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Baumann S, Leão T. Industries, citizens, and non-governmental organizations' positioning and arguments used in European Union initiatives for alcohol taxation and cross-border regulation. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 129:104475. [PMID: 38971018 DOI: 10.1016/j.drugpo.2024.104475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 04/13/2024] [Accepted: 05/29/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The European region has the highest daily alcohol consumption per capita and a high alcohol-related burden of disease. Policymaking at the European Union level is open to participation by interest groups, from public health organizations to alcohol industry representatives. This study aimed to map the interest groups present in the alcohol taxation and cross-border regulation initiatives and identify which arguments were used to support positions in favor or against them. METHODS We used qualitative content analysis on the comments submitted on the official European Commission website during the 2017, 2018, 2020, and 2022 participation periods. Interest groups were characterized considering their positioning, and arguments were identified and compared by position and type of initiative. RESULTS Opponents of changes to the structures of alcohol excise duties and cross-border regulations were mostly representatives of the alcohol and agricultural industries, and the proponents were mostly health-related nongovernmental organizations. Opponents of these initiatives used a wide variety of arguments, from economic and trade to health arguments, while proponents focused mainly on health arguments, such as the effectiveness of alcohol taxation in preventing alcohol-related morbidity and mortality. CONCLUSION This study highlights the wide range of arguments used by opponents around alcohol control policies, contrasting with the health-centered arguments of proponents. It further shows that there is a lobbying network at the European Union level, combining national and international representatives of industry and non-governmental organizations. These findings provide an opportunity for better preparation for upcoming discussions on alcohol control at national and regional levels.
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Affiliation(s)
- Selina Baumann
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal
| | - Teresa Leão
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Rua das Taipas, n° 135, 4050-600 Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses, e Educação Médica, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200 Porto, Portugal.
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McCambridge J, Kypri K, Boehnke JR, Bero L, Bendtsen M. Randomised study of the effects of sense of entitlement and conflict of interest contrarianism on researcher decision-making to work with the alcohol industry. BMC Public Health 2024; 24:1680. [PMID: 38914989 PMCID: PMC11197317 DOI: 10.1186/s12889-024-18961-5] [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: 07/24/2023] [Accepted: 05/27/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND It is well established that the tobacco industry used research funding as a deliberate tactic to subvert science. There has been little wider attention to how researchers think about accepting industry funding. We developed, then tested, hypotheses about two psychological constructs, namely, entitlement and conflict of interest contrarianism (CoI-C) among alcohol researchers who had previously received industry funding. METHODS A mixed-methods pilot study involved construct and instrument development, followed by an online survey and nested 3-arm randomised trial. We randomly allocated alcohol industry funding recipients to one of three conditions. In two experimental conditions we asked participants questions to remind them (and thus increase the salience) of their sense of entitlement or CoI-C. We compared these groups with a control group who did not receive any reminder. The outcome was a composite measure of openness to working with the alcohol industry. RESULTS 133 researchers were randomised of whom 79 completed the experiment. The posterior distribution over effect estimates revealed that there was a 94.8% probability that reminding researchers of their CoI-C led them to self-report being more receptive to industry funding, whereas the probability was 68.1% that reminding them of their sense of entitlement did so. Biomedical researchers reported being more open to working with industry than did psychosocial researchers. CONCLUSION Holding contrarian views on conflict of interest could make researchers more open to working with industry. This study shows how it is possible to study researcher decision-making using quantitative experimental methods.
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Affiliation(s)
- Jim McCambridge
- University of York, Seebohm Rowntree Building, York, YO10 5DD, UK.
| | | | - Jan R Boehnke
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Lisa Bero
- University of Colorado, Aurora, CO, US
| | - Marcus Bendtsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Dumbili EW. Alcohol industry-sponsored music festivals, alcohol marketing and drinking practices among young Nigerians: Implications for policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 127:104384. [PMID: 38492330 DOI: 10.1016/j.drugpo.2024.104384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/17/2024] [Accepted: 03/03/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION The global alcohol industry sponsors social/music events targeting young people; however, existing literature focuses on Westernised contexts. Given the decline in young people's drinking in many Western countries, it appears that multinational alcohol companies are importing the strategies they have used in high-income countries to the Global South countries like Nigeria to recoup profits. This study aims to examine the Guinness Show- a free one-month annual music festival, alcohol marketing at the festival and the extent to which the event encourages diverse drinking practices among its attendees. METHODS We observed the music festival before collecting data through 53 interviews and 3 focus groups (N = 26). Data were analysed to generate themes with the aid of NVivo 12 software. FINDINGS Over 6000 participants attend the Guinness Show daily, and participants gave detailed descriptions of the music festival, alcohol marketing activities that occur in it and the drinking practices of attendees, indicating that they were highly knowledgeable of the event. The Guinness Show attracts famous music artistes and other entertainers. Therefore, young people attend to see them perform free of charge. However, diverse alcohol promotions (e.g., quantity deals, low prices, giveaways) that happen daily, the strategic use of young women as 'beer promoters', and the pleasure the event induces by fusing music/entertainment into alcogenic environments, encourage drinking and drunkenness. All the attendees drank alcohol, and some engaged in impulse buying, while many consumed excessively due to promotions (e.g., buy-two-get-one free), which facilitated intoxication and the loss of control. CONCLUSIONS Guinness Nigeria organises the event for strategic brand communication, generating brand capital, and encouraging alcohol purchases and consumption among young people. Policymakers should reconsider self-regulation and implement national alcohol control policies and other public health interventions to restrain the alcohol industry from sponsoring such events.
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Affiliation(s)
- Emeka W Dumbili
- School of Sociology, College of Social Sciences and Law, University College Dublin, Belfield, Dublin 4, Ireland.
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4
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McCambridge J, Golder S. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of epidemiological studies. Addict Behav 2024; 151:107932. [PMID: 38103279 DOI: 10.1016/j.addbeh.2023.107932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/28/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Alcohol's effects on cardiovascular disease (CVD) are controversial. Alcohol industry actors have shown particular interest in this subject, and been extensively involved through research funding, and in other ways, generating concerns about bias, particularly in reviews. MATERIAL & METHODS We conducted a co-authorship network analysis of the primary studies included within a previous co-authorship study of 60 systematic reviews on the impact of alcohol on CVD. Additionally, we examined the relationships between declared alcohol industry funding and network structure. RESULTS There were 713 unique primary studies with 2832 authors published between 1969 and 2019 located within 229 co-authorship subnetworks. There was industry funding across subnetworks and approximately 8% of all papers declared industry funding. The largest subnetwork dominated, comprising 43% of all authors, with sparse evidence of substantial industry funding. The second largest subnetwork contained approximately 4% of all authors, with largely different industry funders involved. Harvard affiliated authors who at the review level formed co-authorship subnetworks with industry funded authors were seen at the primary study level to belong to the largest epidemiological subnetwork. A small number of key authors make extensive alcohol industry funding declarations. CONCLUSIONS There was no straightforward relationship between co-authorship network formation and alcohol industry funding of epidemiological studies on alcohol and CVD. More fine-grained attention to patterns of alcohol industry funding and to key nodes may shed further light on how far industry funding may be responsible for conflicting findings on alcohol and CVD.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom.
| | - Su Golder
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington York YO10 5DD, United Kingdom
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GÓMEZ EDUARDOJ, MAANI NASON, GALEA SANDRO. The Pitfalls of Ascribing Moral Agency to Corporations: Public Obligation and Political and Social Contexts in the Commercial Determinants of Health. Milbank Q 2024; 102:28-42. [PMID: 37880820 PMCID: PMC10938930 DOI: 10.1111/1468-0009.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/15/2023] [Accepted: 10/02/2023] [Indexed: 10/27/2023] Open
Abstract
Policy Points Government and civil society should be held more accountable for creating food and beverage regulatory policies rather than assigning moral agency to the food and beverage industry. Nutrition policymaking institutions should ensure civil society's ability to design regulatory policy. Government policymaking institutions should be isolated from industry interference.
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Tissaoui T, Davis T, Trevena H, Thow AM. Health policy implications of corporate social responsibility provisions in international investment agreements. Bull World Health Organ 2024; 102:94-104D. [PMID: 38313154 PMCID: PMC10835630 DOI: 10.2471/blt.23.290419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 11/03/2023] [Accepted: 11/03/2023] [Indexed: 02/06/2024] Open
Abstract
Objective To analyse and classify inclusions of corporate social responsibility in international investment agreements, especially inclusions with reference to public health. Method We extracted the text of international investment agreements containing corporate social responsibility inclusions from the Electronic Database of Investment Treaties. We conducted a documentary analysis of the corporate social responsibility inclusions, and we developed a typology categorizing inclusions based on level of detail and reference to international commitments. Findings Of the 3816 agreements signed as of October 2023, 127 agreements contain corporate social responsibility inclusions. Since the first inclusion of corporate social responsibility in 2008, the percentage of agreements containing such inclusion signed each year has steadily increased from 4.6% (4/86) in 2008 to 42.8% (21/49) in 2018 and 33.3% (3/9) in 2023. Using the typology we developed, we categorized the level of detail as follows: nine were minimal, 27 were low, 35 were low-medium, 107 were medium, 11 were medium-high and seven were high. Health is mentioned in 36 of these inclusions. Conclusion This analysis indicates that international investment agreements increasingly incorporate a high level of detail on expectations regarding investors' corporate social responsibility. Such provisions offer a potential tool to increase government guidance and accountability of global corporations, including with respect to governments' public health objectives.
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Affiliation(s)
- Takwa Tissaoui
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, The University of Sydney, Camperdown 2050, New South Wales, Australia
| | - Teresa Davis
- Discipline of Marketing, University of Sydney Business School, Sydney, Australia
| | - Helen Trevena
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, The University of Sydney, Camperdown 2050, New South Wales, Australia
| | - Anne Marie Thow
- Menzies Centre for Health Policy and Economics, Sydney School of Public Health, The University of Sydney, Camperdown 2050, New South Wales, Australia
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Madden M, Bartlett A, McCambridge J. Constructing public-private partnerships to undermine the public interest: critical discourse analysis of Working Together published by the International Alliance for Responsible Drinking. Global Health 2023; 19:103. [PMID: 38104100 PMCID: PMC10725627 DOI: 10.1186/s12992-023-01000-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The global burden of alcohol harm has increased and is forecast to grow further without effective policy implementation. Public-private partnerships aiming to address global health, and other societal challenges, are a burgeoning feature of neoliberal governance. Rhetorically distancing themselves from tobacco, the major alcohol companies are committed to tackling 'harmful drinking' and have created a distinct type of public relations organization for this purpose. The activities of such organizations are increasingly recognized as an impediment to the implementation of policies to reduce alcohol harm, including in low- and middle-income countries where markets are expanding. METHODS The approach of critical discourse analysis is used to examine the discursive tactics and strategies used in Working Together; a 'toolkit' published by the key global level alcohol industry public relations organization, the International Alliance for Responsible Drinking (IARD). This study considers how it works discursively to set the terms of, and overcome skepticism about partnerships, to define aims and position various actors by constructing their roles. The construction of prospective partners provides insights into the alcohol industry itself. RESULTS The toolkit operates as an ideological resource for forming public-private partnerships across the world based on the accumulated know-how of the major companies through IARD. This allows the largest alcohol companies to exercise leadership of the industry, while remaining off-stage. The toolkit relies on a form of rhetorical work which creates distance from obvious corporate interests and the harms caused to population health and society. This is accomplished by working against evidence-informed population level approaches, and thus avoiding policies that will make any significant difference to overall alcohol harm. Unspecific "complexity" affords opportunity for preferred types of "actions", and "partnership" provides opportunity to gain credibility by association, further minimizing the likelihood of any material harm being reduced. CONCLUSIONS The toolkit is designed to not only legitimate the inclusion of alcohol industry actors as initiating 'partners', but also assigns them roles as managers of a set of carefully constructed relationships. This vision of public-private partnership reproduces the hegemonic narrative that has successfully blocked policy advances for decades and led to growing alcohol harm globally.
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Affiliation(s)
- Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England.
| | - Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, England
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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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Bartlett A, McCambridge J. The international center for alcohol policies (ICAP) book series: a key resource globally for alcohol industry political strategies. Subst Abuse Treat Prev Policy 2023; 18:49. [PMID: 37596661 PMCID: PMC10436666 DOI: 10.1186/s13011-023-00556-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/14/2023] [Indexed: 08/20/2023] Open
Abstract
This study examines the functions and purposes of the International Center for Alcohol Policies (ICAP) book series, published by Routledge between 1998 and 2010. The books were authored by invited academics, ICAP staffers, and alcohol industry representatives.The key data source for this paper was the framing material - forewords, introductions, conclusions - of the books. A thematic analysis positioned the contents with regard to ongoing alcohol research and public health policy issues.This was a project to 'shift the paradigm'. ICAP frames alcohol policy choices in ways which direct policy attention to sub-groups rather than the population level. Population-level approaches are caricatured as 'ideological'. The concept of 'balance' is prominent and is employed in multiple ways. Business interests are elided and industry involvement in policy making is promoted on scientific grounds. The intellectual programme is lent credibility by leading scientists and the imprimatur of an academic publisher.While this attempt to change the paradigm in alcohol science has failed, ineffective alcohol policies remain common, uninformed by scientific evidence on how harms at the societal level may be reduced. The ICAP book series continues to serve its function as a resource to support the status quo in respect of alcohol policy.
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Affiliation(s)
- Andrew Bartlett
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.
| | - Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK
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Bartlett A, Garry J, McCambridge J. From the tobacco industry's uses of science for public relations purposes to the alcohol industry: Tobacco industry documents study. Drug Alcohol Rev 2023; 42:1269-1277. [PMID: 36933895 PMCID: PMC10947438 DOI: 10.1111/dar.13649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/24/2023] [Accepted: 02/28/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION Associates for Research in Substances of Enjoyment (ARISE) was formed by tobacco companies in the late 1980s designed to counter public health policy development. This study examines the alcohol content of ARISE and the contribution of ARISE to alcohol industry activities in a key period in the globalisation of the alcohol industry, generating insights into the inter-relationships between the tobacco and alcohol industries in their involvements in policy-oriented science. METHODS We systematically searched the UCSF Truth Tobacco Documents Library for information about ARISE, alcohol and the alcohol industry. This material was supplemented with an analysis of the contributions by ARISE associates to one volume in the International Center for Alcohol Policies (ICAP) book series on alcohol and pleasure. RESULTS ARISE placed nicotine alongside caffeine, chocolate and other foods, and alcohol as treats which brought pleasure and other benefits. Alcohol was thus intrinsic to the ARISE project for the tobacco industry. This study shows that at a formative moment in the mid-1990s the major alcohol companies took advantage of the intellectual inheritance and personnel provided by the tobacco industry when establishing ICAP. Key to this was an ICAP conference that resulted in Alcohol and pleasure: A health perspective (1999). DISCUSSION AND CONCLUSIONS Not only did ARISE use alcohol to play a supporting role in a sophisticated tobacco industry strategy, the alcohol industry engaged with ARISE as part of its own strategy. This shows the importance of careful attention to corporate activities on the fringes of peer-reviewed science.
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Affiliation(s)
- Andrew Bartlett
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
| | - Jack Garry
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
| | - Jim McCambridge
- Department of Health SciencesSeebohm Rowntree Building, University of YorkYorkUK
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de Lacy-Vawdon C, Vandenberg B, Livingstone C. Power and Other Commercial Determinants of Health: An Empirical Study of the Australian Food, Alcohol, and Gambling Industries. Int J Health Policy Manag 2023; 12:7723. [PMID: 37579379 PMCID: PMC10461899 DOI: 10.34172/ijhpm.2023.7723] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 04/19/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Commercial determinants of health (CDoH) represent a critical frame for exploring undue corporate and commercial influence over health. Power lenses are integral to understanding CDoH. Impacts of food, alcohol, and gambling industries are observable CDoH outcomes. This study aims to inform understanding of the systems and institutions of commercial and/or corporate forces working within the Australian food, alcohol, and gambling industries that influence health and well-being, including broader discourses materialised via these systems and institutions. METHODS Twenty semi-structured interviews were conducted with key-informants on Australian public policy processes. Interviewees were current and former politicians, political staff members, regulators and other public servants, industry representatives, lobbyists, journalists, and researchers with expertise and experience of the Australian food, alcohol, and/ or gambling industries. Interviews sought participants' perceptions of Australian food, alcohol, and gambling industries' similarities and differences, power and influence, relationships, and intervention opportunities and needs. RESULTS Strategies and tactics used by Australian food, alcohol and gambling industries are similar, and similar to those of the tobacco industry. They wield considerable soft (eg, persuasive, preference-shaping) and hard (eg, coercive, political, and legal/economic) power. Perceptions of this power differed considerably according to participants' backgrounds. Participants framed their understanding of necessary interventions using orthodox neoliberal discourses, including limiting the role of government, emphasising education, consumer freedom, and personal choice. CONCLUSION Food, alcohol, and gambling industries exercise powerful influences in Australian public policy processes, affecting population health and well-being. Per Wood and colleagues' framework, these manifest corporate, social, and ecological outcomes, and represent considerable instrumental, structural, and discursive power. We identify power as arising from discourse and material resources alike, along with relationships and complex industry networks. Addressing power is essential for reducing CDoH harms. Disrupting orthodox discourses and ideologies underpinning this should be a core focus of public health (PH) advocates and researchers alike.
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Affiliation(s)
- Cassandra de Lacy-Vawdon
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Brian Vandenberg
- School of Social Sciences, Monash University, Melbourne, VIC, Australia
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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12
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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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13
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Bennett E, Topp SM, Moodie AR. National Public Health Surveillance of Corporations in Key Unhealthy Commodity Industries - A Scoping Review and Framework Synthesis. Int J Health Policy Manag 2023; 12:6876. [PMID: 37579395 PMCID: PMC10425693 DOI: 10.34172/ijhpm.2023.6876] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/02/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND Corporations in unhealthy commodity industries (UCIs) have growing influence on the health of national populations through practices that lead to increased consumption of unhealthy products. The use of government-led public health surveillance is best practice to better understand any emerging public health threat. However, there is minimal systematic evidence, generated and monitored by national governments, regarding the scope of UCI corporate practices and their impacts. This study aims to synthesise current frameworks that exist to identify and monitor UCI influence on health to highlight the range of practices deployed by corporations and inform future surveillance efforts in key UCIs. METHODS Seven biomedical, business and scientific databases were searched to identify literature focused on corporate practices that impact human health and frameworks for monitoring or assessment of the way UCIs impact health. Content analysis occurred in three phases, involving (1) the identification of framework documents in the literature and extraction of all corporate practices from the frameworks; (2) initial inductive grouping and synthesis followed by deductive synthesis using Lima and Galea's 'vehicles of power' as a heuristic; and (3) scoping for potential indicators linked to each corporate practice and development of an integrated framework. RESULTS Fourteen frameworks were identified with 37 individual corporate practices which were coded into five different themes according the Lima and Galea 'Corporate Practices and Health' framework. We proposed a summary framework to inform the public health surveillance of UCIs which outlines key actors, corporate practices and outcomes that should be considered. The proposed framework draws from the health policy triangle framework and synthesises key features of existing frameworks. CONCLUSION Systematic monitoring of the practices of UCIs is likely to enable governments to mitigate the negative health impacts of corporate practices. The proposed synthesised framework highlights the range of practices deployed by corporations for public health surveillance at a national government level. We argue there is significant precedent and great need for monitoring of these practices and the operationalisation of a UCI monitoring system should be the object of future research.
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Affiliation(s)
- Elizabeth Bennett
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Stephanie M. Topp
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, VIC, Australia
| | - Alan Rob Moodie
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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McKevitt S, White M, Petticrew M, Summerbell C, Vasiljevic M, Boyland E, Cummins S, Laverty AA, Junghans C, Millett C, De Vocht F, Hrobonova E, Vamos EP. Typology of how 'harmful commodity industries' interact with local governments in England: a critical interpretive synthesis. BMJ Glob Health 2023; 8:e010216. [PMID: 36690378 PMCID: PMC9872461 DOI: 10.1136/bmjgh-2022-010216] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 12/20/2022] [Indexed: 01/25/2023] Open
Abstract
INTRODUCTION Industries that produce and market potentially harmful commodities or services (eg, tobacco, alcohol, gambling, less healthy foods and beverages) are a major influence on the drivers of behavioural risk factors for non-communicable diseases. The nature and impact of interactions between public bodies and 'harmful commodity industries' (HCIs) has been widely recognised and discussed at national and international levels, but to date little is known about such interactions at local or regional government levels. This study aimed to identify and characterise actual and potential interactions and proposes a typology of interactions between HCIs and English local authorities (LAs). METHODS Five electronic databases covering international literature (PubMed, EBSCO, OVID, Scopus and Web of Science) were searched up to June 2021. We also performed online searches for publicly available, web-based grey literature and documented examples of interactions in an English LA context. We conducted a critical interpretive synthesis of the published and grey literature to integrate and conceptualise the data in the context of English LAs. RESULTS We included 47 published papers to provide the frame for the typology, which was refined and contextualised for English LAs through the available grey literature. Three categories were developed, describing the medium through which interactions occur: (1) direct involvement with LAs, (2) involvement through intermediaries and (3) involvement through the local knowledge space. Within these, we grouped interactions into 10 themes defining their nature and identified illustrative examples. CONCLUSION Our typology identifies complex inter-relationships and characterises interactions between HCIs and LAs, with illustrative examples from English LAs. Drawn from well-established theories and frameworks in combination with contextual information on English LAs, this typology explores the LA perspective and could help local decision-makers to maximise population health while minimising negative impacts of HCIs. PROSPERO REGISTRATION NUMBER CRD42021257311.
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Affiliation(s)
- Sarah McKevitt
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Mark Petticrew
- PHP, London School of Hygiene and Tropical Medicine, London, UK
| | - Carolyn Summerbell
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Milica Vasiljevic
- Fuse - Centre for Translational Research in Public Health, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Durham University, Durham, UK
| | - Emma Boyland
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Cornelia Junghans
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
| | - Frank De Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, Bristol, UK
| | | | - Eszter P Vamos
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, UK
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Rezaei N, Ahmadi N, Shams Beyranvand M, Hasan M, Gohari K, Yoosefi M, Djalalinia S, Saeedi Moghaddam S, Modirian M, Pazhuheian F, Mahdavihezaveh A, Moradi G, Delavari F, Larijani B, Farzadfar F. Alcohol consumption and related disorders in Iran: Results from the National Surveillance of Non-Communicable Diseases' Survey (STEPs) 2016. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000107. [PMID: 36962484 PMCID: PMC10021244 DOI: 10.1371/journal.pgph.0000107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 06/28/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Alcohol consumption is a public health concern which is illegal in Iran. Moreover, due to cultural and religious beliefs, the available population-based research findings on alcohol consumption are inadequate. We aimed to provide an estimate on alcohol consumption using a large-scale population-based survey in Iran. MATERIALS AND METHODS The National Surveillance of Non-Communicable Risk Factors in Iran was a population-based survey conducted in 2016. The epidemiologic distribution of alcohol consumption and its related disorders were assessed using weighted survey methods and multiple logistic regression models. Age standardized rates were calculated using Iran's national population census in 2016. RESULTS At the national level, the prevalence rates of lifetime and current alcohol consumption were 8.00% (95% CI: 7.67-8.32) and 4.04% (95% CI: 3.81-4.27), respectively. The highest prevalence was reported among 25 to 34 year-olds. Individuals of higher socioeconomic status consumed significantly greater levels of alcohol. At provincial level, the highest and lowest percentages of the current alcohol drinking rates in Iran's provinces were, 23.92% (95% CI: 17.56-30.28) and 0.4% (95% CI: 0-1.18) in males, 1.58% (95% CI: 0.22-2.94) and 0% in females, respectively. In urban regions, the highest alcohol consumption rate was more than 22 times greater than the lowest alcohol consumption rate. Current alcohol drinkers were 2 times more prone to injury as compared to nondrinkers (ORadj: 2.0, 95%CI: 1.7, 2.3). CONCLUSION In Iran, the prevalence of alcohol consumption is low, although there is a considerable variation of alcohol consumption at provincial level as well as in different gender groups. Therefore, preventive WHO-recommended measures should be adopted more seriously by vulnerable groups.
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Affiliation(s)
- Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Shams Beyranvand
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Hasan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kimiya Gohari
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Djalalinia
- Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mitra Modirian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Pazhuheian
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ghobad Moradi
- Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farnaz Delavari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Ayares G, Idalsoaga F, Arnold J, Fuentes-López E, Arab JP, Díaz LA. Public Health Measures and Prevention of Alcohol-Associated Liver Disease. J Clin Exp Hepatol 2022; 12:1480-1491. [PMID: 36340308 PMCID: PMC9630023 DOI: 10.1016/j.jceh.2022.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/25/2022] [Indexed: 12/12/2022] Open
Abstract
Hazardous alcohol consumption causes approximately 4% of deaths globally, constituting one of the leading risk factors for the burden of the disease worldwide. Alcohol has several health consequences, such as alcohol-associated liver disease, hepatocellular carcinoma, nonliver neoplasms, physical injury, cardiac disease, and psychiatric disorders. Alcohol misuse significantly affects workforce productivity, with elevated direct and indirect economic costs. Due to the high impact of alcohol consumption on the population, public health has led to the development of a range of strategies to reduce its harmful effects. Regulatory public health policies (PHP) for alcohol can exist at the global, regional, international, national, or subnational levels. Effective strategies incorporate a multilevel, multicomponent approach, targeting multiple determinants of drinking and alcohol-related harms. The World Health Organization categorizes the PHP into eight categories: national plan to fight the harmful consequences of alcohol, national license and production and selling control, taxes control and pricing policies, limiting drinking age, restrictions on alcohol access, driving-related alcohol policies, control over advertising and promotion, and government monitoring systems. These policies are supported by evidence from different populations, demonstrating that determinants of alcohol use depend on several factors such as socioeconomic level, age, sex, ethnicity, production, availability, marketing, and others. Although most policies have a significant individual effect, a higher number of PHP are associated with a lower burden of disease due to alcohol. The excessive consequences of alcohol constitute a call for action, and clinicians should advocate for developing and implementing a new PHP on alcohol consumption.
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Key Words
- ACLF, Acute-on-Chronic Liver Failure
- ALD, Alcohol-associated Liver Disease
- AUC, Area Under the Curve
- AUD, Alcohol Use Disorder
- AUDIT, Alcohol Use Disorders Identification Test
- AUDIT-C, Alcohol Use Disorders Identification Test Concise
- AVT, Alcohol Volumetric Tax
- BAC, Blood Alcohol Concentration
- DALYs, Disability-adjusted life years
- GDP, Gross domestic product
- PHP, Public Health Policies
- PNPLA3, Patatin-like Phospholipase Domain-containing 3
- USA, United States
- USD, United States Dollars
- WHO, World Health Organization
- alcohol use disorders
- alcohol-associated hepatitis
- cirrhosis
- fatty liver disease
- steatosis
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Affiliation(s)
- Gustavo Ayares
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Idalsoaga
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Jorge Arnold
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eduardo Fuentes-López
- Departamento de Ciencias de La Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan P. Arab
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Luis A. Díaz
- Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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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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18
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McGill E, Marks D, Petticrew M, Egan M. Addressing alcohol-related harms in the local night-time economy: a qualitative process evaluation from a complex systems perspective. BMJ Open 2022; 12:e050913. [PMID: 36008081 PMCID: PMC9422880 DOI: 10.1136/bmjopen-2021-050913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES English local authorities (LAs) are interested in reducing alcohol-related harms and may use discretionary powers such as the Late Night Levy (LNL) to do so. This study aims to describe how system stakeholders hypothesise the levy may generate changes and to explore how the system, its actors and the intervention adapt and co-evolve over time. DESIGN A process evaluation from a complex systems perspective, using qualitative methods. SETTING A London LA with high densities of residential and commercial properties, which implemented the LNL in 2014. PARTICIPANTS Data were generated through interviews with LNL implementers and alcohol consumers, observations in bars and during LNL patrols and documentary review. INTERVENTION The LNL allows LAs to charge late-night alcohol retailers an annual fee (£299-£4440) to manage and police the night-time economy (NTE). RESULTS When the LNL was being considered, stakeholders from different interest groups advanced diverse opinions about its likely impacts while rarely referencing supporting research evidence. Proponents of the levy argued it could reduce crime and anti-social behaviour by providing additional funds to police and manage the NTE. Critics of the levy hypothesised adverse consequences linked to claims that the intervention would force venues to vary their hours or close, cluster closing times, reduce NTE diversity and undermine public-private partnerships. In the first 2 years, levy-funded patrols developed relationships with the licensed trade and the public. The LNL did not undermine public-private partnerships and while some premises varied their hours, these changes did not undermine the intervention's viability, nor significantly cluster venue closing times, nor obviously damage the area's reputation for having a diverse NTE. CONCLUSIONS This study applies a framework for process evaluation from a complex systems perspective. The evaluation could be extended to measure alcohol-related outcomes and to consider the interplay between the national and local systems.
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Affiliation(s)
- Elizabeth McGill
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Dalya Marks
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Mark Petticrew
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
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McCambridge J, Garry J, Kypri K, Hastings G. "Using information to shape perception": tobacco industry documents study of the evolution of Corporate Affairs in the Miller Brewing Company. Global Health 2022; 18:52. [PMID: 35597943 PMCID: PMC9123667 DOI: 10.1186/s12992-022-00843-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/03/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The Miller Brewing Company (MBC) was wholly owned by Phillip Morris (PM), between 1970 and 2002. Tobacco industry document studies identify alliances between the alcohol and tobacco industries to counter U.S. policies in the 1980s and 1990s. This investigation sought to study in-depth inter-relationships between MBC and PM, with a particular focus on alcohol policy issues. We used the Truth Tobacco Industry Documents library to trace the evolution of corporate affairs and related alcohol policy orientated functions within and between MBC and PM. RESULTS MBC was structured and led by PM senior executives from soon after takeover in 1970. Corporate Affairs sought to influence public perceptions of alcohol to align them with business interests. Alcohol education was specifically designed to prevent the adoption of policies inimical to those interests (e.g., raising excise taxes). Strategic consideration of alcohol policy issues was integrated within company-wide thinking, which sought to apply lessons from tobacco to alcohol and vice versa. PM directly led key alcohol industry organisations nationally and globally, which have successfully delayed the adoption and implementation of known effective policy measures in the U.S. and worldwide. CONCLUSIONS PM has been a key architect of alcohol industry political strategies. This study builds on earlier work on alcohol companies in the tobacco documents, and offers historical data on how tobacco companies have used commercial involvements in other sectors to influence wider public health policy. We are only beginning to appreciate how multi-sectoral companies internally develop political strategies across product categories. Global health and national governmental policy-making needs to be better protected from business interests that fundamentally conflict with public health goals.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD UK
| | - Jack Garry
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD UK
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20
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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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21
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Hoe C, Weiger C, Minosa MKR, Alonso F, Koon AD, Cohen JE. Strategies to expand corporate autonomy by the tobacco, alcohol and sugar-sweetened beverage industry: a scoping review of reviews. Global Health 2022; 18:17. [PMID: 35164801 PMCID: PMC8845406 DOI: 10.1186/s12992-022-00811-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/31/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Noncommunicable diseases contribute to over 70% of global deaths each year. Efforts to address this epidemic are complicated by the presence of powerful corporate actors. Despite this, few attempts have been made to synthesize existing evidence of the strategies used to advance corporate interests across industries. Given this, our study seeks to answer the questions: 1) Is there an emergent taxonomy of strategies used by the tobacco, alcohol and sugar-sweetened beverage (SSB) industries to expand corporate autonomy? 2) How are these strategies similar and how are they different? METHODS Under the guidance of a framework developed by Arksey and O'Malley, a scoping review was carried out whereby six databases were searched in June 2021 to identify relevant peer-reviewed literature. To be included in this review, studies had to explicitly discuss the strategies used by the tobacco, alcohol, and/or sugar-sweetened beverage multinational corporations and be considered review articles aimed to synthesize existing evidence from at least one of the three industries. Eight hundred and fifty-eight articles were selected for full review and 59 articles were retained for extraction, analysis, and categorization. RESULTS Results identified six key strategies the industries used: 1) influencing government policy making and implementation, 2) challenging unfavorable science, 3) creating a positive image, 4) manipulating markets, 5) mounting legal challenges, and 6) anticipating future scenarios. Despite these similarities, there are few but important differences. Under the strategy of influencing government policy making and implementation, for example, literature showed that the alcohol and SSB industries have been "privileged with high levels of participation" within international public health organizations. CONCLUSIONS Understanding how industries resist efforts to control them is important for public health advocates working to reduce consumption of and death and diseases resulting from harmful commodities. Moreover, there is a greater need for the public health community to generate consensus about how to ethically engage or not engage with industries that produce unhealthy commodities. More studies are also needed to build the evidence base of industry tactics to resist regulation, particularly in the case of SSB, and in low-and middle-income countries.
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Affiliation(s)
- Connie Hoe
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Caitlin Weiger
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Marela Kay R Minosa
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Fernanda Alonso
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Adam D Koon
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Joanna E Cohen
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
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22
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McCambridge J, Mitchell G. The Views of Researchers on the Alcohol Industry's Involvement in Science: Findings from an Interview Study. Eur Addict Res 2022; 28:267-274. [PMID: 35316806 PMCID: PMC9501792 DOI: 10.1159/000522603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/11/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Debates in the peer-reviewed literature on alcohol industry involvement in science have been polarized, with the activities of the International Center on Alcohol Policies and industry provision of research funding being particularly contentious. We aimed to explore researchers' views on the nature of the debates and the issues raised. METHODS Qualitative interview study with experienced researchers working on alcohol policy-relevant topics across ten countries (n = 37). Thematic analysis of views articulated, supported where appropriate by accounts of how experiences informed particular perspectives. RESULTS The main finding is how much common ground there now is among participants, regardless of whether they had previously worked with industry organizations or received alcohol industry funding. Norms have changed and participants agree that the earlier debates were dysfunctional. Participants on all sides of these earlier debates experienced significant psychological burdens as a result of industry-related activity in alcohol research. These include reputational harms from working with industry organizations and/or receiving research funding, and harassment by industry for producing findings contrary to commercial interests. Key ongoing contentious issues include the extent to which conflicts of interest can or should be managed by individual researchers, and how distinct the alcohol industry is from other funders and other industries. Participant views on ways forward include improving the evidence-base underpinning the debates, and having collegiate discussions among researchers, including all strands of opinion and experience. CONCLUSIONS This group of alcohol researchers shares more nuanced contemporary positions on issues relating to industry involvement in science than are reflected in the existing material in peer-reviewed journals. Almost all regard the alcohol industry's involvement in research as having been damaging.
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Affiliation(s)
| | - Gemma Mitchell
- Department of Health Sciences, University of York, York, UK
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23
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Golder S, McCambridge J. Alcohol, cardiovascular disease and industry funding: A co-authorship network analysis of systematic reviews. Soc Sci Med 2021; 289:114450. [PMID: 34607052 PMCID: PMC8586735 DOI: 10.1016/j.socscimed.2021.114450] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Alcohol's effects on heart health is the site of a major scientific controversy. We conducted a co-authorship network analysis of systematic reviews on the impacts on alcohol on cardiovascular disease (CVD) in order to investigate patterns of co-authorship in the literature, with particular attention given to industry funding. METHODS We used Epistemonikos to identify systematic reviews. Review characteristics, influential authors, co-authorship subnetworks, prior histories of alcohol industry funding, study outcomes and citations were investigated. RESULTS 60 systematic reviews with 231 unique authors met our inclusion criteria. 14 systematic reviews were undertaken by authors with histories of alcohol industry funding, including 5 that were funded directly by the alcohol industry itself. All 14 such reviews identified a cardioprotective effect of alcohol. These formed distinct co-authorship subnetworks within the literature. Of reviews by authors with no prior histories of alcohol industry funding, the findings were mixed, with 54% (25/46) concluding there was evidence of health protective effects. These two groups of reviews differed in other respects. Those with industry funding were more likely to study broader outcomes such as 'cardiovascular disease' or 'coronary heart disease' as opposed to specific CVD issues such as hypertension or stroke (93% [13/14] versus 41% [19/46]) (chi-squared 12.4, p < 0.001) and have more included studies (mean of 29 versus 20). They were also more widely cited by others. Over time the proportions of systematic reviews on CVD and alcohol undertaken by authors with no prior histories of alcohol industry funding has increased. CONCLUSIONS Systematic reviews undertaken by authors with histories of alcohol industry funding were more likely to study broader outcomes, and be cited more widely, and exclusively reported favorable conclusions.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, United Kingdom.
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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Atkinson AM, Sumnall H, Meadows B. 'We're in this together': A content analysis of marketing by alcohol brands on Facebook and Instagram during the first UK Lockdown, 2020. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 98:103376. [PMID: 34364199 DOI: 10.1016/j.drugpo.2021.103376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/22/2021] [Accepted: 07/01/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND The closure of on-licence premises and the restrictions placed on citizen's movements and leisure to address the COVID-19 pandemic in 2020, created an unprecedented situation for the alcohol industry. With the availability and supply of alcohol being restricted, and the social context of alcohol use transformed, alcohol corporations were required to adapt their marketing materials and actions in response. METHODS A content analysis of alcohol marketing by 18 alcohol brands on Facebook and Instagram during the first UK national lockdown (from 17th March- 4th July 2020) was conducted. Comments left by social media followers on posts advertising what could be defined as brand COVID-19 Corporate Social Responsibility (CSR) initiatives (i.e. monetary donations, production of hand sanitiser) were thematically analysed. FINDINGS Alcohol brands quickly adapted to the changing social, economic and health context of the global pandemic. Changes to the availability and sale of alcohol were evident, with brands encouraging the stockpiling of alcohol as an essential item through predominantly online sales and delivery services. Brands also adapted to the changing social and physical context of alcohol use and intensified encouragement of home drinking. Messages of togetherness underpinned the promotion of virtual interactions, for which alcohol use was presented as a key component. Consumers were encouraged to contribute to pandemic responses by 'staying at home', and consuming alcohol. Importantly, COVID-19 provided a useful marketing opportunity for alcohol producers to present themselves as private partners to a primarily public sector response, through innovative CSR initiatives such as philanthropic donations to help prevent the transmission of COVID-19. An inductive thematic analysis of online comments on CSR posts found that such activities were interpreted by consumers as ethical actions, and that they reinforced positive brand image and loyalty amongst existing and new consumers. CONCLUSION Alcohol corporations are highly resilient in times of crises and the brands analysed were able to quickly adapt their marketing to the COVID-19 pandemic. Future research is required to examine whether these profitable strategies are maintained post pandemic.
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Affiliation(s)
- Amanda Marie Atkinson
- Public Health Institute, Liverpool John Moores University Liverpool, United Kingdom.
| | - Harry Sumnall
- Public Health Institute, Liverpool John Moores University Liverpool, United Kingdom
| | - Beth Meadows
- Public Health Institute, Liverpool John Moores University Liverpool, United Kingdom
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van Schalkwyk MCI, Maani N, Pettigrew S, Petticrew M. Corporate ventriloquism undermines action on alcohol harms. BMJ 2021; 374:n1879. [PMID: 34344716 DOI: 10.1136/bmj.n1879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Nason Maani
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
| | - Simone Pettigrew
- George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
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26
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Mitchell G, McCambridge J. The 'snowball effect': short and long-term consequences of early career alcohol industry research funding. ADDICTION RESEARCH & THEORY 2021; 30:119-125. [PMID: 35299957 PMCID: PMC8919977 DOI: 10.1080/16066359.2021.1952190] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 05/31/2023]
Abstract
Despite extensive evidence of bias resulting from industry sponsorship of research across health sciences, and longstanding concerns about alcohol industry research funding, there has not been a strong tradition of empirical research on this subject. This study explores researcher decision-making regarding industry funding at the early career stage and the consequences of such funding. Data were derived from semi-structured interviews with researchers working on alcohol policy-relevant topics who first received alcohol industry funding early in their careers (n = 7). Data were analyzed thematically using NVivo software. These early-career researchers largely initiated contact with the industry by applying for funding, mostly from industry research funding organizations. Their decisions were shaped by their research environments, where seeking alcohol industry funding early in careers was normative, in large part due to senior colleagues and peers having connections to the industry. Despite being 'no strings attached' a 'snowball' effect occurred, whereby initial funding led to more industry funding and other opportunities. Receiving early career industry funding had long-term consequences for researchers, not only shaping research networks but also leading to reputational harms as norms around the acceptability of industry funding changed. Exploring this controversial subject in the context of researcher careers adds depth and meaning to larger quantitative studies on bias resulting from industry sponsorship, and identifies mechanisms through which bias may be produced. Further research is required to study the impact of these processes on alcohol policy-relevant research agendas, and also to explore the wider generalizability of these exploratory findings.
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Affiliation(s)
- Gemma Mitchell
- Department of Health Sciences, University of York, Heslington, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, UK
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Nyemcsok C, Pitt H, Kremer P, Thomas SL. Expert by Experience engagement in gambling reform: qualitative study of gamblers in the United Kingdom. Health Promot Int 2021; 37:6327920. [PMID: 34304273 DOI: 10.1093/heapro/daab077] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
To explore how Experts by Experience (EbyE) conceptualize key priorities for preventing and reducing gambling-related harm in the United Kingdom (UK). To identify barriers and facilitators to EbyE engagement in decisions for gambling research, education, treatment (RET) and policy development. Qualitative study utilizing semi-structured interviews with 20 participants from the UK between March and July 2020. Gamblers aged 29-60 years who self-reported that they had experienced gambling-related harm, and who actively used their experiences to inform strategies to prevent and reduce gambling-related harm in the UK. Participants were motivated to: advocate for gambling reform, and raise awareness of their experiences of gambling addiction or disorder. Gambling regulation was described as not adequately keeping pace with gambling industry practices, with initiatives needed to prevent the harms associated with product design, how individuals engaged with products and marketing practices. The reliance on voluntary contributions by the gambling industry for RET was perceived as a potential barrier to reform. Participants recommended new independent structures which engaged EbyE in meaningful ways in contributing to decision-making. An independent body run by and for EbyE was one mechanism that participants perceived could represent the voices of those impacted by gambling-related harm. Individuals with a lived experience of gambling-related harm, including affected social network members, bring a range of unique experiences and perspectives, and should be seen as valuable stakeholders in co-producing strategies to prevent and reduce gambling-related harm.
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Affiliation(s)
- Christian Nyemcsok
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Hannah Pitt
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
| | - Peter Kremer
- Centre for Sport Research, School of Exercise & Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia
| | - Samantha L Thomas
- Institute for Health Transformation, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Australia
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McCambridge J. Reimagining brief interventions for alcohol: towards a paradigm fit for the twenty first century? : INEBRIA Nick Heather Lecture 2019: This lecture celebrates the work of Nick Heather in leading thinking in respect of both brief interventions and wider alcohol sciences. Addict Sci Clin Pract 2021; 16:41. [PMID: 34187582 PMCID: PMC8243462 DOI: 10.1186/s13722-021-00250-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background There is no longer support for the idea that brief intervention programmes alone can contribute meaningfully to the improvement of population health relating to alcohol. As a result, calls for major innovations and paradigm shifts grow, notably among research leaders. This paper briefly examines the history of the development of the evidence-base from the landmark World Health Organisation projects on Screening and Brief Intervention (SBI) in the 1980s onwards. Particular attention is given to weaknesses in the theorisation of social influence and interventions design, and declining effect sizes over time. Although the old SBI paradigm may be exhausted where it has been applied, it has not been replaced by a new paradigm. Alcohol marketing encourages heavy drinking and today may have more powerful effects on thinking about alcohol, and about alcohol problems, than previously. The nature of the societal challenge being faced in an alcogenic environment in which alcohol is widely promoted and weakly regulated underpins consideration of the possibilities for contemporary evidence-informed public health responses. Evidence-informed perspectives in discourses on alcohol problems need to be strengthened in redeveloping rationales for brief interventions. This process needs to move away from sole reliance on a model based on a two-person discussion of alcohol, which is divorced from wider concerns the person may have. Reimagining the nature of brief interventions involves incorporating digital content, emphasising meso-level social processes based on material that people want to share, and seeking synergies with macro-level population and media issues, including alcohol policy measures. Conclusions Current versions of brief interventions may be simply too weak to contend with the pressures of an alcogenic environment. A new generation of brief interventions could have a key role to play in developing multi-level responses to the problems caused by alcohol.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK.
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Mitchell G, McCambridge J. Recruitment, risks, rewards and regrets: Senior researcher reflections on working with alcohol industry social aspects organisations. Drug Alcohol Rev 2021; 41:27-35. [PMID: 34170047 DOI: 10.1111/dar.13342] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/09/2021] [Accepted: 05/30/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION A growing body of literature suggests alcohol industry corporate social responsibility activity, including the creation of 'social aspects' organisations (SAO), may harm rather than improve public health. We aimed to explore established researcher experiences of working with SAOs, and the factors informing their decisions to do so. METHODS Qualitative interview study with senior alcohol researchers who had previous or ongoing connections to SAOs or their predecessors initiated when their careers were established (n = 16). Thematic analysis using NVivo software. RESULTS Established researchers were recruited for their expertise by alcohol industry SAOs via employees who were previously academics or via academic colleagues with SAO connections. Motivated by the desire to improve public health and 'reach out' beyond academia, researchers were confident that they could maintain their independence when sharing their expertise with SAOs. Short-term connections included attendance at SAO-funded events and book chapter contributions. Sometimes, these led to long-term relationships with SAOs, or researchers were invited to long-term roles by a colleague. These included memberships of scientific advisory committees, board positions, or work as independent consultants. Most researchers reflected negatively on their experiences and had ended their associations, while some had positive experiences. DISCUSSION AND CONCLUSION Current and former researchers play key roles in initiating connections with SAOs, with industry-funded events and invitations to long-term roles by trusted colleagues, mechanisms used to facilitate the development of such relationships. Our study adds to existing evidence that SAO scientific activity does not contribute to public health goals, but does present industry with public relations opportunities.
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Affiliation(s)
- Gemma Mitchell
- Department of Health Sciences, University of York, York, UK
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30
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Golder S, Garry J, McCambridge J. Declared funding and authorship by alcohol industry actors in the scientific literature: a bibliometric study. Eur J Public Health 2021; 30:1193-1200. [PMID: 32939544 PMCID: PMC7733050 DOI: 10.1093/eurpub/ckaa172] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Alcohol industry actors are known to be involved in scientific research. Despite concerns regarding bias, the extent of involvement and coverage of this research are unknown. Methods We aimed to investigate the extent and type of scientific research 1918–2019 which was supported by the alcohol industry, including alcohol companies themselves and other organizations, such as trade associations. We identified bibliographic records from the Web of Science suite of databases which have named alcohol companies or organizations in the fields relating to author affiliations and support declarations. We then ascertained trends in publications over time, type of support, funding, outlets (such as journal titles), subject areas covered (such as health) and named companies (such as Carlsberg) and organizations (such as Drinkaware). Results The analysis included 13 481 unique records, 11 014 (82%) were authored or funded by alcohol companies and 2488 (18%) were authored or funded by other organizations. The majority of the records (90%, 12 157/13 481) were journal publications. The most common subject areas covered by the publications were biology (5415/13 481, 40%), chemistry (3937/13 481, 29%) and health (3707/13 481, 27%). In line with general publishing trends, there has been an overall increase in research funded or supported by alcohol companies and organizations since records began. The main exception is the steady decline in company author affiliations, particularly in health-related topics since the mid-1990s. Conclusions Alcohol companies and related organizations are extensively involved in or supporting scientific research according to data in Web of Science. This does not, however, necessarily reflect the totality of scientific research produced by alcohol companies and related organizations.
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Affiliation(s)
- Su Golder
- Department of Health Sciences, University of York, York, UK
- Correspondence: Su Golder, Department of Health Sciences, University of York, York YO10 5DD, UK, Tel: +44 (0) 1904 321904, Fax: 01904 321383, e-mail:
| | - Jack Garry
- Department of Health Sciences, University of York, York, UK
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31
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Legg T, Hatchard J, Gilmore AB. The Science for Profit Model-How and why corporations influence science and the use of science in policy and practice. PLoS One 2021; 16:e0253272. [PMID: 34161371 PMCID: PMC8221522 DOI: 10.1371/journal.pone.0253272] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 06/01/2021] [Indexed: 12/15/2022] Open
Abstract
Science has been at the centre of attempts by major industries, including tobacco, chemical, and pharmaceutical, to delay progress in tackling threats to human and planetary health by, inter alia, obscuring industry harms, and opposing regulation. Some aspects of this influence are well documented, others remain poorly understood, and similarities between industries remain underexplored. This study, therefore, aims to synthesise the literature to develop an evidence-based typology and model of corporate influence on science in order to provide an overview of this multi-faceted phenomenon. We obtained literature examining corporate attempts to influence science and the use of science in policy and practice from: database searches, bibliographies, expert recommendations, and web alerts; using a modified scoping review methodology (n = 68). Through interpretive analysis we developed the Science for Profit Typology and Model. We identified eight corporate sectors repeatedly engaging in activities to influence science, including: manipulation of scientific methods; reshaping of criteria for establishing scientific "proof"; threats against scientists; and clandestine promotion of policy reforms that increase reliance on industry evidence. The typology identifies five macro-level strategies used consistently across the eight industries, comprising 19 meso-level strategies. The model shows how these strategies work to maximise the volume, credibility, reach, and use of industry-favourable science, while minimising these same aspects of industry-unfavourable science. This creates doubt about harms of industry products/practices or efficacy of policies affecting industry; promotes industry-favoured policy responses and industry products as solutions; and legitimises industry's role as scientific stakeholder. These efforts ultimately serve to weaken policy, prevent litigation, and maximise use of industry products/practices-maximising corporate profitability. We provide an accessible way to understand how and why corporations influence science, demonstrate the need for collective solutions, and discuss changes needed to ensure science works in the public interest.
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Affiliation(s)
- Tess Legg
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
| | - Jenny Hatchard
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
| | - Anna B. Gilmore
- Department for Health, Tobacco Control Research Group, University of Bath, Bath, United Kingdom
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32
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Lesch M, McCambridge J. Policy communities, devolution and policy transfer: The case of alcohol pricing in Wales. REGIONAL & FEDERAL STUDIES 2021; 33:163-185. [PMID: 37082296 PMCID: PMC10108489 DOI: 10.1080/13597566.2021.1934454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study investigates how processes of horizontal policy transfer can unfold in the context of devolution, examining the development of legislation on minimum unit pricing (MUP) in Wales, following on from Scotland's earlier policy decision. The study draws on a range of sources, including primary documents, media coverage, and interviews with policy participants. Our analysis identifies the importance of the specific character of Welsh political institutions, particularly the emphasis given to participation and consultation in policymaking. In the case of MUP, we document a process of policy-oriented learning, where policymakers made a concerted effort to draw on an assortment of expertise and experiences, including but not limited to the Scottish model. We also find that the Welsh public health policy community was well placed to support the framing of MUP and to address limitations in policy capacity. The findings hold implications for future studies of learning, devolution, and alcohol policy more generally.
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Affiliation(s)
- Matthew Lesch
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK
| | - Jim McCambridge
- Department of Health Sciences, Mental Health and Addiction Research Group, University of York, York, UK
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33
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Petticrew M, Fitzgerald N, Maani N, McCambridge J, Pettigrew S, van Schalkwyk M. Responsible Drinking, Conflicts of Interest, and the Elephant in the Room: A Commentary on A Scoping Review of "Responsible Drinking" Interventions by Gray, Williams & Shaffer (2020). HEALTH COMMUNICATION 2021; 36:257-259. [PMID: 32981342 DOI: 10.1080/10410236.2020.1827541] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
| | | | - Nason Maani
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
- School of Public Health, Boston University
| | | | | | - May van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine
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Drummond C, Hillyard M, Leonhardt M, Wurst F, Dom G, Mann K, Bramness JG. Comparison of European Clinical Guidelines on the Management of Alcohol Use Disorders. Eur Addict Res 2021; 27:227-236. [PMID: 33291106 DOI: 10.1159/000512112] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/23/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Alcohol is a leading cause of morbidity and mortality in the European region, and tackling the harmful use of alcohol is a public health priority. Most countries in the region have national strategies for treating alcohol use disorders (AUD), but there is significant between-country variation. OBJECTIVES This study aimed to compare clinical guidelines for the management of AUD from countries of the European region and to determine whether countries' relative wealth or quality of their health systems had affected the guidelines. METHODS A survey was conducted of 24 countries. The survey encompassed how AUD clinical guidelines were researched, the range and expertise of contributors, which topics of AUD treatment were included, the definition of a "standard drink" used, and the publishing, funding, endorsement, and dissemination of the guideline. RESULTS Twenty-one of the 24 countries surveyed had a clinical guideline for AUD. All guidelines were underpinned by a literature review, and psychiatrists were the professional group most commonly involved in producing them. Most of the guidelines covered typical cornerstones of AUD care such as treatment of alcohol dependence, pharmacotherapy for relapse prevention, and detoxification. Definitions of a "standard drink" ranged from 8 to 20 grams of ethanol. Governments or governmental bodies were the main publishers and funders of guidelines, and the vast majority of guidelines were freely available online. There were no statistically significant effects of GDP, GDP per capita, or World Health Organization's World Health Report rankings on whether countries were more likely to have an AUD clinical guideline, to have performed a systematic literature review, or to have involved service users in producing their guideline. CONCLUSIONS The results of this survey reflect widespread good practice in producing AUD clinical guidelines across European countries. Regional research collaborations could offer significant time and cost savings in producing the evidence base from which guidelines are then written.
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Affiliation(s)
- Colin Drummond
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom,
| | - Miriam Hillyard
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Marja Leonhardt
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway and VID Specialized University, Faculty of Health Science, Oslo, Norway
| | - Frieder Wurst
- Psychiatry Department, Psychiatric University Hospital Basel, Basel, Switzerland.,Center for Interdisciplinary Addiction Research, Hamburg University, Hamburg, Germany
| | - Geert Dom
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), Antwerp University, Wilrijk, Belgium
| | - Karl Mann
- The Central Institute of Mental Health (CIMH), Mannheim, Germany
| | - Jørgen G Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway and Institute of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
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Conde K, Peltzer RI, Pantani D, Pinsky I, Cremonte M. Alcohol industry, corporate social responsibility and country features in Latin America. Drug Alcohol Rev 2020; 40:423-430. [PMID: 33156567 DOI: 10.1111/dar.13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION AND AIMS Research on corporate behaviour can contribute to the understanding of the possible adverse impacts of alcohol-industry corporate social responsibility (CSR) initiatives and their potential influence on policymaking. This study explores the association between alcohol-industry CSR activities and selected country features in Latin America and the Caribbean. DESIGN AND METHODS Nine health experts evaluated 148 CSR activities using a standardised protocol; activities were classified into the categories risk management CSR (rmCSR), that is, to avoid/rectify externalities (n = 67), and strategic CSR, that is, to fulfill philanthropic responsibilities (n = 81). We evaluated the associations, separately, between the number of rmCSR and of strategic CSR actions in each country with threats from public health measures (specifically, the level of research into alcohol consumption and harms, the existence of an alcohol surveillance system and the number of governmental alcohol policy actions) and per capita alcohol consumption; we adjusted by economic indices (country income level and the gross domestic product) and population size. RESULTS Multivariate analyses showed that the higher the level of alcohol research within a country and its per capita consumption, the more likely rmSCR activities were to occur, independently of the country's economic development or population. DISCUSSION AND CONCLUSIONS Results suggest rmSCR actions could be implemented as a way to preserve markets by counteracting scientific evidence about alcohol related harms. This evidence could serve as a starting point to future research, contributing to the understanding of alcohol industry behaviour and the advancement of effective public policies.
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Affiliation(s)
- Karina Conde
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
| | - Raquel Inés Peltzer
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
| | - Daniela Pantani
- Department of Preventive Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Ilana Pinsky
- School of Public Health, City University of New York, New York, USA
| | - Mariana Cremonte
- Institute of Basic, Applied and Technologic Psychology, National Scientific and Technical Research Council, National University of Mar del Plata, Mar del Plata, Argentina
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Hill SE, Friel S. 'As Long as It Comes off as a Cigarette Ad, Not a Civil Rights Message': Gender, Inequality and the Commercial Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7902. [PMID: 33137876 PMCID: PMC7663661 DOI: 10.3390/ijerph17217902] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 12/12/2022]
Abstract
Scholarship on the commercial determinants of health (CDoH) has sought to understand the multiple ways corporate policies, practices and products affect population health. At the same time, gender is recognised as a key determinant of health and an important axis of health inequalities. To date, there has been limited attention paid to the ways in which the CDoH engage with and impact on gender inequalities and health. This review seeks to address this gap by examining evidence on the practices and strategies of two industries-tobacco and alcohol-and their interaction with gender, with a particular focus on women. We first describe the practices by which these industries engage with women in their marketing and corporate social responsibility activities, reinforcing problematic gender norms and stereotypes that harm women and girls. We then examine how tobacco and alcohol companies contribute to gender inequalities through a range of strategies intended to protect their market freedoms and privileged position in society. By reinforcing gender inequalities at multiple levels, CDoH undermine the health of women and girls and exacerbate global health inequalities.
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Affiliation(s)
- Sarah E. Hill
- Global Health Policy Unit, University of Edinburgh, Edinburgh EH8 9LD, UK
| | - Sharon Friel
- Menzies Centre for Health Governance, School of Regulation and Global Governance (RegNet), Australian National University, Canberra ACT0200, Australia;
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Petticrew M, Maani N, Pettigrew L, Rutter H, VAN Schalkwyk MC. Dark Nudges and Sludge in Big Alcohol: Behavioral Economics, Cognitive Biases, and Alcohol Industry Corporate Social Responsibility. Milbank Q 2020; 98:1290-1328. [PMID: 32930429 PMCID: PMC7772646 DOI: 10.1111/1468-0009.12475] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Policy Points Nudges steer people toward certain options but also allow them to go their own way. “Dark nudges” aim to change consumer behavior against their best interests. “Sludge” uses cognitive biases to make behavior change more difficult. We have identified dark nudges and sludge in alcohol industry corporate social responsibility (CSR) materials. These undermine the information on alcohol harms that they disseminate, and may normalize or encourage alcohol consumption. Policymakers and practitioners should be aware of how dark nudges and sludge are used by the alcohol industry to promote misinformation about alcohol harms to the public.
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Affiliation(s)
| | - Nason Maani
- London School of Hygiene and Tropical Medicine.,Boston University School of Public Health
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Oral Health Inequalities and the Corporate Determinants of Health: A Commentary. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186529. [PMID: 32911694 PMCID: PMC7559480 DOI: 10.3390/ijerph17186529] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 11/17/2022]
Abstract
Empirical research critically examining the role of the corporate determinants of health has gained traction in the past few years. Many of these reports have received strong, sometimes litigious, backlash from the corporations exposed. The aim of this paper is to provide a critical commentary on existing literature, policies, procedures and observations of issues, especially regarding the use of the corporate determinants of health as a research construct, in the persistence and flourishing of oral health inequalities at a global level. We discuss theoretical frameworks that underpin the power constructs of the corporate determinants of health, including Lukes “three faces of power” theory. This theory posits that power is exercised in three ways: through decision-making, through non-decision-making and ideologically. We will demonstrate, using examples of corporate determinants of health and oral health inequalities from several countries, how intervening at key leverage points is a crucial strategy for improving oral health inequalities at a global level.
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Nakkash R, Ali A, Alaouie H, Asmar K, Hirschhorn N, Mugharbil S, Nuwayhid I, London L, Saban A, Rashid SF, Ahmed MK, Knai C, Bigland C, Afifi RA. Attitudes and practices of public health academics towards research funding from for-profit organizations: cross-sectional survey. Int J Public Health 2020; 65:1133-1145. [PMID: 32840634 PMCID: PMC7497330 DOI: 10.1007/s00038-020-01416-0] [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: 01/31/2020] [Revised: 06/16/2020] [Accepted: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives The growing trend of for-profit organization (FPO)-funded university research is concerning because resultant potential conflicts of interest might lead to biases in methods, results, and interpretation. For public health academic programmes, receiving funds from FPOs whose products have negative health implications may be particularly problematic. Methods A cross-sectional survey assessed attitudes and practices of public health academics towards accepting funding from FPOs. The sampling frame included universities in five world regions offering a graduate degree in public health; 166 academics responded. Descriptive, bivariate, and logistic regression analyses were conducted. Results Over half of respondents were in favour of accepting funding from FPOs; attitudes differed by world region and gender but not by rank, contract status, % salary offset required, primary identity, or exposure to an ethics course. In the last 5 years, almost 20% of respondents had received funding from a FPO. Sixty per cent of respondents agreed that there was potential for bias in seven aspects of the research process, when funds were from FPOs. Conclusions Globally, public health academics should increase dialogue around the potential harms of research and practice funded by FPOs. Electronic supplementary material The online version of this article (10.1007/s00038-020-01416-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rima Nakkash
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Ahmed Ali
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Hala Alaouie
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil Asmar
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Sanaa Mugharbil
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Iman Nuwayhid
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Leslie London
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Amina Saban
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Sabina Faiz Rashid
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Md Koushik Ahmed
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Cecile Knai
- London School of Hygiene and Tropical Medicine, London, UK
| | - Charlotte Bigland
- UK Specialty Registrar, Severn Postgraduate Medical Education School of Public Health, Health Education England, London, UK
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, 145 N Riverside Drive, Iowa City, IA, USA.
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Maani N, Collin J, Friel S, Gilmore AB, McCambridge J, Robertson L, Petticrew MP. Bringing the commercial determinants of health out of the shadows: a review of how the commercial determinants are represented in conceptual frameworks. Eur J Public Health 2020; 30:660-664. [PMID: 31953933 PMCID: PMC7445044 DOI: 10.1093/eurpub/ckz197] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The term 'commercial determinants of health' (CDOH) is increasingly focussing attention upon the role of tobacco, alcohol and food and beverage companies and others-as important drivers of non-communicable diseases (NCDs). However, the CDOH do not seem to be clearly represented in the most common social determinants of health (SDOH) frameworks. We review a wide range of existing frameworks of the determinants of health to determine whether and how commercial determinants are incorporated into current SDOH thinking. METHODS We searched for papers and non-academic reports published in English since 2000 describing influences on population health outcomes. We included documents with a formal conceptual framework or diagram, showing the integration of the different determinants. RESULTS Forty-eight framework documents were identified. Only one explicitly included the CDOH in a conceptual diagram. Ten papers discussed the commercial determinants in some form in the text only and fourteen described negative impacts of commercial determinants in the text. Twelve discussed positive roles for the private sector in producing harmful commodities. Overall, descriptions of commercial determinants are frequently understated, not made explicit, or simply missing. The role of commercial actors as vectors of NCDs is largely absent or invisible in many of the most influential conceptual diagrams. CONCLUSIONS Our current public health models may risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping the broader environment and individual behaviours, and thus population health outcomes.
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Affiliation(s)
- Nason Maani
- London School of Hygiene and Tropical Medicine, London, UK
- School of Public Health, Boston University, Boston, MA, USA
| | - Jeff Collin
- Global Health Policy Unit, School of Social and Political Science, University of Edinburgh, Edinburgh, UK
- SPECTRUM Consortium, UK
| | - Sharon Friel
- SPECTRUM Consortium, UK
- School of Regulation and Global Governance (RegNet), College of Asia and the Pacific, The Australian National University, Canberra, ACT, Australia
| | - Anna B Gilmore
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, UK
| | - Lindsay Robertson
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Mark P Petticrew
- London School of Hygiene and Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
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Non-market strategy as a framework for exploring commercial involvement in health policy: A primer. Soc Sci Med 2020; 262:113257. [PMID: 32771875 DOI: 10.1016/j.socscimed.2020.113257] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 11/22/2022]
Abstract
This paper outlines the role of non-market strategy and its relevance to public health. Three broad categories of non-market activity are described: corporate political activity, Corporate Social Responsibility (CSR) and legal activity, with examples relevant to public health. The importance to public health researchers of considering business activity through a non-market lens has been outlined. Using a non-market strategy perspective can assist with understanding the commercial determinants of health and analysing the writing of the 'rules of the game'.
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Lesch M, McCambridge J. Reconceptualising the study of alcohol policy decision-making: the contribution of political science. ADDICTION RESEARCH & THEORY 2020; 29:427-435. [PMID: 34566546 PMCID: PMC8460360 DOI: 10.1080/16066359.2020.1773445] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 05/28/2023]
Abstract
In this article, we demonstrate the applicability of a 3-I (interests, institutions, and ideas) framework to alcohol policy research. The analysis uses literature from political science research to provide a core theoretical framework. To help illustrate the argument, we draw on relevant examples from alcohol policy in the UK as well as initial findings from an ongoing research study on minimum-unit pricing in Wales. The Welsh case study provides an opportunity to examine the value of the framework in generating testable hypotheses in alcohol policy research. We find that several interrelated factors promoted policy change in Wales, including the government's power to legislate on matters of public health (institutionally), a relatively weak alcohol industry (a key interest group), and a public health community with specific policy arguments on why and how to tackle alcohol-related harms (ideas). Our analysis has important implications for public health research and evidence-based policymaking. It suggests that the uptake of new ideas depends on the existing configuration of interests, institutions and ideas. This analysis provides alcohol policy researchers with a portable framework for analysing the policy context.
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Affiliation(s)
- Matthew Lesch
- Department of Health Sciences, University of York, York, United Kingdom
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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McCambridge J, Kypri K, Sheldon TA, Madden M, Babor TF. Advancing public health policy making through research on the political strategies of alcohol industry actors. J Public Health (Oxf) 2020; 42:262-269. [PMID: 31220307 PMCID: PMC7297281 DOI: 10.1093/pubmed/fdz031] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 02/04/2019] [Indexed: 12/16/2022] Open
Abstract
Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Kypros Kypri
- School of Medicine & Public Health, University of Newcastle, Australia
| | - Trevor A Sheldon
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Mary Madden
- Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York YO10 5DD, UK
| | - Thomas F Babor
- Department of Community Medicine and Health Care, UConn Health, Farmington, Connecticut
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Lim AWY, van Schalkwyk MCI, Maani Hessari N, Petticrew MP. Pregnancy, Fertility, Breastfeeding, and Alcohol Consumption: An Analysis of Framing and Completeness of Information Disseminated by Alcohol Industry-Funded Organizations. J Stud Alcohol Drugs 2020. [PMID: 31603753 PMCID: PMC6811724 DOI: 10.15288/jsad.2019.80.524] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective: Alcohol use during pregnancy can harm the developing fetus. The exact amount, pattern, and critical period of exposure necessary for harm to occur are unclear, although official guidance often emphasizes precautionary abstention. The impacts on fertility and breastfeeding are also unclear. Information on alcohol and pregnancy is disseminated by the alcohol industry–funded organizations, and there are emerging concerns about its accuracy, suggesting the need for detailed analysis. Method: Information on alcohol consumption in relation to fertility, pregnancy, and breastfeeding was extracted from the websites of 23 alcohol industry–funded bodies (e.g., Drinkaware [United Kingdom] and DrinkWise [Australia]), and 19 public health organizations (e.g., Health.gov and NHS Choices). Comparative qualitative and quantitative analysis of the framing and completeness of this information was undertaken. Results: Alcohol industry–funded organizations were statistically significantly less likely than public health websites to provide information on fetal alcohol spectrum disorder and less likely to advise that no amount of alcohol is safe during pregnancy. They were significantly more likely to emphasize uncertainties and less likely to use direct language (e.g., “don’t drink”). Some alcohol industry–funded (and no public health) websites appear to use “alternate causation” arguments, similar to those used by the tobacco industry, to argue for causes of alcohol harms in pregnancy other than alcohol. Conclusions: Alcohol industry–funded websites omit and misrepresent the evidence on key risks of alcohol consumption during pregnancy. This may “nudge” women toward continuing to drink during pregnancy. These findings suggest that alcohol industry–funded bodies may increase risk to pregnant women by disseminating misinformation. The public should be made widely aware of the risks of obtaining health information from alcohol industry–funded sources.
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Affiliation(s)
- Audrey W Y Lim
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - May C I van Schalkwyk
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Nason Maani Hessari
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mark P Petticrew
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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45
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McCambridge J, Coleman R, McEachern J. Public Health Surveillance Studies of Alcohol Industry Market and Political Strategies: A Systematic Review. J Stud Alcohol Drugs 2020. [PMID: 31014459 PMCID: PMC6582508 DOI: 10.15288/jsad.2019.80.149] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This review examines public health surveillance (PHS) studies of alcohol industry actors that explore the implications of the integration of business and political strategies for public health. METHOD Eligible for inclusion were studies published in English language peer-reviewed journals since 1980 that sought to investigate both alcohol industry business and political strategies and their implications for public health. Studies were also required to present economic, political, and health data together. Seven databases were searched until May 2018. RESULTS Six studies were identified as eligible for inclusion in this review, undertaken in high-, middle-, and low-income countries and published between 2000 and 2015. Political strategies are driven largely by business interests, whether at the company, sectoral, or industry level, and corporate social responsibility activities may be integrated within overall strategies. There is a high degree of collaboration in political strategy development between companies, facilitated by growing concentration among global producers operating in increasingly oligopolistic markets. There are limited insights into the dynamics of market competition and limited methodological data available. CONCLUSIONS PHS studies play a valuable role in identifying aspects of alcohol industry strategies that warrant more detailed and carefully designed research, as well as in elucidating global health implications. Further research in PHS and other kinds of studies will assist efforts to reduce the global burden of disease caused by alcohol.
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Affiliation(s)
- Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Rachel Coleman
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
| | - Julie McEachern
- Department of Health Sciences, University of York, Heslington, York, United Kingdom
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46
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Mitchell G, Lesch M, McCambridge J. Alcohol Industry Involvement in the Moderate Alcohol and Cardiovascular Health Trial. Am J Public Health 2020; 110:485-488. [PMID: 32078349 DOI: 10.2105/ajph.2019.305508] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The National Institutes of Health stopped the worldwide Moderate Alcohol and Cardiovascular Health (MACH) trial in 2018 because of institutional failings that led to the biased design of this major study. Drawing on e-mail correspondence among officials, researchers, and alcohol companies, we provide the first, to our knowledge, detailed analysis of alcohol industry involvement in the MACH trial.Alcohol companies agreed to fund the MACH trial to advance their commercial interests rather than to help answer a major scientific question. Alcohol industry executives seized opportunities presented by discussions of the MACH trial to try to influence this study and wider public health, research, and policy decision-making.The process of soliciting research funding from corporations, which included convincing alcohol companies that the study design supported their commercial interests, was intrinsically biased. Thus, the three parties-research funding officials, researchers, and industry executives-coproduced the biased trial design. A detailed understanding of this episode will be helpful in advancing efforts to protect public health research from biases associated with corporate donations.
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Affiliation(s)
- Gemma Mitchell
- All of the authors are with the Department of Health Sciences, University of York, York, UK
| | - Matthew Lesch
- All of the authors are with the Department of Health Sciences, University of York, York, UK
| | - Jim McCambridge
- All of the authors are with the Department of Health Sciences, University of York, York, UK
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47
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Corporate social responsibility vs. financial interests: the case of responsible gambling programs. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01219-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Abstract
Aim
Corporate social responsibility (CSR) is supposed to play an important part in public health. Critics argue that opposing financial interests can prevent companies from implementing effective CSR programs. We shed light on this discussion by analyzing CSR programs of gambling operators.
Subjects and methods
Two data sets are used: (1) seven responsible gambling (RG) programs of German slot machine hall operators and (2) a survey carried out among 512 problem gamblers in treatment who play primarily in slot machines halls.
Results
Results show that the RG programs list mostly mandatory measures with one major exception: to approach possible problem gamblers with the intention to help them. However, operators’ staff approach only 1% of problem gamblers.
Conclusion
We argue that the observed ineffective implementation of voluntary CSR measures is grounded in the strong financial incentive of operators to serve precisely the group they should stop from playing: problem gamblers. We conclude that financial interests reduce the effectiveness of CSR.
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48
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Hydes TJ, Williams R, Sheron N. Exploring the gap in the public's understanding of the links between alcohol and cancer. Clin Med (Lond) 2020; 20:4-7. [PMID: 31941725 PMCID: PMC6964189 DOI: 10.7861/clinmed.ed.20.1.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Theresa J Hydes
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Roger Williams
- Foundation for Liver Research, London, UK and King's College London, London, UK
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49
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Hawkins B, McCambridge J. Public-private partnerships and the politics of alcohol policy in England: the Coalition Government's Public Health 'Responsibility Deal'. BMC Public Health 2019; 19:1477. [PMID: 31747916 PMCID: PMC6865032 DOI: 10.1186/s12889-019-7787-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 10/16/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The 2010-2015 Conservative-led Coalition Government launched their flagship Public Health Responsibility Deal (PHRD) for England in 2011; a year before their alcohol strategy. This co-regulatory regime placed alcohol industry actors at the heart of policy-making, but was viewed with scepticism by public health actors. This article examines the ways in which the PHRD structured the alcohol policy environment throughout this period, which included the rejection of evidence-based policies such as minimum unit pricing. METHODS This article draws on 26 semi-structured interviews with policy actors (parliamentarians, civil servants, civil society actors and academics) in 2018. Respondents were identified and recruited using purposive sampling. Interviews were recorded, transcribed and analysed using thematic coding. RESULTS The PHRD shaped the context of alcohol policy development at Westminster throughout this period. It circumscribed the policy space by taking evidence-based measures not amenable to industry partnership off the agenda. While the PHRD created important opportunities for industry engagement with policy-makers, it undermined public health actors' access to government, particularly following their withdrawal from the process. Moreover, the PHRD demonstrates the enduring appeal of partnership as a policy idea for governments, despite a lack of evidence of their effectiveness. CONCLUSIONS This study of the PHRD demonstrates the ways in which industry actors are able to influence policy through long-term relationship building and partnership working on policy decision-making. Whilst such partnership approaches may appear to have the potential to mitigate some of alcohol harms, they create fundamental conflicts of interest, and may undermine the very causes they seek to further.
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Affiliation(s)
- Benjamin Hawkins
- Faculty fo Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Plave, London, WC1H9SH, UK.
| | - Jim McCambridge
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
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50
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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: 170] [Impact Index Per Article: 34.0] [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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