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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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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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Doernberg S, Truog R. Spheres of Morality: The Ethical Codes of the Medical Profession. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2023; 23:8-22. [PMID: 36607309 DOI: 10.1080/15265161.2022.2160514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The medical profession contains five "spheres of morality": clinical care, clinical research, scientific knowledge, population health, and the market. These distinct sets of normative commitments require physicians to act in different ways depending on the ends of the activity in question. For example, a physician-scientist emphasizes patients' well-being in clinic, prioritizes the scientific method in lab, and seeks to maximize shareholder returns as a board member of a pharmaceutical firm. Physicians increasingly occupy multiple roles in healthcare and move between them frequently, creating the possibility of conflict between the ethical obligations of their various roles. This paper examines the entire moral landscape of medicine through the lens of role morality. It develops a novel framework that helps physicians recognize how their moral commitments depend on the nature and context of the situation, clarifies ethical conflicts that physicians face, and concludes with ideas for resolving these conflicts.
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Jaeger L, Devi T, Barbazza E, Neufeld M, Franz C, Marten R, Tello JE. Describing and mapping scientific articles on alcohol globally for the period 2010-2021: a bibliometric analysis. BMJ Open 2022; 12:e063365. [PMID: 36127108 PMCID: PMC9490636 DOI: 10.1136/bmjopen-2022-063365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To describe and map scientific literature related to alcohol consumption, its determinants, governance, harm and control policies by publication output, author affiliations, funding, countries of study and research themes. DESIGN Bibliometric analysis using performance analysis and science mapping techniques. DATA SOURCES Scientific articles. ELIGIBILITY CRITERIA Indexed scientific articles published between 1 January 2010 and 31 December 2021 with an English abstract focused on alcohol consumption, its determinants, harms, governance and control policies. DATA EXTRACTION AND SYNTHESIS Searches were run in Web of Science and PubMed. Performance metrics were analysed using descriptive statistics. Keywords were used for science mapping in a deductive approach to cluster articles by five main research themes. The 'policy response' theme was further analysed by six subthemes. RESULTS 4553 articles were included in the analysis. Three out of four articles (3479/4553, 76.4%) were authored solely by authors affiliated with HIC institutions. One in five articles (906/4553, 19.9%) had at least one author affiliated to an institution from an upper-middle-income, middle-income or low-income country context. Governments, followed by research institutions, were the predominant funding source. Half (53.1%) studied a single country and, of these, 77.0% were high-income countries (HICs). Australia, USA and UK were the most studied countries, together accounting for 44.9% (975/2172) of country-specific articles. Thematically, 'consumption' was most studied, and 'alcohol determinants', least. 'Policy response' articles were predominately conducted in HIC contexts. CONCLUSIONS Although the attributable harm of alcohol is known to affect more significantly lower-income and middle-income countries, scientific publications primarily report on HIC contexts by authors from HICs. Research themes reflect known cost-effective policy actions, though skewed towards HICs and a focus on consumption. The implementation of context-specific alcohol control policies requires addressing the determinants of the uneven geographical and thematic distribution of research.
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Affiliation(s)
| | - Tanmay Devi
- Data Analysis, CPC Analytics, Berlin, Germany
| | - Erica Barbazza
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
| | - Maria Neufeld
- WHO European Office for Prevention and Control of Noncommunicable Diseases, Moscow, Russian Federation
| | | | - Robert Marten
- Alliance for Health Policy and Systems Research, World Health Organization, Geneve, Switzerland
| | - Juan E Tello
- Department of Health Promotion, World Health Organization, Geneve, Switzerland
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Winter K, Edman J. Förnuft och känsla Kunskapsbruk hos gårdagens förbudskritiker och dagens alkoholliberaler. NORDIC STUDIES ON ALCOHOL AND DRUGS 2022; 39:240-261. [PMID: 35720517 PMCID: PMC9152234 DOI: 10.1177/14550725211072631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/17/2021] [Accepted: 12/21/2021] [Indexed: 11/26/2022] Open
Abstract
Aim: The aim is to study non-governmental actors’ production and use of alcohol policy knowledge in the early 20th and the 21st century respectively, by analyzing their main arguments, knowledge substantiation and their overarching discursive legitimacy. Design: The first impact focuses on prohibitionist-critical actors’ engagement against the alcohol ban in the years 1916–1922. The second impact focuses on the Swedish think tank Timbro’s engagement in alcohol policy in the years 2012–2020. The analysis of the two empirical cases was based on an open coding strategy with a focus on what type of knowledge claims that were made and how which reasoning was put forward in relation to these. Results: Great similarities are distinguished between the two time periods. Alcohol is an issue of freedom and at the same time a threat of crucial importance for the future society. The arguments are supported by historical, international, media and scientific evidence. The biggest difference lies in the legitimization of the argumentation. In the early 20th century this is rooted in democracy and the will of the people while the arguments of the 21st century are rooted in public health and governmentally sanctioned knowledge. Conclusion: The knowledge processes are explored as matters of political appropriation that takes place through processes of directing and stealing the spotlight. These processes show how the aspiring democracy and the existing public health policy respectively are productive preconditions for what kind of knowledge that can be brought forward. This enables a renegotiation regarding what democracy and public health policy can involve.
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The Ubiquitous Experience of Alcohol Industry Involvement in Science: Findings From a Qualitative Interview Study. J Stud Alcohol Drugs 2022; 83:260-266. [PMID: 35254249 PMCID: PMC7612520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE There is little formal study of alcohol industry involvement in science, despite longstanding concerns about various activities and broader evidence of corporate manipulation of research. Our aim was to explore the experiences of researchers who had no relationship with the alcohol industry, including how industry involvement in alcohol science more broadly had impacted their research work. METHOD This was a qualitative, semi-structured interview study with senior researchers working on alcohol policy-relevant topics who had not received any form of payment from the alcohol industry or performed any unpaid work for alcohol industry companies or organizations they have created (n = 14). A thematic analysis of transcripts using NVivo software was undertaken. RESULTS Despite not having worked with industry, contact with industry was nonetheless unavoidable for these alcohol researchers. This was particularly the case at conferences and policy-related events, which formed a key strand of broader industry surveillance of the research field, including individuals in the research community, and research outputs. Monitoring of the research community at conferences also afforded opportunities for informal relationship building and attempts to exercise influence. Where research findings were contrary to business interests, surveillance served as a platform for interventions of various kinds, including issuing legal threats. CONCLUSIONS The alcohol industry extensively monitors research and researchers. Researchers who study the alcohol industry are targeted in particular, both covertly and overtly. Researchers experience the alcohol industry as ubiquitous in alcohol policy-related research, with conferences and policy-related events key venues for both relationship building and surveillance.
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Heredia NI, Nguyen N, Martinez BA, Obasi EM, McNeill LH. The positive association between physical activity and alcohol use in African American adults. Prev Med Rep 2021; 23:101487. [PMID: 34381666 PMCID: PMC8333140 DOI: 10.1016/j.pmedr.2021.101487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/26/2021] [Accepted: 07/03/2021] [Indexed: 12/27/2022] Open
Abstract
Alcohol intake positively associated with physical activity in African Americans. This association appears to be driven by females, with no association in males. Alcohol intake not associated with Body Mass Index in this African American sample.
African Americans have highest incidence and mortality from obesity-related cancers. Physical activity (PA), minimal alcohol use, and maintaining a low body mass index (BMI) are important cancer prevention behaviors, though there is little research on how these behaviors are associated with one another in African Americans. The purpose of this study is to assess the relationship between PA, alcohol use, and BMI using secondary data from an African American cohort recruited from Houston-area churches. Self-administered questionnaires measured self-reported PA, alcohol use, height, weight, and sociodemographic factors. Univariate and multivariable analyses assessed the relation between PA, alcohol use, BMI, controlling for covariates. Participants (N = 1009) were mostly female (77%), employed (72%), and college graduates (55%). Most (53%) reported both light-to-moderate alcohol use & moderate-to-high levels of PA. There was a statistically significant positive linear association between PA and alcohol use (Pearson’s r = 0.15, p < 0.001). We also found that every one hour increase per week in PA was associated with 3% increased odds of being a heavy drinker (>2 drinks/day men, >1 drink/day women), as compared to an abstainer (Adjusted OR = 1.03, 95%CI 1.01–1.06). There was a statistically significant inverse association between PA and BMI, but no statistically significant association between alcohol use and BMI. In this sample of African Americans, PA and alcohol use were positively associated, mirroring results among Non-Hispanic Whites. However, alcohol use and BMI were not statistically significantly associated. Cancer and obesity prevention for African Americans should stress PA promotion while emphasizing messaging to curtail any associated increases in alcohol use.
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Affiliation(s)
- Natalia I. Heredia
- The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
- Corresponding author.
| | - Nga Nguyen
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Bryan A. Martinez
- The University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, United States
| | - Ezemenari M. Obasi
- University of Houston, HEALTH Research Institute, Houston, TX, United States
| | - Lorna H. McNeill
- The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Vos M, van Soest APM, van Wingerden T, Janse ML, Dijk RM, Brouwer RJ, de Koning I, Feskens EJM, Sierksma A. Exploring the Influence of Alcohol Industry Funding in Observational Studies on Moderate Alcohol Consumption and Health. Adv Nutr 2020; 11:1384-1391. [PMID: 32392308 PMCID: PMC7490152 DOI: 10.1093/advances/nmaa052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 09/10/2019] [Accepted: 04/17/2020] [Indexed: 01/02/2023] Open
Abstract
Funding of research by industry in general can lead to sponsorship bias. The aim of the current study was to conduct an initial exploration of the impact of sponsorship bias in observational alcohol research by focusing on a broad spectrum of health outcomes. The purpose was to determine whether the outcome depended on funding source. We focused on moderate alcohol consumption and used meta-analyses that are the basis of several international alcohol guidelines. These meta-analyses included observational studies that investigated the association of alcohol consumption with 14 different health outcomes, including all-cause mortality, several cardiovascular diseases and cancers, dementia, and type 2 diabetes. Subgroup analyses and metaregressions were conducted to investigate the association between moderate alcohol consumption and the risk of different health outcomes, comparing findings of studies funded by the alcohol industry, ones not funded by the alcohol industry, and studies with an unknown funding source. A total of 386 observational studies were included. Twenty-one studies (5.4%) were funded by the alcohol industry, 309 studies (80.1%) were not funded by the alcohol industry, and for the remaining 56 studies (14.5%) the funding source was unknown. Subgroup analyses and metaregressions did not show an effect of funding source on the association between moderate alcohol intake and different health outcomes. In conclusion, only a small proportion of observational studies in meta-analyses, referred to by several international alcohol guidelines, are funded by the alcohol industry. Based on this selection of observational studies the association between moderate alcohol consumption and different health outcomes does not seem to be related to funding source.
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Affiliation(s)
- Moniek Vos
- The Dutch Beer Institute, Wageningen, the Netherlands
| | | | | | | | - Rick M Dijk
- The Dutch Beer Institute, Wageningen, the Netherlands
| | | | | | - Edith J M Feskens
- Division of Human Nutrition, Wageningen University and Research, Wageningen, the Netherlands
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Mialon M, Vandevijvere S, Carriedo-Lutzenkirchen A, Bero L, Gomes F, Petticrew M, McKee M, Stuckler D, Sacks G. Mechanisms for addressing and managing the influence of corporations on public health policy, research and practice: a scoping review. BMJ Open 2020; 10:e034082. [PMID: 32690498 PMCID: PMC7371213 DOI: 10.1136/bmjopen-2019-034082] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE We identified mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, as well as examples of where these mechanisms have been adopted from across the globe. DESIGN We conducted a scoping review. We conducted searches in five databases on 4 June 2019. Twenty-eight relevant institutions and networks were contacted to identify additional mechanisms and examples. In addition, we identified mechanisms and examples from our collective experience working on the influence of corporations on public health policy, research and practice. SETTING We identified mechanisms at the national, regional and global levels. RESULTS Thirty-one documents were included in our review. Eight were peer-reviewed scientific articles. Nine discussed mechanisms to address and/or manage the influence of different types of industries; while other documents targeted specific industries. In total, we identified 49 mechanisms for addressing and/or managing the influence of corporations on public health policy, research and practice, and 43 of these were adopted at the national, regional or global level. We identified four main types of mechanisms: transparency; management of interactions with industry and of conflicts of interest; identification, monitoring and education about the practices of corporations and associated risks to public health; prohibition of interactions with industry. Mechanisms for governments (n=17) and academia (n=13) were most frequently identified, with fewer for the media and civil society. CONCLUSIONS We identified several mechanisms that could help address and/or manage the negative influence of corporations on public health policy, research and practice. If adopted and evaluated more widely, many of the mechanisms described in this manuscript could contribute to efforts to prevent and control non-communicable diseases. TRIAL REGISTRATION DETAILS The protocol was registered with the Open Science Framework on 27 May 2019 (https://osf.io/xc2vp).
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Affiliation(s)
- Melissa Mialon
- School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
- School of Nutrition and Dietetics, University of Antioquia, Medellin, Colombia
| | | | | | - Lisa Bero
- Charles Perkins Centre and School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Fabio Gomes
- Pan American Health Organization, Washington, District of Columbia, USA
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, London, UK
| | - David Stuckler
- Dondena Research Centre and Department of Policy Analysis and Public Management, Bocconi University, Milano, Lombardia, Italy
| | - Gary Sacks
- Global Obesity Centre, Deakin University, Burwood, Victoria, Australia
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Hawkins B, McCambridge J. 'Tied up in a legal mess': The alcohol industry's use of litigation to oppose minimum alcohol pricing in Scotland. SCOTTISH AFFAIRS 2020; 29:3-23. [PMID: 32733118 PMCID: PMC7357823 DOI: 10.3366/scot.2020.0304] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This article examines the alcohol industry's legal challenges to minimum unit pricing (MUP) in Scotland through the stages heuristic of the policy process. It builds on previous studies of alcohol pricing policy in Scotland and across the UK, and of the use of legal challenges by health harming industries to oppose health policy globally. Having failed to prevent MUP passing into law, industry actors sought to frustrate the implementation of the legislation via challenges in the Scottish, European and UK courts. However, the relevance of legal challenges is not limited to the post-legislative stage of the policy process but was foreshadowed in all earlier stages of the policy process. The potential for a legal challenge to MUP, and the alcohol industry's clearly articulated intention to pursue such action, was used by industry actors to seek to prevent the adoption of MUP in the agenda setting, policy formulation and legislative stages and created significant 'regulatory chill' in other areas of Scottish and UK alcohol policy. Litigation, and the prospect of it, was thus part of a coherent and integrated long-term strategy which adapted to changes in the political climate and to different stages in the policy process. While both the rhetoric and reality of litigation failed to prevent policy implementation, it succeeded in causing a delay of six years, imposing significant costs on the Scottish government and creating policy inertia in Scottish alcohol policy subsequently. Moreover, the inclusion of a 'sunset clause' in the legislation, requiring ongoing evaluation of the policy's effects, presents additional opportunities for the industry to reverse MUP. Thus, industry strategies to undermine MUP and delay further alcohol policy developments require ongoing attention by policy actors and scholars.
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Affiliation(s)
- Benjamin Hawkins
- Dr Benjamin Hawkins is Associate Professor at the London School of Hygiene and Tropical Medicine. His research focuses principally on the role of corporate actors, particularly in the alcohol and tobacco industries, on health policy debates at the national, European and global levels. In addition, he has published work on European integration, multi-level governance, international trade and political economy approaches to health policy
| | - Jim McCambridge
- Professor Jim McCambridge holds the Chair in Addictive Behaviours & Public Health at the University of York. His research interests span alcohol, drugs and other addictions and research methodology. He is also Visiting Professor at Linkoping University in Sweden, and Conjoint Professor at the University of Newcastle in Australia. His alcohol policy work is primarily concerned with better understanding the ways in which corporate actors influence science and policy in order to strengthen public health policy making
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Miranda JJ, Barrientos-Gutiérrez T, Corvalan C, Hyder AA, Lazo-Porras M, Oni T, Wells JCK. Understanding the rise of cardiometabolic diseases in low- and middle-income countries. Nat Med 2019; 25:1667-1679. [PMID: 31700182 DOI: 10.1038/s41591-019-0644-7] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 10/04/2019] [Indexed: 12/22/2022]
Abstract
Increases in the prevalence of noncommunicable diseases (NCDs), particularly cardiometabolic diseases such as cardiovascular disease, stroke and diabetes, and their major risk factors have not been uniform across settings: for example, cardiovascular disease mortality has declined over recent decades in high-income countries but increased in low- and middle-income countries (LMICs). The factors contributing to this rise are varied and are influenced by environmental, social, political and commercial determinants of health, among other factors. This Review focuses on understanding the rise of cardiometabolic diseases in LMICs, with particular emphasis on obesity and its drivers, together with broader environmental and macro determinants of health, as well as LMIC-based responses to counteract cardiometabolic diseases.
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Affiliation(s)
- J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | | | - Camila Corvalan
- Unit of Public Health, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile
| | - Adnan A Hyder
- Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Maria Lazo-Porras
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland
| | - Tolu Oni
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
- Research Initiative for Cities Health and Equity (RICHE), Division of Public Health Medicine, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health, London, UK
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Costanzo S, de Gaetano G, Di Castelnuovo A, Djoussé L, Poli A, van Velden DP. Moderate alcohol consumption and lower total mortality risk: Justified doubts or established facts? Nutr Metab Cardiovasc Dis 2019; 29:1003-1008. [PMID: 31400826 DOI: 10.1016/j.numecd.2019.05.062] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 05/16/2019] [Accepted: 05/17/2019] [Indexed: 12/20/2022]
Abstract
For almost a century, the scientific community is aware of the J-shaped curve between alcohol consumption and all-cause mortality. Moderate drinkers seem to live longer than both abstainers and heavy drinkers. These epidemiological observations regarding moderate alcohol consumption and beneficial health effects have been incessantly scrutinised for confounding and bias. This viewpoint discusses previous and recent criticisms regarding the J-shaped curve between alcohol consumption and total mortality risk. The controversies regarding the J-shaped curve between alcohol consumption and mortality are ongoing, as well as the debate among scientists in this area of research, resulting in conflicting messages in media and in different alcohol guidelines. Although it appears quite difficult to come up with a position statement only based on the currently available scientific data, it is imperative to fairly inform the public, without creating confusion and, worst case, disbelief in science.
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Affiliation(s)
- Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy.
| | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, IS, Italy
| | | | - Luc Djoussé
- Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Massachusetts Veterans Epidemiology and Research Information Center (MAVERIC), Boston Veterans Affairs Healthcare System, Boston, MA, USA
| | - Andrea Poli
- NFI (Nutrition Foundation of Italy), Viale Tunisia 38, 20124, Milan, Italy
| | - David P van Velden
- Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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McCambridge J, Daube M, McKee M. Brussels Declaration: a vehicle for the advancement of tobacco and alcohol industry interests at the science/policy interface? Tob Control 2019; 28:7-12. [PMID: 29941544 PMCID: PMC6317438 DOI: 10.1136/tobaccocontrol-2018-054264] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/21/2018] [Accepted: 03/27/2018] [Indexed: 11/17/2022]
Abstract
The case for policies to be based on evidence appeared to gain a major boost with the publication of the Brussels Declaration, apparently with support from many leading scientists and institutions. Yet, as we show in this analysis, there are major concerns about how it was developed and, in particular, the extensive involvement of tobacco and alcohol industry actors. We describe how its coverage of conflicts of interest and vested interests is consistent with the perspectives of these same actors. The process of developing the Declaration successfully involved science advisors, other senior officials in governments and politicians in its preparation. Despite this, the final Declaration fails to address the need for safeguards to protect the integrity of science or policy from corporate interests, including in relation to the tobacco industry. This undermines Article 5.3 of the Framework Convention on Tobacco Control which seeks to protect public health policies from interference by the tobacco companies. More broadly, the Declaration offers potential to serve as a vehicle for advancing the vested interests of corporate sectors in public policymaking and appears to have been regarded in this way by a range of organisations related to the alcohol industry. This exercise is now being extended to the continent of Africa, which is strategically important to both the tobacco and alcohol industries. It will be important to study carefully to what extent initiatives like this form part of the global political strategies of tobacco and alcohol industry actors.
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Affiliation(s)
| | - Mike Daube
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Martin McKee
- ECOHOST, London School of Hygiene and Tropical Medicine, London, UK
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Bhattacharya A, Angus C, Pryce R, Holmes J, Brennan A, Meier PS. How dependent is the alcohol industry on heavy drinking in England? Addiction 2018; 113:2225-2232. [PMID: 30136436 DOI: 10.1111/add.14386] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/13/2018] [Accepted: 07/04/2018] [Indexed: 12/13/2022]
Abstract
AIMS To understand the extent of the alcohol industry's financial dependence on drinking above government low-risk guidelines in England. DESIGN Scenario modelling using descriptive analyses of pooled data from the 2013 and 2014 waves of two nationally representative surveys: the Health Survey for England (HSE) and the Living Costs and Food Survey (LCF). We estimated the proportion of alcohol sales revenue accounted for by drinkers above guideline levels, and how this varies between different beverage and retailer types. We then estimated the impact on sales revenue if the entire population reduced their drinking to within guideline levels, as well as the average price increases necessary to compensate for such a loss of revenue. SETTING England. PARTICIPANTS A total of 16 872 individual (HSE) and 9975 household (LCF) survey respondents. MEASUREMENTS Transaction-level estimates of volume of alcohol purchased and price paid by beverage type and trade sector. FINDINGS Those drinking above guideline levels are estimated to account for 68% of total alcohol sales revenue in 2013/14: 81% of off-trade revenue and 60% of on-trade revenue. This represents 77% of beer, 70% of cider, 66% of wine and 50% of spirits sales value. The heaviest drinking 4% of the population account for 30% of all consumption and 23% of all industry revenue. If all consumers reduced their drinking to within guideline levels, alcohol sales revenue could decline by 38% (£13 billion). To mitigate this loss, average prices paid would have to rise substantially-for example, by £2.64 for a pint of on-trade beer or £12.25 for a 70 cl bottle of off-trade spirits. CONCLUSIONS In England, the alcohol industry appears to be highly financially dependent upon heavy drinking, and might face significant financial losses were consumers to drink within guideline levels.
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Affiliation(s)
| | - Colin Angus
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Robert Pryce
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - John Holmes
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Alan Brennan
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Petra S Meier
- School of Health and Related Research, University of Sheffield, Sheffield, UK
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15
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McCambridge J, Mialon M. Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community. Drug Alcohol Rev 2018; 37:565-579. [PMID: 29900619 PMCID: PMC6055701 DOI: 10.1111/dar.12826] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 05/11/2018] [Accepted: 05/16/2018] [Indexed: 01/02/2023]
Abstract
ISSUES Alcohol companies have recently invested large sums of money in answering research questions to which they have clear vested interests in the outcomes. There have been extensive concerns about corporate influence on public health sciences, following the experience with the tobacco industry. APPROACH This systematic review aims to investigate the perspectives of researchers on the activities of alcohol industry actors in relation to science, in order to guide future research. All data published in peer-reviewed journals (including commentaries, opinion pieces, editorials and letters as well as research reports) were eligible for inclusion. This analysis focuses on the manifest rather than latent content of the articulated views, and accordingly adopts a thematic analysis using an inductive approach to the generation of themes. KEY FINDINGS There are serious concerns identified in three main areas, principally defined by where the impacts of industry scientific activities occur; on evidence informed policy making (instrumental uses of research by industry actors), on the content of the scientific evidence base itself (industry funding as a source of bias); and on the processes of undertaking research (transgressions of basic scientific norms). There are also opposing views which provide a useful critique. The evidence-base on the validity of all concerns has been slow to develop. IMPLICATIONS The concerns are extensive, longstanding and unresolved and high quality investigations are needed. CONCLUSION This study informs the detailed content of the research needed to address the concerns identified here.
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Affiliation(s)
| | - Melissa Mialon
- Department of Health Sciences, University of York, York, UK
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16
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Cowlishaw S, Thomas SL. Industry interests in gambling research: Lessons learned from other forms of hazardous consumption. Addict Behav 2018; 78:101-106. [PMID: 29136556 DOI: 10.1016/j.addbeh.2017.11.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/28/2017] [Accepted: 11/04/2017] [Indexed: 01/26/2023]
Abstract
Research indicates that the evidential bases for many harm reduction policies targeting hazardous consumptions (including tobacco, alcohol and gambling) have been distorted by commercial industries that derive revenue from such commodities. These distortions are best illustrated by research on tobacco and alcohol, which indicates similar tactics used by industries to determine favourable policy environments through engineering of evidence, among other approaches. Although there is concern that gambling research is similarly vulnerable to commercial interests, the relevant literature lags far behind other fields and the aim of this paper is to increase familiarity with tactics used by industries for influencing research. It summarises the conceptual and empirical bases for expecting conflicts between goals of public health and companies that profit from hazardous consumptions. It also summarises evidence describing practices deployed by tobacco corporations, which include third-party techniques and the selective funding of research to manufacture doubt and deflect attention away from the consequences of smoking. It then reviews both early and emerging evidence indicating similar strategies used by alcohol industry, and uses this literature to view practices of the gambling industry. It argues that parallels regarding selective funding of research and third-party techniques provide grounds for strong concern about commercial influences on gambling research, and implementation of precautionary approaches to management of vested interests.
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Affiliation(s)
- S Cowlishaw
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, UK.
| | - S L Thomas
- Centre for Population Health Research, School of Health and Social Development, Faculty of Health, Deakin University, Australia
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Hawkins B, Holden C, Eckhardt J, Lee K. Reassessing policy paradigms: A comparison of the global tobacco and alcohol industries. Glob Public Health 2018; 13:1-19. [PMID: 26998944 PMCID: PMC6620754 DOI: 10.1080/17441692.2016.1161815] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Tobacco is widely considered to be a uniquely harmful product for human health. Since the mid-1990s, the strategies of transnational tobacco corporations to undermine effective tobacco control policy has been extensively documented through internal industry documents. Consequently, the sale, use and marketing of tobacco products are subject to extensive regulation and formal measures to exclude the industry from policy-making have been adopted in the Framework Convention on Tobacco Control. In contrast to tobacco, alcohol is subject to less stringent forms of regulation, and the alcohol industry continues to play a central role in policy-making in many countries and at the global level. This article examines whether there is a sufficient rationale for such different regulatory approaches, through a comparative analysis of the political economy of the tobacco and alcohol industries including the structure of the industries, and the market and political strategies they pursue. Despite some important differences, the extensive similarities which exist between the tobacco and alcohol industries in terms of market structure and strategy, and political strategy, call into question the rationale for both the relatively weak regulatory approach taken towards alcohol, and the continued participation of alcohol corporations in policy-making processes.
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Affiliation(s)
- Benjamin Hawkins
- a Department of Global Health and Development , London School of Hygiene and Tropical Medicine , London , UK
| | - Chris Holden
- b Department of Social Policy & Social Work , University of York , Heslington , UK
| | - Jappe Eckhardt
- c Department of Politics , University of York , Heslington , UK
| | - Kelley Lee
- d Faculty of Health Sciences , Simon Fraser University , Burnaby , Canada
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18
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A Scientific and Socioeconomic Review of Betel Nut Use in Taiwan with Bioethical Reflections. Asian Bioeth Rev 2017. [DOI: 10.1007/s41649-017-0028-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Jakovljevic M, Varavikova EA, Walter H, Wascher A, Pejcic AV, Lesch OM. Alcohol Beverage Household Expenditure, Taxation and Government Revenues in Broader European WHO Region. Front Pharmacol 2017; 8:303. [PMID: 28603498 PMCID: PMC5445193 DOI: 10.3389/fphar.2017.00303] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 05/10/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Mihajlo Jakovljevic
- Health Economics and Pharmacoeconomics, Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Elena A. Varavikova
- Federal Research Institute for Public Health Organization and Information (CNIIOIZ), Ministry of HealthMoscow, Russia
| | - Henriette Walter
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
| | | | - Ana V. Pejcic
- Faculty of Medical Sciences, University of KragujevacKragujevac, Serbia
| | - Otto M. Lesch
- Department of Psychiatry and Psychotherapy, Medical University of ViennaVienna, Austria
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20
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Thornton M, Hawkins B. Between a rock and a hard place: Economic expansion and social responsibility in UK media discourses on the global alcohol industry. Soc Sci Med 2017; 175:169-176. [PMID: 28092758 PMCID: PMC5303881 DOI: 10.1016/j.socscimed.2017.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 11/06/2016] [Accepted: 01/03/2017] [Indexed: 12/26/2022]
Abstract
CONTEXT Transnational alcohol corporations (TACs) employ a range of strategies to achieve their business objectives, including attempts to frame perceptions of their activities in media debates. TACs aim to achieve a favourable regulatory environment by presenting themselves as socially responsible actors. However, the need to secure financial investment means they must also emphasise their potential for growth. This article investigates tensions between these objectives in coverage of the global alcohol industry in the UK print media. METHODS This article examines coverage of the world's four largest TACs in five British daily newspapers and one industry publication between March 2012 and February 2013. 477 articles were identified for analysis through keyword searches of the LexisNexis database. Thematic coding of articles was conducted using Nvivo software. FINDINGS Two conflicting framings of the alcohol industry emerge from our analysis. The first presents TACs as socially responsible actors; key partners to government in reducing alcohol-related harms. This is targeted at policy-makers and the public in an attempt to shape policy debates. The second framing highlights TACs' potential for economic growth by establishing new markets and identifying new customer bases. This is targeted at an audience of potential investors. CONCLUSIONS A fundamental contradiction lies at the heart of these framings, reflecting the tensions that exist between TACs' political and financial strategies. Alcohol industry involvement in policy-making thus involves a fundamental conflict of interests. Consequently, the UK government should reassess the prominence it currently affords to the industry in the development and delivery of alcohol policy.
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Affiliation(s)
- Mary Thornton
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, UK.
| | - Benjamin Hawkins
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Pl, London WC1H 9SH, UK.
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21
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Nelson JP. Reply to the critics on "binge drinking and alcohol prices". HEALTH ECONOMICS REVIEW 2016; 6:6. [PMID: 26829943 PMCID: PMC4735044 DOI: 10.1186/s13561-016-0084-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 06/17/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Jon P Nelson
- Department of Economics, Pennsylvania State University, University Park, PA, 16802, USA.
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22
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Ferreira-Borges C, Dias S, Babor T, Esser MB, Parry CDH. Alcohol and public health in Africa: can we prevent alcohol-related harm from increasing? Addiction 2015; 110:1373-9. [PMID: 25944026 DOI: 10.1111/add.12916] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/05/2015] [Accepted: 03/05/2015] [Indexed: 01/24/2023]
Abstract
AIMS According to the World Health Organization (WHO), the total amount of alcohol consumed in the African region is expected to increase due to the growth of new alcohol consumers, especially young people and women. With the changing alcohol environment, increases in the alcohol-attributable burden of disease are inevitable. To our knowledge, there has not been a comprehensive analysis of the factors that could be driving those increases. The objective of this study was to examine the evidence from peer reviewed literature regarding the factors that could be instrumental in this process, in order to inform strategic policy-related decisions. METHOD A narrative review was conducted using a thematic analysis approach. We searched papers published between January 2000 and July 2014 in PubMed, the WHO's Global Health Library and African Journals Online. RESULTS Our analysis identified seven factors (demographics, rapid urbanization, economic development, increased availability, corporate targeting, weak policy infrastructure and trade agreements) which are potentially tied to changes in alcohol consumption in Africa. Driven largely by globalization, a potential convergence of these various factors is likely to be associated with continued growth in alcohol consumption and alcohol-related morbidity and mortality. CONCLUSIONS To address the emerging risk factors associated with increased alcohol consumption, African governments need to take a more active role in protecting the public's health. In particular, important strategic shifts are needed to increase implementation of intersectoral strategies, community involvement in the policy dialogue, health services re-orientation and better regulation of the alcohol beverage industry.
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Affiliation(s)
- Carina Ferreira-Borges
- Instituto de Higiene e Medica Tropical & GHTM, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Sonia Dias
- Instituto de Higiene e Medica Tropical & GHTM, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Thomas Babor
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, USA
| | - Marissa B Esser
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Charles D H Parry
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
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23
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Buykx P, Gilligan C, Ward B, Kippen R, Chapman K. Public support for alcohol policies associated with knowledge of cancer risk. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:371-9. [DOI: 10.1016/j.drugpo.2014.08.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 08/08/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022]
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24
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Hawkins B, McCambridge J. Industry actors, think tanks, and alcohol policy in the United kingdom. Am J Public Health 2014; 104:1363-9. [PMID: 24922137 DOI: 10.2105/ajph.2013.301858] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Corporate actors seek to influence alcohol policies through various means, including attempts to shape the evidential content of policy debates. In this case study, we examined how SABMiller engaged the think tank Demos to produce reports on binge drinking, which were heavily promoted among policymakers at crucial stages in the development of the UK government's 2012 alcohol strategy. One key report coincided with other SABMiller-funded publications, advocating measures to enhance parenting as an alternative to minimum unit pricing. In this instance, the perceived independence of an influential think tank was used to promote industry interests in tactics similar to those of transnational tobacco corporations. This approach is in keeping with other alcohol industry efforts to marginalize the peer-reviewed literature.
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Affiliation(s)
- Benjamin Hawkins
- Benjamin Hawkins and Jim McCambridge are with the London School of Hygiene and Tropical Medicine, London, England
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25
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Adams PJ. Addiction industry studies: understanding how proconsumption influences block effective interventions. Am J Public Health 2013; 103:e35-8. [PMID: 23409882 PMCID: PMC3673249 DOI: 10.2105/ajph.2012.301151] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2012] [Indexed: 11/04/2022]
Abstract
The legalized consumption of products with addiction potential, such as tobacco and alcohol, contributes in myriad ways to poor physical and mental health and to deterioration in social well- being. These impacts are well documented, as are a range of public health interventions that are demonstrably effective in reducing harm. I have discussed the capacity for the profits from these substances to be deployed in ways that block or divert resources from interventions known to be effective. Addiction industry studies constitute a new and previously neglected area of research focusing specifically on understanding the salient relationships that determine policy and regulation. This understanding will increase the odds of adopting effective interventions.
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Affiliation(s)
- Peter J Adams
- Centre for Addiction Research, University of Auckland, Auckland, New Zealand.
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26
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Babor TF, Robaina K. Public health, academic medicine, and the alcohol industry's corporate social responsibility activities. Am J Public Health 2012; 103:206-14. [PMID: 23237151 DOI: 10.2105/ajph.2012.300847] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We explored the emerging relationships among the alcohol industry, academic medicine, and the public health community in the context of public health theory dealing with corporate social responsibility. We reviewed sponsorship of scientific research, efforts to influence public perceptions of research, dissemination of scientific information, and industry-funded policy initiatives. To the extent that the scientific evidence supports the reduction of alcohol consumption through regulatory and legal measures, the academic community has come into increasing conflict with the views of the alcohol industry. We concluded that the alcohol industry has intensified its scientific and policy-related activities under the general framework of corporate social responsibility initiatives, most of which can be described as instrumental to the industry's economic interests.
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Affiliation(s)
- Thomas F Babor
- Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT 06030-6325, USA.
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27
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Adams PJ. Ways in which gambling researchers receive funding from gambling industry sources. INTERNATIONAL GAMBLING STUDIES 2011. [DOI: 10.1080/14459795.2011.601316] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Abstract
AIMS To describe the extent to which the content of the European Commission's Communication on alcohol reflects public health-based scientific evidence. DESIGN Document retrieval and content analysis. SETTING European Union. PARTICIPANTS Background documents leading up to the European Commission's Communication on alcohol, the Communication itself and implementation actions following the Communication. MEASUREMENTS Documents were read and analyzed for evidence-based alcohol policy content. FINDINGS Although the Communication acknowledges and supports existing interventions which have high evidence for effectiveness, such as enforcing blood alcohol concentration (BAC) limits for drivers, it extensively promotes other interventions which have been shown to be ineffective; for example, recommending education and persuasion strategies as a measure across all its five priority areas. Measures to influence price are mentioned only once in relation to sales in drinking venues limiting two-for-one drinks offers. Measures to control physical availability are mentioned infrequently. CONCLUSIONS The Communication reflects the science, in that it acknowledges the significance of alcohol as a social and health determinant in Europe. However, it places more emphasis on policy actions with less evidence for effectiveness than on those with strong evidence. It also focuses its efforts more on mapping member state actions and coordinating knowledge exchange than on providing concrete recommendations for action or developing Europe-wide policy measures. This may be a compromise between the rights of Member States to develop national policy and legislation and the obligation of the European Union as a collaborative body to protect health. Furthermore, it has been suggested that the European Union's roots as a trading block emphasizes collaboration with industry stakeholders and this influences the ability to prioritize health over trade considerations.
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Abstract
This article summarizes the contents of Alcohol: No Ordinary Commodity (2nd edn). The first part of the book describes why alcohol is not an ordinary commodity, and reviews epidemiological data that establish alcohol as a major contributor to the global burden of disease, disability and death in high-, middle- and low-income countries. This section also documents how international beer and spirits production has been consolidated recently by a small number of global corporations that are expanding their operations in Eastern Europe, Asia, Africa and Latin America. In the second part of the book, the scientific evidence for strategies and interventions that can prevent or minimize alcohol-related harm is reviewed critically in seven key areas: pricing and taxation, regulating the physical availability of alcohol, modifying the drinking context, drink-driving countermeasures, restrictions on marketing, education and persuasion strategies, and treatment and early intervention services. Finally, the book addresses the policy-making process at the local, national and international levels and provides ratings of the effectiveness of strategies and interventions from a public health perspective. Overall, the strongest, most cost-effective strategies include taxation that increases prices, restrictions on the physical availability of alcohol, drink-driving countermeasures, brief interventions with at risk drinkers and treatment of drinkers with alcohol dependence.
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30
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Affiliation(s)
- Antoni Gual
- Alcohol Unit, ICN, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain.
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Affiliation(s)
- Gerhard Gmel
- SFA-ISPA, Avenue Louis-Ruchonnet 14 Lausanne CH 1003, Switzerland.
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32
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Affiliation(s)
- Pekka Sulkunen
- Department of Sociology, PO Box 18, 0014 University of Helsinki, Helsinki, Finland.
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Affiliation(s)
- Dwight B Heath
- Department of Anthropology, Brown University, Providence, RI, USA.
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34
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Chikritzhs T. Protecting the integrity of shared scientific knowledge: is the conflict of interest statement enough? Addiction 2010; 105:200-1; author reply 205-6. [PMID: 20078474 DOI: 10.1111/j.1360-0443.2009.02743.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Tanya Chikritzhs
- National Drug Research Institute, Curtin University of Technology, Perth, Western Australia, WA 6845, Australia.
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Hunt G, Barker JC. Socio-cultural anthropology and alcohol and drug research: towards a unified theory. Soc Sci Med 2001; 53:165-88. [PMID: 11414385 DOI: 10.1016/s0277-9536(00)00329-4] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The arrival of the millennium has understandably created a growing tendency for social commentators to evaluate the current state of the world, assess prior developments and suggest new and enlightened ways forward. In this time of re-appraisals, we assess the current state of the anthropology of alcohol and drug research, consider its early history, examine the range and theoretical underpinnings of work done today, and propose the elements of a possible future model. In formulating the model, we have borrowed from a number of different theoretical approaches and insights not only from anthropological discussions of alcohol and drug issues but also from anthropological research outside these arenas. In examining these issues, and as a way of attempting to answer the question--where has the field come from and where is it heading--we situate anthropological contributions to this area not merely within the wider context of anthropological thought and research, but more importantly within a wider social and political context that takes account of the organizational, funding and conceptual influences, constraints and pressures that operate on anthropologists who wish to conduct research on alcohol and drug issues.
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Affiliation(s)
- G Hunt
- Institute for Scientific Analysis, Alameda, CA 94501-3682, USA.
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