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Even D, Abdalla SM, Maani N, Galea S. News media as a commercial determinant of health. Lancet Glob Health 2024; 12:e1365-e1369. [PMID: 38908393 DOI: 10.1016/s2214-109x(24)00191-8] [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: 01/14/2024] [Revised: 03/31/2024] [Accepted: 04/25/2024] [Indexed: 06/24/2024]
Abstract
Commercial determinants of health frameworks aim to identify the features and actions of corporate entities that can influence health. This Viewpoint conceptualises the work of the news media as a set of commercial forces and provides a framework that can help researchers better understand how features and actions of the news media shape health and health equity. We discuss four key features of news media action that can shape health: agenda setting, framing, priming, and tactics of persuasion. Beyond the direct role of the media in shaping health, we also explore pathways (ie, public relation activities, advertising, and economic pressures) in which the media is used by other commercial actors to affect health. A better understanding of how news media operates can help inform efforts to improve media actions to aid in improving population health outcomes.
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Affiliation(s)
- Dan Even
- School of Public Health, Boston University, Boston, MA, USA; Moshe Prywes Center for Medical Education, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | | | - Nason Maani
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Sandro Galea
- School of Public Health, Boston University, Boston, MA, USA
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Zuckermann AME, Morissette K, Boland L, Garcia AJ, Domingo FR, Stockwell T, Hobin E. The effects of alcohol container labels on consumption behaviour, knowledge, and support for labelling: a systematic review. Lancet Public Health 2024; 9:e481-e494. [PMID: 38942559 DOI: 10.1016/s2468-2667(24)00097-5] [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: 01/24/2024] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 06/30/2024]
Abstract
Alcohol container labels might reduce population-level alcohol-related harms, but investigations of their effectiveness have varied in approach and quality. A systematic synthesis is needed to adjust for these differences and to yield evidence to inform policy. Our objectives were to establish the effects of alcohol container labels bearing one or more health warnings, standard drink information, or low-risk drinking guidance on alcohol consumption behaviour, knowledge of label message, and support for labels. We completed a systematic review according to Cochrane and synthesis without meta-analysis standards. We included all peer-reviewed studies and grey literature published from Jan 1, 1989, to March 6, 2024, in English, French, German, or Spanish that investigated the effects of alcohol container labels compared with no-label or existing label control groups in any population on alcohol consumption behaviour, knowledge of label message, or support for labels. Data were synthesised narratively as impact statements and assessed for risk of bias and certainty in the evidence. A protocol was preregistered (PROSPERO CRD42020168240). We identified 40 publications that studied 31 labels and generated 17 impact statements. 24 (60%) of 40 publications focused on consumption behaviour and we had low or very low certainty in 13 (59%) of 22 outcomes. Alcohol container labels bearing health warnings might slow the rate of alcohol consumption (low certainty), reduce alcoholic beverage selection (moderate certainty), reduce consumption during pregnancy (low certainty), and reduce consumption before driving (moderate certainty). Interventions with multiple types of rotating alcohol container labels likely substantially decrease alcohol use (moderate certainty) and reduce alcohol sales (high certainty). To the best of our knowledge, this is the first systematic review on multiple types of alcohol container labels assessing their effects for certainty in the evidence. Limitations included heterogeneity in label designs and outcome measurements. Alcohol container labels probably influence some alcohol consumption behaviour, with multiple rotating messages being particularly effective, although effects might vary depending on individual health literacy or drinking behaviour. Alcohol container labels might therefore be effective components of policies designed to address population-level alcohol-related harms.
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Affiliation(s)
- Alexandra M E Zuckermann
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada.
| | - Kate Morissette
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Laura Boland
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | | | - Francesca Reyes Domingo
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, ON, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease, and Injury Prevention, Public Health Ontario, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, 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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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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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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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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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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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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Brennan E, Dunstone K, Vittiglia A, Mancuso S, Durkin S, Slater MD, Hoek J, Pettigrew S, Wakefield M. Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers. PLoS One 2022; 17:e0276189. [PMID: 36476743 PMCID: PMC9729007 DOI: 10.1371/journal.pone.0276189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Abstract
Health warning labels (HWLs) on alcohol containers may help reduce population-level alcohol consumption. However, few studies have examined the most effective formats for alcohol HWLs. This study tested the effects of three different types of alcohol HWLs. In an online experiment, N = 1,755 Australian adult drinkers were randomly assigned to one of five conditions: (a) No HWL control; (b) DrinkWise control (industry-developed labels currently on some containers); (c) Text-Only HWLs; (d) Text + Pictogram HWLs; or (e) Text + Photograph HWLs. In the three intervention conditions, participants were exposed to eight HWLs, each depicting a different long-term harm. Exposure occurred during an initial session, and repeatedly over the subsequent eight days. Differences between conditions were assessed immediately following initial exposure and at nine-day follow-up. Compared to participants in the No HWL control, participants exposed to Text + Pictogram HWLs were more likely to have intentions to avoid drinking alcohol completely in the next month (post-exposure) and intentions to drink less alcohol in the next week (follow-up), and participants in all three intervention conditions reported stronger negative emotional arousal (follow-up) and weaker positive emotional arousal (follow-up). Compared to participants in the DrinkWise control, those exposed to Text + Pictogram HWLs had stronger intentions to drink less alcohol in the next week and intentions to avoid drinking alcohol completely in the next month (follow-up), participants in the Text + Photograph condition reported significantly weaker positive emotional arousal, and all three intervention conditions resulted in stronger negative emotional arousal. There would likely be benefits to public health if any of the three types of intervention HWLs were implemented. However, there is some evidence that Text + Pictogram HWLs should be recommended over Text-Only or Text + Photograph HWLs, given they were the only HWLs to increase intentions to drink less.
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Affiliation(s)
- Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- * E-mail:
| | - Kimberley Dunstone
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Amanda Vittiglia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sam Mancuso
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Michael D. Slater
- School of Communication, The Ohio State University, Columbus, Ohio, United States of America
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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Davies EL, Cooke R, de Visser RO, Conroy D. Calling time on responsible drinking: A qualitative study of perceptions of information on alcohol product labels. Br J Health Psychol 2022; 28:320-337. [PMID: 36263853 DOI: 10.1111/bjhp.12627] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to explore (a) how people interpret responsible drinking messages on alcohol product labels, and (b) the acceptability of including health information on labels. DESIGN Qualitative interviews. METHODS Face-to-face semi-structured interviews were conducted with 20 people aged 21-63; 18 were classified risky drinkers using AUDIT-C. They were shown three sets of alcohol product labels: one including three responsible drinking messages (drink responsibly), one with three positively worded health messages (drinking less reduces risks) and one with three negatively worded health messages (drinking more increases risks). Health messages included information about cancer, liver and heart disease. RESULTS Thematic analysis identified three themes: ambiguity about alcohol labelling; identifying oneself as responsible; and acceptability of enhanced product labelling. Participants were critical of responsible drinking messages and wary of conflicting health information in the media. They positioned themselves as responsible, knowledgeable drinkers and distanced themselves from problem drinkers. They did not appear to support the inclusion of health information on labels; however, novel information was considered more impactful. CONCLUSIONS Responsible drinking messages were seen by our sample as an alcohol industry ploy. Although health messages about cancer were seen as potentially impactful, the ability of consumers to position themselves as unproblematic drinkers means that they may not see the information on the label as relevant to themselves. Understanding factors that increase the personal relevance of messages is needed, alongside an exploration of a wider range of methods for alcohol health communication.
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Affiliation(s)
- Emma L Davies
- Centre for Psychological Research, Oxford Brookes University, Oxford, UK
| | - Richard Cooke
- Staffordshire Centre for Psychological Research, Staffordshire University, Stoke-on-Trent, UK
| | - Richard O de Visser
- Department of Primary Care & Population Health, Brighton & Sussex Medical School, Brighton, UK
| | - Dominic Conroy
- School of Social Sciences and Professions, London Metropolitan University, London, UK
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Giesbrecht N, Reisdorfer E, Rios I. Alcohol Health Warning Labels: A Rapid Review with Action Recommendations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11676. [PMID: 36141951 PMCID: PMC9517222 DOI: 10.3390/ijerph191811676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 06/16/2023]
Abstract
A rapid review of research on health warning labels located on alcohol containers (AWLs) was conducted. Using five search engines (Embase, Medline, Pubmed, Scopus, Psyinfo), 2975 non-duplicate citations were identified between the inception date of the search engine and April 2021. Of those, 382 articles were examined and retrieved. We selected 122 research papers for analysis and narrative information extraction, focusing on population foci, study design, and main outcomes. Research included public opinion studies, surveys of post-AWL implementation, on-line and in-person experiments and real-world quasi-experiments. Many studies focused on the effects of the 1989 United States Alcoholic Beverage Labeling Act on perceptions, intentions and behavior. Others focused on Australia, Canada, the United Kingdom, England or Scotland, Italy and France. There was substantial variation in the design of the studies, ranging from small-scale focus groups to on-line surveys with large samples. Over time, evidence has been emerging on label design components, such as large size, combination of text and image, and specific health messaging, that is likely to have some desired impact on knowledge, awareness of risk and even the drinking behavior of those who see the AWLs. This body of evidence provides guidance to policy-makers, and national and regional authorities, and recommendations are offered for discussion and consideration.
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Affiliation(s)
- Norman Giesbrecht
- Centre for Addiction and Mental Health, 33 Ursulla Franklin St., Toronto, ON M5S 2S1, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, ON M5T 3M7, Canada
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Millot A, Serra M, Gallopel-Morvan K. How the alcohol industry fought against pregnancy warning labels in France. A press coverage analysis spanning 20 years. Front Public Health 2022; 10:933164. [PMID: 36091564 PMCID: PMC9458884 DOI: 10.3389/fpubh.2022.933164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/01/2022] [Indexed: 01/25/2023] Open
Abstract
Background Drinking alcohol while pregnant is dangerous for health. To inform on this issue, various countries have adopted pregnancy warning labels on alcoholic beverages, including France since 2007, where wine holds deep cultural consonance. The aim of this research was to analyze the arguments put forward by the alcohol industry (producers, distributors, wholesalers, allied industries, trade associations, social aspects and public relations organizations, councilors who publicly defend wine-sector interests) via the press in France: (1) in 2007 when pregnancy warnings were first implemented, and (2) in 2018 when larger pregnancy warnings to increase visibility were proposed but not adopted. Methods We used documentary method to analyze the arguments advanced by the alcohol industry in mainstream (national, regional and specialized) press in France from 2000 to 2020, using the Europresse documentary database. Quantitative analysis (number and trend curve of articles, mapping alcohol-industry actors who spoke in the press) and inductive thematic content analysis (analytical framework of the arguments identified) using NVivo software were carried out. Results We found a total of 559 relevant press articles in the database, of which 85 were included in the analysis. Peaks in number of publications were found to coincide with the warning label implementation and with the expansion-project schedule. A large majority of the arguments promoted by the alcohol industry contested the pregnancy warnings measure (very few were in favor). They argued that (1) pregnancy warnings were a questionable measure (e.g., ineffective, or the pictogram clearly links alcohol to mortality), (2) pregnancy warnings would have counterproductive effects (on women and the wider economy), (3) better alternatives exist (e.g., targeted prevention programs, prevention by health professionals). A large majority of the actors who spoke in the press came from the winegrowing sector. Conclusion This study fills a gap in the Anglosphere research on lobbying against alcohol warnings by analyzing lobbyists' arguments over a 20-year period covering both failed and successful industry lobbying. New findings have emerged that are likely related to the wine-oriented culture of France. In order to counter the alcohol lobbying practices we conclude with a number of public health recommendations.
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Affiliation(s)
- Ana Millot
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France,*Correspondence: Ana Millot
| | | | - Karine Gallopel-Morvan
- Univ Rennes, EHESP, CNRS, Inserm, Arènes - UMR 6051, RSMS (Recherche sur les Services et Management en Santé) - U 1309, Rennes, France
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van der Maas M, Cho SR, Nower L. Problem gambling message board activity and the legalization of sports betting in the US: A mixed methods approach. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Thompson C, Clary C, Er V, Adams J, Boyland E, Burgoine T, Cornelsen L, de Vocht F, Egan M, Lake AA, Lock K, Mytton O, Petticrew M, White M, Yau A, Cummins S. Media representations of opposition to the 'junk food advertising ban' on the Transport for London (TfL) network: A thematic content analysis of UK news and trade press. SSM Popul Health 2021; 15:100828. [PMID: 34141852 PMCID: PMC8184652 DOI: 10.1016/j.ssmph.2021.100828] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/28/2021] [Accepted: 05/22/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Advertising of less healthy foods and drinks is hypothesised to be associated with obesity in adults and children. In February 2019, Transport for London implemented restrictions on advertisements for foods and beverages high in fat, salt or sugar across its network as part of a city-wide strategy to tackle childhood obesity. The policy was extensively debated in the press. This paper identifies arguments for and against the restrictions. Focusing on arguments against the restrictions, it then goes on to deconstruct the discursive strategies underpinning them. METHODS A qualitative thematic content analysis of media coverage of the restrictions (the 'ban') in UK newspapers and trade press was followed by a document analysis of arguments against the ban. A search period of March 1, 2018 to May 31, 2019 covered: (i) the launch of the public consultation on the ban in May 2018; (ii) the announcement of the ban in November 2018; and (iii) its implementation in February 2019. A systematic search of printed and online publications in English distributed in the UK or published on UK-specific websites identified 152 articles. RESULTS Arguments in favour of the ban focused on inequalities and childhood obesity. Arguments against the ban centred on two claims: that childhood obesity was not the 'right' priority; and that an advertising ban was not an effective way to address childhood obesity. These claims were justified via three discursive approaches: (i) claiming more 'important' priorities for action; (ii) disputing the science behind the ban; (iii) emphasising potential financial costs of the ban. CONCLUSION The discursive tactics used in media sources to argue against the ban draw on frames widely used by unhealthy commodities industries in response to structural public health interventions. Our analyses highlight the need for interventions to be framed in ways that can pre-emptively counter common criticisms.
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Affiliation(s)
- Claire Thompson
- Centre for Research in Public Health and Community Care, School of Health and Social Work, University of Hertfordshire, Hatfield, United Kingdom
| | - Christelle Clary
- Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Vanessa Er
- Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jean Adams
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Emma Boyland
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Thomas Burgoine
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Laura Cornelsen
- Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
- National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), Bristol, United Kingdom
| | - Matt Egan
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Amelia A. Lake
- Centre for Public Health Research, School of Health and Life Sciences Teesside University, Middlesbrough, United Kingdom
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, United Kingdom
| | - Karen Lock
- Department of Health Services Research & Policy, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Oliver Mytton
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Mark Petticrew
- Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Martin White
- Centre for Diet & Activity Research, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Amy Yau
- Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments & Society, Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Critchlow N, Moodie C, Jones D. Health information and warnings on alcohol packaging in Ireland: it is time to progress the Public Health (Alcohol) Act 2018. Ir J Med Sci 2021; 191:1461-1463. [PMID: 34319546 PMCID: PMC8316105 DOI: 10.1007/s11845-021-02719-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Nathan Critchlow
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland. .,UK-Ireland Alcohol Research Network (ACORN), University of Stirling, Stirling, Scotland.
| | - Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
| | - Daniel Jones
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, Scotland
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16
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Lesch M, McCambridge J. A long-brewing crisis: The historical antecedents of major alcohol policy change in Ireland. Drug Alcohol Rev 2021; 41:135-143. [PMID: 34085320 DOI: 10.1111/dar.13331] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The Public Health (Alcohol) Act 2018 in Ireland has been hailed as a world-leading package of alcohol policy reforms. Existing studies have identified the events that led to alcohol emerging onto the high-level policy agenda in Ireland, particularly after 2009. Using policy feedback theory, this study specifically investigates the political consequences of accumulating alcohol-related health and social harms for processes of policy change prior to 2009. METHODS The study traces the development of alcohol policy in Ireland over the past three decades. It draws on primary documents, secondary literature and interviews with public health advocates, medical doctors, public health experts and key decision-makers. RESULTS The study documents a decades-long struggle to have alcohol recognised as a public health issue in Ireland. We identify 2008/2009 as the key turning point, where policy conditions decisively shifted in a public health direction. We show how insufficient institutional authority and the accumulation of the effects of earlier policy failures helped foster this dynamic. These two factors elevated the visibility of alcohol-related harm for key stakeholders, helping spur greater demand for major policy change. DISCUSSION AND CONCLUSIONS Not acting on the population health harms caused by alcohol can produce significant societal costs, particularly when consumption is rising, and entail subsequent political consequences. Understanding of innovations in alcohol policy decision making requires an appreciation of the historical context, including earlier policy failures.
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Affiliation(s)
- Matthew Lesch
- Department of Health Sciences, University of York, York, UK
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Strebel J, Terry MB. Alcohol, Binge Drinking, and Cancer Risk: Accelerating Public Health Messaging Through Countermarketing. Am J Public Health 2021; 111:812-814. [PMID: 33826398 DOI: 10.2105/ajph.2021.306233] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Judi Strebel
- Judi Strebel is with the Department of Marketing, Lam Family College of Business, San Francisco State University, San Francisco, CA. Mary Beth Terry is with the Department of Epidemiology, Mailman School of Public Health, and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Mary Beth Terry
- Judi Strebel is with the Department of Marketing, Lam Family College of Business, San Francisco State University, San Francisco, CA. Mary Beth Terry is with the Department of Epidemiology, Mailman School of Public Health, and the Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
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18
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Room R, Gleeson D, Miller M. Alcoholic beverages in trade agreements: Industry lobbying and the public health interest. Drug Alcohol Rev 2021; 40:19-21. [PMID: 33184904 PMCID: PMC7839679 DOI: 10.1111/dar.13214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/23/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Robin Room
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneAustralia
- Centre for Social Research on Alcohol and Drugs, Department of Public Health SciencesStockholm UniversityStockholmSweden
| | - Deborah Gleeson
- School of Psychology and Public HealthLa Trobe UniversityMelbourneAustralia
| | - Mia Miller
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneAustralia
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Schoueri-Mychasiw N, Weerasinghe A, Vallance K, Stockwell T, Zhao J, Hammond D, McGavock J, Greenfield TK, Paradis C, Hobin E. Examining the Impact of Alcohol Labels on Awareness and Knowledge of National Drinking Guidelines: A Real-World Study in Yukon, Canada. J Stud Alcohol Drugs 2020; 81:262-272. [PMID: 32359057 PMCID: PMC7201209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 01/15/2020] [Indexed: 03/29/2024] Open
Abstract
OBJECTIVE Alcohol labels are one strategy for communicating health information to consumers. This study tested the extent to which consumers recalled alcohol labels with national drinking guidelines and examined the impact of labels on awareness and knowledge of the guidelines. METHOD A quasi-experimental study was conducted in two jurisdictions in northern Canada examining the impact of labels on the following outcomes: unprompted and prompted recall of the drinking guideline label message, awareness of the drinking guidelines, and knowledge of the daily and weekly recommended drink limits. The intervention site applied labels with national drinking guidelines, a cancer warning, and standard drink information to alcohol containers in its liquor store, whereas the comparison site did not apply these labels. In total, 2,049 cohort participants in both sites were recruited to complete surveys before and at two time points after the intervention. Changes in outcomes were examined using generalized estimating equations. RESULTS After the intervention, unprompted and prompted recall of the drinking guideline label message increased more in the intervention versus comparison site (adjusted odds ratio [AOR] = 10.8, 95% CI [0.9, 127.6]; AOR = 7.0, 95% CI [3.3, 14.9], respectively). Awareness of the drinking guidelines increased 2.9 times more in the intervention versus comparison site (AOR = 2.9, 95% CI [2.0, 4.3]). In addition, knowledge of the daily and weekly drink limits increased 1.5 and 1.4 times more in the intervention versus comparison site, respectively (daily: AOR = 1.5, 95% CI [1.0, 2.1]; weekly: AOR = 1.4, 95% CI [1.0, 2.0]). CONCLUSIONS Enhanced alcohol labels get noticed and may be an effective population-level strategy for increasing awareness and knowledge of national drinking guidelines.
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Affiliation(s)
| | | | - Kate Vallance
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - Jinhui Zhao
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, British Columbia, Canada
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan McGavock
- Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Thomas K. Greenfield
- Alcohol Research Group, Public Health Institute, Emeryville, California, United States
| | - Catherine Paradis
- Canadian Centre on Substance Use and Addiction, Ottawa, Ontario, Canada
| | - Erin Hobin
- Public Health Ontario, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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