A new report in BMJ Global Health explores the links between unhealthy commodity industries (UCIs) such as tobacco, alcohol, unhealthy food, and gambling; analyzes the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs. The authors conclude that UCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and to inform a more effective and coherent response.Continue reading Developing a cohesive systems approach to research across unhealthy commodity industries
The 2010 World Health Organization Global Strategy to Reduce the Harmful Use of Alcohol recommends countries adopt evidence-based interventions. A recent review in PLOS One updated, summarized, and appraised the methodological rigor of systematic reviews of selected alcohol control interventions in the Strategy. The authors identified 42 systematic reviews. Most reviews identified only observational studies with no studies from low or lower-middle income (LMIC) countries. Ten reviews were rated as low risk of bias. Methodological deficiencies included publication and language limits, no duplicate assessment, no assessment of study quality, and no integration of quality into result interpretation. We evaluated the following control measures as possibly beneficial: 1) community mobilization; 2) multi-component interventions in the drinking environment; 3) restricting alcohol advertising; 4) restricting on- and off-premise outlet density; 5) police patrols and ignition locks to reduce drink driving; and 6) increased price and taxation including minimum unit pricing. The authors concluded that robust and well-reported research synthesis is deficient in the alcohol control field despite the availability of clear methodological guidance. The lack of primary and synthesis research arising from LMIC should be prioritized globally.
Citation: Siegfried N, Parry C. Do alcohol control policies work? An umbrella review and quality assessment of systematic reviews of alcohol control interventions (2006–2017). PLoS One. 2019 Apr 10;14(4):e0214865.
Alcohol use is a leading risk factor for global disease burden, and data on alcohol exposure are crucial to evaluate progress in achieving global non-communicable disease goals. A new report in Lancet presents estimates on the main indicators of alcohol exposure for 189 countries from 1990–2017, with forecasts up to 2030.
The authors found that between 1990 and 2017, global adult per-capita consumption increased from 5·9 L to 6·5 L, and is forecasted to reach 7·6 L by 2030. The report forecasts that abstinence will decrease to 40% by 2030 and the proportion of current drinkers will increase to 50% by 2030. In 2017, 20% of adults were heavy episodic drinkers (compared with 1990 when it was estimated at 18·5%, and this prevalence is expected to increase to 23% in 2030.
Based on these data, global goals for reducing the harmful use of alcohol are unlikely to be achieved, and known effective and cost-effective policy measures should be implemented to reduce alcohol exposure.
Citation: Manthey J, Shield K, Rylett M, Hasan OS, Probst C. JR Alcohol exposure between 1990 and 2017 and forecasts until 2030: a global modelling study. Lancet.2019https://doi.org/10.1016/S0140-6736(18)32744-2
Alcopops comprise a wide array of low-price, sugary, carbonated, heavily flavored alcoholic beverages. They can be very strong and very large, going as high as 14% alcohol by volume (ABV) and coming in single-serving cans as large as 25 oz. Their strength, combined with their resemblance in both packaging and flavor to sodas and energy drinks, makes them extraordinarily attractive—and dangerous—for youth. Read a new report on alcopops by Alcohol Justice.
“This month, National Institutes of Health Director Francis Collins seemed to shut down a noxious ethical problem,” writes Paul Thacker, a former Senate staff member, in The Washington Post. “The agency released a 165-page internal investigation of an alcohol consumption study that had been funded mostly by beer and liquor companies. The study’s lead investigator and NIH officials were in frequent contact with the alcohol industry while designing the study, which, according to the postmortem, seemed predetermined to find alcohol’s benefits but not potential harms, such as cancer. In several email exchanges published in the report, NIH scientists seemed to joke about taking a drink every time somebody said “cheers,” which was a proposed acronym for their study. Collins ended the trial and promised to create new ethical boundaries for how NIH officials deal with industry. But the intellectual corruption at our government research agencies runs much deeper, and this was only the latest scandal involving hidden corporate influence. I spent 3 1 / 2 years as a Senate investigator studying conflict-of-interest problems at the NIH and the research universities it funds. During that time, I found that the agency often ignored obvious conflicts. Even worse, its industry ties go back decades and are never really addressed unless the agency faces media scrutiny and demands from the public and Congress for change.”
There is growing awareness of the detrimental effects of alcohol industry commercial activities, and concern about possible adverse impacts of its corporate social responsibility (CSR) initiatives, on public health. This systematic review examines what is known about CSR initiatives undertaken by alcohol industry actors to address harmful drinking globally. Based on a review of 21 studies, the authors identified five types of CSR initiatives relevant to the reduction of harmful drinking: (1) alcohol information and education provision; (2)drink driving prevention; (3) research involvement; (4) policy involvement and (5) the creation of social aspects organizations. Individual companies appear to undertake different CSR initiatives than do industry-funded social aspects organizations. There is no robust evidence that alcohol industry CSR initiatives reduce harmful drinking. There is good evidence, however, that CSR initiatives are used to influence the framing of the nature of alcohol-related issues in line with industry interests. The authors concluded that alcohol policy measures to reduce harmful drinking are needed, and the alcohol industry CSR initiatives studied so far do not contribute to the attainment of this goal.
Citation: Mialon M, McCambridge J. Alcohol industry corporate social responsibility initiatives and harmful drinking: a systematic review. European Journal of Public Health. 2018 Apr 25.
There is a “direct link between alcohol and fatal cancers” — that’s what Irish health officials want their country’s drinkers to know each time they look at a bottle of alcohol, reports the European edition of Politico. Even as producers of wine, beers and spirits fret about any European Commission regulation that would force them to list ingredients and calories on their products, health officials in Dublin are making a big push for what the alcohol industry considers a nightmare scenario: mandatory cancer warnings on liquor. “Reducing alcohol intake is an important step in reducing the burden of cancer,” Irish Health Minister Simon Harris said in February, ahead of submitting to the parliament a bill with proposals that include some of the toughest provisions on alcohol labeling on the Continent, including a label stating the link between drinking and cancer. “This is a landmark piece of public health legislation which will make a real difference when it comes to reducing the harm caused by alcohol,” Harris added.
In this five minute video, Michael Greger summarizes the evidence on alcohol’s role in cancer. And in a March 2018 article in Drug and Alcohol Review, the authors conclude that the alcohol industry “appears to be engaged in the extensive misrepresentation of evidence about the alcohol-related risk of cancer. These activities have parallels with those of the tobacco industry. This finding is important because the industry is involved in developing alcohol policy in many countries, and in disseminating health information to the public, including school children. Policymakers, academics, public health and other practitioners should reconsider the appropriateness of their relationships to these alcohol industry bodies.”
Excessive alcohol consumption contributes to an average of 4,350 deaths among people under age 21 each year, and is associated with many other health risk behaviors, including smoking, physical fighting, and high-risk sexual activity. At least 25 longitudinal studies affirmed that youth exposure to alcohol advertising is associated with the initiation of alcohol consumption by youth, the amount of alcohol consumed per drinking occasion, and adverse health consequences. A new report by the Center on Alcohol Marketing and Youth at the Johns Hopkins School of Public Health examined non-compliant alcohol advertising exposure on cable TV that aired in 2015 and 2016. The report identified 25 alcohol brands that were responsible for the largest amount of non-compliant alcohol advertising exposure, and assessed the brand-specific distribution of non-compliant exposure using no-buy list criteria. The report also identified 25 programs and network-dayparts that were responsible for the largest amount of non-compliant alcohol advertising exposure. The study found that in the 2-year period, about 1 in 13 alcohol advertising impressions viewed on cable TV by youth under the legal drinking age did not comply with the alcohol industry’s voluntary placement guideline. This resulted in 2.5 billion non-compliant underage impressions during these two years. Youth exposure to alcohol advertising has been associated with the initiation of underage drinking, consuming a larger amount of alcohol, and adverse health and social problems. Reducing this exposure is an important priority for the prevention of alcohol consumption and alcohol-related harms among youth.
Corporations use a range of strategies to dispute their role in causing public health harms and to limit the scope of effective public health interventions. This study analyzed alcohol, food, soda and gambling industry documents and websites and minutes of reports of relevant health select committees, using standard document analysis methods. Two main framings were identified: (i) these industries argue that aetiology is complex, so individual products cannot be blamed; and (ii) they argue that population health measures are ‘too simple’ to address complex public health problems. However, in this second framing, there are inherent contradictions in how industry used ‘complexity’, as their alternative solutions are generally not, in themselves, complex. Corporate arguments and language may reflect the existence of a cross-industry ‘playbook’, whose use results in the undermining of effective public health policies – in particular the undermining of effective regulation of profitable industry activities that are harmful to the public’s health.
Petticrew M, Katikireddi SV, Knai C, Cassidy R, Maani Hessari N, Thomas J, Weishaar H. ‘Nothing can be done until everything is done’: the use of complexity arguments by food, beverage, alcohol and gambling industries. J Epidemiol Community Health. 2017;71(11):1078-1083.
An ad for beer on the New York City subway
Last month, reported The New York Times, the Metropolitan Transportation Authority board voted to ban advertising of alcoholic beverages on New York City buses, subway cars and stations, contending that the social benefits of deterring underage drinking outweighed the loss of revenue. After years of pressure from grass-roots organizations, the board voted unanimously in favor of the ban, which will go into effect in January. Advocates have long said that alcohol advertising is a public health issue and that the proliferation of such advertising increases the likelihood of underage drinking. “Alcohol advertisements on the M.T.A. are disproportionally targeting communities of color, lower-income communities and also young people,” said Jazmin Rivera, a spokeswoman for Building Alcohol Ad-Free Transit.
In a letter to the editor responding to the article, David Jernigan, director of the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health, wrote “subways are the way many New York City young people get to school every day. The M.T.A.’s decision will help reduce their exposure to alcohol advertising, and is a significant step in the right direction.”