data, technical barriers arising from the format of data disclosures and coding challenges arising from the diverse nature of the commercial sector. Despite these challenges, our pilot study demonstrates the potential to implement a monitoring program and to expand its scope to other commercial determinants of health.
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Affiliation(s)
- Jennifer Lacy-Nichols
- Melbourne School of Population and Global Health, Centre for Health Policy, The University of Melbourne, Level 5, 207 Bouverie St, Melbourne, VIC, 3010, Australia.
| | - Katherine Cullerton
- grid.1003.20000 0000 9320 7537School of Public Health, The University of Queensland, Brisbane, Australia
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47
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Current Developments in European Alcohol Policy: An Analysis of Possible Impacts on the German Wine Industry. BEVERAGES 2022. [DOI: 10.3390/beverages8040075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In February 2022, the European Parliament agreed on a far-reaching package of measures to regulate alcohol consumption in its vote on “Strengthening Europe in the fight against cancer”. This article therefore elaborates on the most important positions and directions of current European alcohol policy and discusses possible effects on the German wine industry based on existing literature. It can be shown that the attitudes towards alcohol consumption sometimes differ considerably within the European Union, but that there is increasing harmonization of consumption-regulating measures in the course of European integration. However, alcohol policies in the EU are limited by an unclear scientific assessment of “moderate” consumption. This is supplemented by moderate social awareness and the scientific discourse on the effectiveness of alcohol policy measures, as well as a lack of government initiative and legal barriers. Ultimately, the German wine industry finds itself confronted with new scientific findings, associated political demands and creeping changes in social attitudes towards alcoholic beverages.
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Mair C, Sumetsky N, Dougherty M, Thakar M. Do Changes to the Alcohol Retail Environment Reduce Interpersonal Violence? CURR EPIDEMIOL REP 2022; 9:282-289. [PMCID: PMC9672597 DOI: 10.1007/s40471-022-00315-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Christina Mair
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Natalie Sumetsky
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Michelle Dougherty
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, 6136 Public Health, 130 DeSoto Street, Pittsburgh, PA 15261 USA
- Center for Social Dynamics and Community Health, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
| | - Maya Thakar
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA USA
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49
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Jessani NS, Williamson RT, Choonara S, Gautier L, Hoe C, Jafar SK, Khalid AF, Rodríguez Salas I, Turcotte-Tremblay AM, Rodríguez DC. Evidence attack in public health: Diverse actors' experiences with translating controversial or misrepresented evidence in health policy and systems research. Glob Public Health 2022; 17:3043-3059. [PMID: 34996335 DOI: 10.1080/17441692.2021.2020319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Bringing evidence into policy and practice discussions is political; more so when evidence from health studies or programme data are deemed controversial or unexpected, or when results are manipulated and misrepresented. Furthermore, opinion and misinformation in recent years has challenged our notions about how to achieve evidence-informed decision-making (EIDM). Health policy and systems (HPS) researchers and practitioners are battling misrepresentation that only serves to detract from important health issues or, worse, benefit powerful interests. This paper describes cases of politically and socially controversial evidence presented by researchers, practitioners and journalists during the Health Systems Research Symposium 2020. These cases cut across global contexts and range from public debates on vaccination, comprehensive sexual education, and tobacco to more inward debates around performance-based financing and EIDM in refugee policy. The consequences of engaging in controversial research include threats to commercial profit, perceived assaults on moral beliefs, censorship, fear of reprisal, and infodemics. Consequences for public health include research(er) hesitancy, contribution to corruption and leakage, researcher reflexivity, and ethical concerns within the HPS research and EIDM fields. Recommendations for supporting researchers, practitioners and advocates include better training and support structures for responding to controversy, safe spaces for sharing experiences, and modifying incentive structures.
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Affiliation(s)
- Nasreen S Jessani
- Centre for Evidence-Based Health CareStellenbosch University, Cape Town, South Africa.,Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Shakira Choonara
- Shakira Choonara Development Consulting, Johannesburg, South Africa
| | - Lara Gautier
- Département de Gestion, d'Évaluation et de Politique de Santé, École de Santé Publique de l'Université de Montréal, Montreal, Canada
| | - Connie Hoe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | - Sakeena K Jafar
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
| | | | - Irene Rodríguez Salas
- Canadian Institutes of Health Research, Health System Impact Fellowship, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Anne-Marie Turcotte-Tremblay
- Health & Science Section, La Nación Newspaper, San José, Costa Rica.,Department of Global Health and Population, Harvard T.H. Chan School of Public health, Cambridge, MA, USA
| | - Daniela C Rodríguez
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Zaltz DA, Bisi LE, Ruskin G, Hoe C. How independent is the international food information council from the food and beverage industry? A content analysis of internal industry documents. Global Health 2022; 18:91. [PMID: 36309701 PMCID: PMC9618198 DOI: 10.1186/s12992-022-00884-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The International Food Information Council (IFIC) and its partner foundation (IFIC Foundation) widely disseminate nutrition information and participate in relevant policymaking processes. Prior research has established a connection between IFIC and large food and beverage companies, representing a potential conflict of interest. The authors reviewed public records documents to investigate the connection between IFIC and industry, and to describe how IFIC communicates policy-relevant information about nutrition science to the public. METHODS The research team collected communications between IFIC and members of the research and policymaking communities by using state and federal transparency laws. The team analyzed the content of these documents with a commercial determinants of health framework while allowing for new themes to emerge, guided by the broad analytic questions of how and why does IFIC communicate nutrition information to policymakers and the broader public? RESULTS IFIC employs self-designed research and media outreach to disseminate nutrition information. Communications from IFIC and its affiliates related to nutrition information fell within major themes of manufacturing doubt and preference shaping. CONCLUSIONS IFIC uses media outlets to preemptively counter information about the negative health impacts of added sugars and ultra-processed foods, and promotes a personal-responsibility narrative about dietary intake and health. IFIC and its affiliates disseminate a narrow subset of nutrition and health information consistent with corporate interests and in opposition to public health policies associated with improved population health.
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Affiliation(s)
- Daniel A Zaltz
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA.
| | - Lauren E Bisi
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
| | - Gary Ruskin
- U.S. Right To Know, 4096 Piedmont Ave. #963, Oakland, CA, 94611, USA
| | - Connie Hoe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD, 21205, USA
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