Alcohol Industry Interference: A Report from the Global Alcohol Policy Conference 2013

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Scotch whiskey at the pub. Credit: Cobalt 123

 

On October 7-9, the city of Seoul, Korea served as host for the third Global Alcohol Policy Conference.  At the conference, more than 850 participants from 45 countries discussed the current state of science-based alcohol policies, recent successes in the alcohol policy field, the prospects for improvement, and the challenges facing alcohol policy advocates.

 

One important theme running through the conference was the role of the global alcohol industry in maintaining and intensifying alcohol-related harm through its tactics and practices.

 

Dr. Thomas Babor of the University of Connecticut, for example,  stressed reasons to doubt the sincerity of the global alcohol industry in its insistence to be part of the solution to alcohol problems.  This is particularly true, given that the strategy of the multi-national alcohol producers and their industry associations and social aspects organizations is clearly to increase overall consumption – a strategy which is inimical to public health and public safety.  Additionally, the industry clings to “self-regulation” – a strategy Babor described as “spectacularly ineffective” in actually preventing industry misconduct or associated alcohol-related harms.

 

Other plenary speakers and workshop presenters illustrated specific cases of alcohol industry efforts either to prevent evidence-based policies from taking effect or to render such policies ineffective.  Dr. Ronald Laranjeira (Professor of the Federal University of São Paulo [UNIFESP], Brazil; Director of Alcohol and Drug Research Unit of UNIAD) described the almost total lack of functional alcohol policies in much of Latin America.  He called attention to the suspension of a national ban on the sales of alcohol beverages in soccer stadia during the forthcoming 2014 World Soccer Cup in Brazil.  The removal of the ban was forced by the Fédération Internacionale de Football Association (FIFA), linked to that organization’s multimillion-dollar contract with Anheuser-Busch InBev’s Budweiser brand.

 

Similarly, Dr. Evelyn Gillan,  Chief Executive of Alcohol Focus Scotland (AFS), Scotland’s national alcohol charity, addressed the tactics of the Scotch Whiskey Association to work to prevent or delay implementation of the Scottish Government’s Minimum Unit Pricing policy.

 

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In South Africa – and the rest of that continent – multinational brewer SABMiller has made clear its intention to “grow per capita beer consumption.” Dr. Charles Parry, Director of the South African Medical Research Council’s Alcohol & Drug Abuse Research Unit (ADARU), described the efforts of SABMiller and other alcohol operators to resist a proposed total ban on alcohol advertising.  Specifically, he listed the various arguments marshaled by industry groups and related associations and media outlets – all of which should be familiar to public health advocates vying with health-harming industries:

 

  • ŸCasting doubt on the underlying science (the “scientific evidence is not uniform”)
  • Attacking public health advocates (the Minister of Health is a “Nanny from Hell,” and his allies are akin to the Nazi and Apartheid regimes)
  • ŸWarning of the “unintended consequences” of regulating industries, including dire economic consequences
  • Claiming that the measures would be disproportionately burdensome to small businesses (“hurt the little guy”).  (Dr. Parry noted that this claim begs the question:  if this measure is so beneficial to big business, why would SABMiller raise such vigorous opposition?)

Finally, one of the workshops at GAPC 2013 specifically addressed alcohol industry influences in the alcohol policy process.

 

During that session, Professor Jeff Collin (Director of the Global Public Health Unit at the University of Edinburgh) called out the disconnect between the British government’s ostensible embrace of a multi-sectoral approach to global health in its “Health is Global” framework – and the reality of its trade policy, including the active promotion of hard liquor as a key export.

 

Sven-Olov Carlsson, International President of IOGT International, compared the tactics of Big Alcohol to those of Big Tobacco and found many parallels, including the creation of front groups to “fill the policy space.”

 

Sri Lanka’s Shakyra Nanayakkara detailed the various legal maneuvers utilized by alcohol industry interests to undermine that nation’s National Authority on Tobacco and Alcohol (NATA) Act – which prohibits the sale of alcohol and tobacco to person under the age of twenty-one.  These maneuvers include legal challenges and infiltrating the NATA training panel with industry-funded lawyers.

 

A key takeaway of the conference is that understanding the current gap between alcohol policy science and alcohol policy practice is impossible without taking into consideration the machinations of an industry which profits handsomely from underage and excessive adult alcohol consumption.

 

Thus, reducing the global burden of alcohol-related harm will require advocates to effectively counter that industry influence – through reliance on the best science, savvy media advocacy, and robust grassroots organization.

 

By Robert Pezzolesi  is the Founding Director at NY Center for Alcohol Policy Solutions/NY Alcohol Policy Alliance

New York Alcohol Policy Summit: Expanding Public Health Protection

In the United States today, much of the focus on alcohol problems is limited to the issues of underage drinking and drunk driving, with both narrowly defined in terms of the problem and the acceptable solutions.  To expand this frame, several organizations including the New York Alcohol Policy Alliance (NYAPA), the New York State Public Health Association (NYSPHA), and the Council on Addiction of New York State (CANYS) met at the New York Alcohol Policy Summit in Syracuse October 6.

About 200 participants – including faith leaders, police officers, pediatric nurse practitioners, prevention educators, research scientists, coalition members, public health practitioners, policy analysts, university faculty, registered nurses, and suicide prevention advocates met to consider the health and social consequences of excessive alcohol consumption and to propose new policy approaches to reduce the adverse consequences of alcohol use in New York State.

Alcohol Harms

The starting point for the Summit was the many serious health problems associated with current patterns of alcohol use.  These include:

Suicide. Alcohol has been found to “increase the lethality of suicide attempts in individuals with mood disorders,”[1] with a CDC analysis of suicide victims finding one-third testing positive for alcohol in their systems.[2] Furthermore, age of drinking onset among young people has been linked to risk of lifetime suicide attempt (i.e., the earlier the age of drinking onset, the greater chance for a suicide attempt later in life).[3]

Cancer. Alcohol is a recognized carcinogen, which has been connected to cancers of the head and neck, liver, female breast, & colon/rectum.[4] [5] It is estimated that alcohol is responsible for 5% of the preventable cancer cases worldwide.[6]

HIV/AIDS. Excessive alcohol consumption has been shown to worsen the severity and progression of HIV through impacts on the immune system and adherence to medication.[7]

Fire Safety. Research has found that from 15-40% of decedents of residential fires are alcohol impaired.[8] Several mechanisms have been cited for this relationship, including impaired judgment, reduced ability for detection, reduced ability to escape, compromised caretakers, burn severity, and suppressed cough reflex. [8]

Gun Violence.  Alcohol has been shown to be significant factor in violence in general, but particularly related to gun violence through off-premise alcohol outlet density.[9]

And the economic consequences are just as staggering, with the CDC just releasing a study reporting that excessive alcohol consumption costs the US $224 billion a year, or approximately $1.90 per drink. [10]

Making Alcohol Policy Health Policy

With this in mind, it is apparent that those engaged in alcohol policy – and the broader public health community – need to recognize the multiple pathways of alcohol-related harm, and the parallel need to implement effective policies to stem those harms. This will require proactive media advocacy, dynamic professional education, and strategic countering of alcohol industry attempts to frame the problem – the goals of the October 6 Summit.

The plenary sessions of the Summit focused on the big picture, including the larger socioeconomic context and the state-of-the-science in alcohol policy, while the panels and workshops drilled down to the specific effects of alcohol consumption on particular health and social issues and populations. The Summit sessions were designed to break through the artificial barriers which tend to marginalize alcohol policy concerns (in prevention, treatment, and recovery) from mainstream public health concerns.

Noted attorney and alcohol policy expert James Mosher, JD was the Summit keynote speaker. He appealed to Martin Luther King, Jr. and the broader socioeconomic climate to demonstrate the need for public health advocates to embrace the opportunity of alcohol policy advocacy and work to place people ahead of profits.

Other Summit plenary speakers and their topics included:

Stacy Carruth, MPH (Regional Center for Healthy Communities, Cambridge, MA) spoke on the efforts in Massachusetts to remove alcohol advertising from the public transportation system, and the need for regional cooperation and collaboration among New York and the New England states.

Michele Simon, JD, MPH (President, Eat Drink Politics; Author, “Appetite For Profit”) described the disturbing (and sometimes amusing) parallels between the deceptive marketing practices of the food and alcohol industries;

Donald W. Zeigler, PhD (Director of Prevention & Healthy Lifestyle, American Medical Association) discussed the work of the Task Force on Community Preventive Services and the necessity of prevention advocates in engaging with medical professionals; and

Robert Lindsey (MEd, CEAP) (President/CEO, National Council on Alcoholism & Drug Dependence) described the challenge of engaging individuals in recovery in policy efforts, in light of the paradox between the personal, emotional nature of recovery and the public health population-level paradigm.

In addition, Arlene González-Sánchez, Commissioner of the New York State Office of Alcoholism and Substance Abuse Services and Pamela J. Westlake, Director of Enforcement for the New York State Liquor Authority, offered an overview of the problem of underage drinking in New York State and the ongoing efforts of their agencies to combat that problem.

Summit workshops addressed the issues of suicide, gun violence, child maltreatment, cancer, HIV/AIDS, fire safety, gambling, eating disorders, and on alcohol policy impacts on special populations, including rural communities, Native Americans, seniors, and the military (active duty and veterans).

The Summit also tackled two issues which are explicitly alcohol-related but which are rarely addressed in the context of alcohol policy: Fetal Alcohol Spectrum Disorders (FASD) and Treatment & Recovery. FASD sometimes tends to be defined, with limited goals of educating individual women to refrain from drinking during their pregnancy. While those educational efforts are necessary, they are not sufficient, considering that states with higher rates of binge drinking among women of childbearing age have higher rates of alcohol-exposed pregnancies.  This points to a need to bring drinking rates down among all women of child-bearing age, and to push back against alcohol industry attempts to target women as a growth market.

In the longer term, Summit organizers hope to catalyze action in these specific areas of alcohol policy, rather than function as one-and-done educational event.  In addition, the Summit and its aftermath may suggest directions for other advocates for more health-oriented alcohol policy for how best to expand policy advocacy from local and national arenas to a statewide focus.

 

References


[1] Sher, L., Oquendo, M. A., Richardson-Vejlgaard, R., Makhija, N. M., Posner, K., Mann, J. J., & Stanley, B. H. Effect of acute alcohol use on the lethality of suicide attempts in patients with mood disorders.  Journal of Psychiatric Research, 2009; 43(10), 901-05 .doi:10.1016/ j.jpsychires. 2009.01.005

[2] MMWR. Toxicology testing and results for suicide victims -13 states, 2004. Morbidity and Mortality Weekly Report, 2006; 55(46), 1245-1248.

[3] Bossarte, R. M., & Swahn, M. H. The associations between early alcohol use and suicide attempts among adolescents with a history of major depression. Addictive Behaviors,2011;  36(5), 532-535. doi:10.1016/j.addbeh.2010.12.031

[4] Allen, N.E., Beral, V., Casabonne, D., Kan, S.W., Reeves, G.K., Brown, A., et al.. Moderate alcohol intake and cancer incidence in women. Journal of the National Cancer Institute,2009;  101(5),296-305.
[5] Boffetta, P., Hashibe, M., La Vecchia, C., Zatonski, W., & Rehm, J. The burden of cancer attributable to alcohol drinking. International Journal of Cancer,2006;  119(4), 884-887.
[6] Danaei, G., Vander Hoorn, S., Lopez, A.D., Murray, C.J.L., Ezzati, M., et al. Causes of cancer in the world: Comparative risk assessment of nine behavioural and environmental risk factors. Lancet, 2005; 366, 1784–1793.

[7] Shuper, P. A., Neuman, M., Kanteres, F., Baliunas, D., Joharchi, N., & Rehm, J. Causal considerations on alcohol and HIV/AIDS–a systematic review. Alcohol and Alcoholism (Oxford, Oxfordshire), 2010; 45(2), 159-166. doi:10.1093/alcalc/agp091.

[8] U.S. Federal Emergency Management Administration. Establishing a relationship between alcohol and casualties of fire. Report. National Fire Data Center, United States Fire Administration.  Arlington, VA:  TriData Corporation, 1999. Retrieved on June 12, 2011 from http://instruct1.cit.cornell.edu/Courses/arch465/arch465f06-firesafety/alcohol-fire.pdf

[9] Branas, C. C., Elliott, M. R., Richmond, T. S., Culhane, D. P., & Wiebe, D. J.  Alcohol consumption, alcohol outlets, and the risk of being assaulted with a gun. Alcoholism, Clinical and Experimental Research, 2009; 33(5), 906-915. doi:10.1111/j.1530-0277.2009.00912.x

[10] Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic Costs of Excessive Alcohol Consumption in the U.S., 2006. American Journal of Preventive Medicine, 2011; 41(5), A4. doi:10.1016/S0749-3797(11)00692-1]

 

Image Credits:

  1. Turtlemom4bacon via Flickr
  2. Cle0patra via Flickr