Addiction industry studies: understanding how proconsumption influences block effective interventions

A review of Returned and Services League venues operating electronic gambling machines in Victoria, Australia and the level of funding contributed to veterans

OBJECTIVE

Globally, funding 'good causes' is a legitimation tactic for gambling operations. This research aimed to determine if an Australian system allowing tax concessions to not-for-profits (NFPs) meets its primary intention of funding community purpose.

METHODS

Not-for-profit (NFP) venues operating electronic gaming machines (EGMs) in the state of Victoria must submit records to the gambling regulator showing contribution to community purposes. The community benefit statements (CBS) of licensed Returned and Services League (RSL) venues were analysed, with an initial survey of the years 2010-19 and a more detailed analysis of the years 2017-19.

RESULTS

Veteran support constituted less than 10% of the total community contributions claimed, or 1.5% of electronic gaming machine (EGM) user losses. On average, business expenses exceeded the claims for veteran support by 12:1. Contributions for addressing gambling-related harm represented less than 0.002% of recorded claims.

CONCLUSIONS & IMPLICATIONS FOR PUBLIC HEALTH

This research demonstrates that the provision of charitable services derived from gambling revenue is very modest amongst Australia's principal veteran's organisation. Deficiencies in harm prevention and minimisation reinforce the need for changes to community benefit schemes. Regulatory reforms emphasising the vulnerability of veterans to gambling harm are required to ensure that this population is better protected.

Towards an Active Role of Financial Institutions in Preventing Problem Gambling: A Proposed Conceptual Framework and Taxonomy of Financial Wellbeing Indicators

The transformation of gambling into a largely digital commodity has created a need for online payment technologies to facilitate online gambling, thereby also raising the question of what role these actors can play in the promotion of Responsible Gambling (RG). With the means and access they maintain, financial institutions are in a unique position to alleviate financial pitfalls, yet their role in the gambling context has thus far received little scrutiny. The objective of this study was to conduct an extant literature review to develop an initial set of financial indicators tailored for financial institutions, enabling them to engage in the RG initiatives. We conducted a two-step narrative literature review to identify both general Financial Well-Being (FWB) indicators across financial research disciplines, and one specific to gambling. A literature search over the past 20 years was performed across the following academic databases: Medline (Ovid), Sociological Abstracts (ProQuest), Web of Science (Clarivate), and PsycInfo (EBSCO). Manifest content analysis was used in step one to review general financial well-being, yielding a general FWB conceptual framework. In step two, we applied latent content analysis to the gambling-specific literature, linking essential concepts of gambling-related financial harms to the broader FWB literature. This resulted in a tentative taxonomy of indicators applicable to financial institutions with gambling customers. In tandem with the FWB conceptual framework, the preliminary taxonomy could provide a foundation for financial institutions catering to gambling customers to engage in the duty of care agenda, potentially broadening player protection beyond the current operator-focused RG measures.

Australian parents' perceptions of the risks posed by harmful products to the health of children

Cigarettes, alcohol, vaping and gambling products can cause significant harm to children and young people. The industries that make these products employ a range of tactics that aim to normalize their products and resist policy and regulatory reform. This includes 'responsibility' framing, in which parents are often held responsible for educating their children about the risks of these products. However, there has been very little research, which has investigated parents' perceptions of these industries. A qualitatively led online panel survey was conducted with n = 455 Australian parents who had at least one child aged between 11 and 17 years. Participants were asked questions relating to concerns about harmful products; what they talked about with their children; other potential sources of risk information; and who were responsible for protecting young people from these industries. Four themes were constructed. (i) Parents identified that parental influence, peer pressure, social media and advertising influenced children's attitudes towards these products. (ii) They had concerns about the short- and long-term consequences of these products. (iii) Parents actively engaged in educating their children about these products but recognized that it was difficult to counter industry messages. (iv) Parents emphasized the need for a collective approach, advocating for increased information and government regulations, particularly relating to marketing. This study demonstrates that parents are concerned about these industries and do their best to protect their children from harm but recognize that they need more support. Evidence-based education and comprehensive regulations particularly around marketing are needed to de-normalize products and protect young people.

Perspectives from gambling expert stakeholders in relation to electronic gaming machines in New Zealand

Electronic gaming machines (EGMs) are one of the most addictive and harmful forms of gambling. Gaming machine characteristics, easy accessibility of EGMs and normalisation of gambling behaviour have exacerbated these effects. We conducted a pilot study investigating the perspectives of gambling expert stakeholders on gambling harm and effective harm-minimisation policies regarding EGMs. In-depth individual interviews were undertaken with 14 health professionals working in the addiction sector, academics in the field of gambling and individuals from a range of government and non-government organisations who have an impact on gambling policy making in New Zealand. Five major themes were identified: the need to shift focus from problematic people to the problematic product, the need for a holistic approach to gambling intervention, focus on creating an empowered population, and improving protective factors and refining public health initiatives to gambling harm. The results suggest the need to challenge current narratives of EGM-related gambling harm and have wide-ranging implications for EGM harm minimisation and health promotion policies.

Unpacking the differing understandings of "alcohol industry" in public health research

BACKGROUND

Use of the term 'alcohol industry' plays an important role in discussions of alcohol and public health. In this paper, we examine how the term is currently used and explore the merits of alternative conceptualisations.

METHODS

We start by examining current ways of referring to 'alcohol industry' in public health and then explore the potential for organisational theory, political science, and sociology to provide alcohol research with more inclusive and nuanced conceptualizations.

RESULTS

We identify, and critique, three conceptualisations based on purely economic understandings of industry: literal, market, and supply-chain understandings. We then examine three alternative conceptualizations based on systemic understandings of industry: organizational, social-network, and common-interest understandings. In examining these alternatives, we also identify the extent to which they open up new ways of approaching the levels at which industry influence is understood to operate in alcohol and public health research and policy.

CONCLUSIONS

Each of the six understandings of 'industry' can play a role in research but their utility depends on the question being asked and the breadth and depth of the analysis being undertaken. However, for those intending to engage with a broader disciplinary base, approaches grounded in the systemic understandings of 'industry' are better positioned to study the complex nexus of relationships that contribute to alcohol industry influence.

Distilling the distillers: examining the political activities of the Distilled Spirits Council of the United States

BACKGROUND

Understanding of the alcohol industry's means of influencing public policy is increasingly well established. Less is known, however, about the specific organisations that lead the political strategies of the alcohol industry. To fill this gap, this paper explores the Distilled Spirits Council of the United States (DISCUS), a key trade association in the United States (US), which also operates internationally.

METHODS

This study explores how DISCUS is organised and the main political activities it pursues to advance its policy interests. The study triangulates data from several sources, including DISCUS documents, as well as federal lobbying and election expenditure data.

RESULTS

This study demonstrates that DISCUS is a key political actor in the US and global alcohol policymaking context. There are identifiable strategies used by DISCUS to shape alcohol policy debates, including framing and lobbying. We also find key synergies between these strategies and identify their operation at varying levels of policy decision-making.

CONCLUSIONS

Generating more secure inferences about the nature of the alcohol industry's efforts to advance its interests, and with what success and at what cost, requires researchers to investigate other trade associations in different contexts, and use other data sources.

Public opinion of alcohol industry corporate political activities

OBJECTIVES

This study explores Australian public awareness and attitudes towards political donations from the alcohol industry and the 'revolving door' of politicians into industry or lobbyist positions.

METHODS

Data were collected via a nationwide online panel.

RESULTS

In total, n=1,044 participants completed the survey. More than half of the participants agreed that donations are made to influence government policy and to support the interests of the industry. More than half of the participants did not believe that it is appropriate for political parties to accept donations from the alcohol industry or for politicians to attend alcohol industry-hosted events. One-third of the participants agreed that public officials (including politicians) with a role in health policy should never be allowed to work or lobby for the alcohol industry (31.7%) and one-third endorsed a waiting time of 4-5 years.

DISCUSSION

There were demographic differences in the views that participants held of the alcohol industry and the relationship between the government and the alcohol industry. The findings suggest that the laws and controls governing industry-government relationships should be reviewed to ensure they are in line with public expectations, accompanied by education programs including a focus on corporate political activity by the alcohol industry.

How Do State Gambling Monopolies Affect Levels of Gambling Harm?

Purpose of Review

This systematic literature review evaluates the potential of gambling monopolies to affect gambling harms. It compares the occurrence of gambling harms in jurisdictions with gambling monopolies to jurisdictions with license-based regimes.

Recent Findings

The review identified 21 publications concerning three gambling-related harm indicators: problem gambling prevalence, total consumption, and the appearance of conflicts of interest. Due to the dearth of literature, concept papers and older publications were also included.

Summary

Results show that there is a paucity of empirical research on the effectiveness of different regulatory regimes in affecting gambling harms. Available research demonstrates that monopolistic regimes appear to perform somewhat better in terms of problem gambling prevalence and total consumption but may also be more prone to conflicts of interest than license-based regimes. Monopolistic configurations also differ between themselves, and issues such as availability, accessibility, product range, scope of preventive work, monitoring, as well as the recognition of the public health approach may better predict the levels of harm in society than the existence of a monopoly.

Advancing public health policy making through research on the political strategies of alcohol industry actors

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.

The handling of evidence in national and local policy making: a case study of alcohol industry actor strategies regarding data on on-premise trading hours and violence in Norway

BACKGROUND

Effective alcohol policy measures conflict with the interests of the alcohol industry. In this study we addressed how various alcohol industry actors in Norway have responded to research findings and police data relating to the possible impacts of changes in on-premise trading hours on violent offending.

METHODS

A content analysis of documents was undertaken. The documents comprised i) hearing statements from policy processes on on-premise trading hours at the national level, and in 15 Norwegian cities, and ii) newspaper articles and other media coverage of this topic in Norway.

RESULTS

Alcohol industry actors employed a range of strategies to shape the use of evidence regarding on-premise trading hours and violence. Nationally, the relevance of the international research literature was questioned before the publication of an unfavourable national study which was criticized directly. This led to commissioned attacks on the findings, constructing what were claimed to be disagreements between experts, emphasis on the complexity of violence and the role of confounding variables, and deflecting attention to alternative interventions. The handling of evidence at the local level was importantly different, where different industry actors and forms of evidence, notably police data, were involved in debates.

CONCLUSION

Alcohol industry actors employed various strategies to shape perceptions and use of evidence to advance their interests. The particular strategies and arguments changed over time as new data and research became available, and also varied between the national and the local levels, and by categories of industry actors.

Changes over time in Lithuanian schoolchildren's attitudes toward addictive behaviors: Promoting and preventing factors

Background

Concern is growing about the high prevalence of traditional and new forms of addictive behaviors among young people due to the health risks and a better understanding of the factors causing these behaviors is needed.

Aim

To evaluate tendencies in the attitudes of Lithuanian schoolchildren toward addictive behaviors over a three year period and to ascertain the promoting and preventing factors of such behaviors.

Methods

The researchers developed a survey which was conducted twice over a three year period. The sample consisted of pupils in the 5^th, 9^th and 12^th grades (N = 1590, age range 11–19 years) from both urban and rural areas.

Results

Both the recognition of and involvement in addictive behaviors significantly increased with age. Motivation to abstain due to internal factors decreased with age and increased among pupils already involved in addictive behaviors. Time- and age-related differences were found regarding substance abuse and behavioral addictions. Whilst betting adverts were increasingly noticed over time, smoking adverts were decreasingly noticed over the three year period and it was concomitant with inconsistent changes in self-reported involvement in these behaviors.

Conclusions

Most significant changes in the attitudes of Lithuanian pupils toward addictive behaviors occur between the ages of 11 and 15 years. However, age-related changes differ for the pupils’ attitudes toward substance abuse and behavioral addictions. Increasing awareness of the potential risk of addictive behaviors does not prevent their increasing prevalence with age. Increased risk of involvement in addictive behavior correlates with decreased internal motivation to abstain from addictive behavior and decreased recognition of its potential risks. No clear correlation was found between significant changes in noticing adverts and involvement in addictive behaviors.

Research in the field of gambling disorders funded by gambling providers: lessons to learn fromthe pharmaceutical industry?

Abstract. Introduction: The importance of research funding for potential conflicts of interests has been widely discussed in the field of substance-related disorders: research funding by industries producing alcohol, tobacco or drugs as well as by pharmaceutical companies contains a substantial risk of publication bias, conflicts of health care authorities as well as researchers and opinion leaders in the field of addiction research and medicine. Disclosure of all conflicts of interest is an indispensable consequence in every case. Extent of financial support, fields of sponsoring and publication bias are presented. Due to parallels between funding in substance related research and research on pathological gambling and the industrial interest in research of pathological gambling interferences as common in the research of other substances have to be considered as problematic. Discussion and Conclusion: We need (1) evaluation of the potential conflicts of interest on the part of state organizations (2) limitation of advertising and indirect sponsoring, (3) disclosure of any financial and non-financial relationship and, in particular, the scope of a financial relationship between universities, research institutes, study leaders, authors, reviewers and responsible editors of research journals on the gambling providers, (4) a rating system that quantifies a potential publication bias, (5) an exclusion of persons with significant sponsorship in the past five years from responsible functions with regard to the field of gambling, and (6) a pool of public funds for research funding managed by an independent body.

Alcohol industry involvement in science: A systematic review of the perspectives of the alcohol research community

ISSUES

Alcohol companies have recently invested large sums of money in answering research questions to which they have clear vested interests in the outcomes. There have been extensive concerns about corporate influence on public health sciences, following the experience with the tobacco industry.

APPROACH

This systematic review aims to investigate the perspectives of researchers on the activities of alcohol industry actors in relation to science, in order to guide future research. All data published in peer-reviewed journals (including commentaries, opinion pieces, editorials and letters as well as research reports) were eligible for inclusion. This analysis focuses on the manifest rather than latent content of the articulated views, and accordingly adopts a thematic analysis using an inductive approach to the generation of themes.

KEY FINDINGS

There are serious concerns identified in three main areas, principally defined by where the impacts of industry scientific activities occur; on evidence informed policy making (instrumental uses of research by industry actors), on the content of the scientific evidence base itself (industry funding as a source of bias); and on the processes of undertaking research (transgressions of basic scientific norms). There are also opposing views which provide a useful critique. The evidence-base on the validity of all concerns has been slow to develop.

IMPLICATIONS

The concerns are extensive, longstanding and unresolved and high quality investigations are needed.

CONCLUSION

This study informs the detailed content of the research needed to address the concerns identified here.

Alcohol industry involvement in policymaking: a systematic review

AIMS

To summarize the substantive findings of studies of alcohol industry involvement in national or supranational policymaking, and to produce a new synthesis of current evidence.

METHODS

This study examined peer-reviewed journal reports published in the English language between 1980 and 2016 of studies of alcohol industry involvement in policymaking. Included studies were required to provide information on data collection and analysis and to have sought explicitly to investigate interventions by alcohol industry actors within the process of public policymaking. Eight electronic databases were searched on 27 February 2017. The methodological strengths and limitations of individual studies and the literature as a whole were examined. A thematic synthesis using an inductive approach to the generation of themes was guided by the research aims and objectives.

RESULTS

Twenty reports drawn from 15 documentary and interview studies identify the pervasive influence of alcohol industry actors in policymaking. This evidence synthesis indicates that industry actors seek to influence policy in two principal ways by: (1) framing policy debates in a cogent and internally consistent manner, which excludes from policy agendas issues that are contrary to commercial interests; and (2) adopting short- and long-term approaches to managing threats to commercial interests within the policy arena by building relationships with key actors using a variety of different organizational forms. This review pools findings from existing studies on the range of observed impacts on national alcohol policy decision-making throughout the world.

CONCLUSIONS

Alcohol industry actors are highly strategic, rhetorically sophisticated and well organized in influencing national policymaking.

Corporate social responsibility and conflicts of interest in the alcohol and gambling industries: a post-political discourse?

The corporate pursuit of social goals - known as Corporate Social Responsibility or 'CSR' - has been subject to critique on a number of grounds. However, a hitherto underexplored potential consequence of CSR has been suggested in a recent paper by C. Garsten and K. Jacobsson ('Post-Political Regulation: Soft Power and Post-political Visions in Global Governance' (2013), Critical Sociology 39: 421-37). They suggest that CSR is part of an international trend towards 'post-political' governance discourses, where an emphasis on different actors' common goals obscures conflicts of interest, subverting the open political conflict necessary for a well-functioning democracy. This paper examines whether such post-political discourses - including an outright denial of conflict of interest - can be found within the alcohol and gambling industries, where conflicts of interest are likely to be particularly acute given the addictive nature of the goods/services in question. Based on interviews with CSR professionals in these industries in Italy, the UK, and at EU-level, we do indeed find evidence of a post-political discourse. In these discourses, alcohol/gambling industry staff deny potential conflicts of interest on the basis that any small benefits from sales to a small number of addicts are seen to be outweighed by the reputational damage that addicts cause. Crucially, however, this coexists with another, less post-political discourse, where addictions CSR professionals emphasize 'common ground' as a basis for CSR, while accepting some instances of possible conflict of interest. Here interviewees make considerable efforts to differentiate good (sustainable) from bad (short-term) self-interest in order to stress the genuineness of their own actions. We conclude the paper by considering whether CSR embedded within a 'common ground' discourse still hides conflicts of interests and subverts democratic debate, or overcomes the problems identified by Garsten and Jacobsson.