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Knai C, Petticrew M, Capewell S, Cassidy R, Collin J, Cummins S, Eastmure E, Fafard P, Fitzgerald N, Gilmore AB, Hawkins B, Jensen JD, Katikireddi SV, Maani N, Mays N, Mwatsama M, Nakkash R, Orford JF, Rutter H, Savona N, van Schalkwyk MCI, Weishaar H. The case for developing a cohesive systems approach to research across unhealthy commodity industries. BMJ Glob Health 2021; 6:e003543. [PMID: 33593757 PMCID: PMC7888371 DOI: 10.1136/bmjgh-2020-003543] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Revised: 10/22/2020] [Accepted: 11/11/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Most non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs. METHODS We held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries. RESULTS There are clear commonalities across UCIs' strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types. CONCLUSION 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 also to inform a more effective and coherent response.
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Affiliation(s)
- Cécile Knai
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
| | - Mark Petticrew
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
| | - Simon Capewell
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Rebecca Cassidy
- Department of Anthropology, Goldsmiths University of London, London, UK
| | - Jeff Collin
- SPECTRUM Consortium, UK
- Global Public Health Unit, University of Edinburgh, Edinburgh, UK
| | - Steven Cummins
- Population Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Elizabeth Eastmure
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Patrick Fafard
- Faculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Niamh Fitzgerald
- SPECTRUM Consortium, UK
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Anna B Gilmore
- SPECTRUM Consortium, UK
- Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
| | - Ben Hawkins
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jørgen Dejgård Jensen
- Institute of Food and Resource Economics, University of Copenhagen, Frederiksberg, Denmark
| | | | - Nason Maani
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
- SPECTRUM Consortium, UK
- School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Nicholas Mays
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Rima Nakkash
- Health Promotion and Community Health, American University of Beirut, Beirut, Lebanon
| | - Jim F Orford
- School of Psychology, University of Birmingham, Birmingham, UK
- King's College London, London, UK
| | - Harry Rutter
- Department of Social and Policy Sciences, University of Bath, Bath, Bath and North East Somer, UK
| | - Natalie Savona
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - May C I van Schalkwyk
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Heide Weishaar
- Center for International Health Protection, Robert Koch Institute, Berlin, Germany
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Nakkash RT, Ghandour LA, Yassin N, Anouti S, Chalak A, Chehab S, El-Aily A, Afifi RA. "Everyone Has the Right to Drink Beer": A Stakeholder Analysis of Challenges to Youth Alcohol Harm-Reduction Policies in Lebanon. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162874. [PMID: 31408935 PMCID: PMC6719017 DOI: 10.3390/ijerph16162874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 08/03/2019] [Accepted: 08/05/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Alcohol use is a major risk factor in premature death and disability, especially among youth. Evidence-based policies to prevent and control the detrimental effect of alcohol use have been recommended. In countries with weak alcohol control policies-such as Lebanon, stakeholder analysis provides critical information to influence policy interventions. This paper assesses the views of stakeholders regarding a national alcohol harm reduction policy for youth. METHODS We interviewed a total of 22 key stakeholders over a period of 8 months in 2015. Stakeholders were selected purposively, to include representatives of governmental and non-governmental organizations and industry that could answer questions related to core intervention areas: affordability, availability, regulation of marketing, and drinking and driving. We analyzed interview transcripts using thematic analysis. RESULTS Three themes emerged: Inadequacy of current alcohol control policies; weak governance and disregard for rule of law as a determinant of the status quo; and diverting of responsibility towards 'other' stakeholders. In addition, industry representatives argued against evidence-based policies using time-worn strategies identified globally. CONCLUSIONS Our findings indicate that alcohol harm reduction policies are far from becoming a policy priority in Lebanon. There is a clear need to shift the narrative from victim blaming to structural conditions.
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Affiliation(s)
- Rima T Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Nasser Yassin
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Sirine Anouti
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Ali Chalak
- Department of Agriculture, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Sara Chehab
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Aida El-Aily
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut 1107-2020, Lebanon
| | - Rima A Afifi
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, IA 52242, USA.
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Rockers PC, Laing RO, Scott N, Ashigbie P, Lucca EH, Umeh CA, Wirtz VJ. Evaluation of pharmaceutical industry-led access programmes: a standardised framework. BMJ Glob Health 2019; 4:e001659. [PMID: 31423348 PMCID: PMC6688691 DOI: 10.1136/bmjgh-2019-001659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/15/2019] [Accepted: 07/20/2019] [Indexed: 11/17/2022] Open
Abstract
Pharmaceutical industry-led access programmes are increasing in number and scope worldwide. We present a new standardised framework for evaluation of these programmes that includes three components: a taxonomy of 11 access programme strategies; a series of logic models, one for each strategy and a set of measurement indicators. The logic models describe pathways of potential programme impact. Concepts relevant across a broad range of strategies were prioritised for inclusion in logic models to ensure consistency and to facilitate synthesis and learning across programmes. Each concept has at least one corresponding measurement indicator with metadata that includes the definition, details on how it should be measured and recommended data sources. The framework establishes a shared language for the collection and reporting of meaningful industry-led access programme information. Broad adoption by programme developers and implementing partners in the for-profit sector and beyond could facilitate shared learning on effective strategies and best practices.
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Affiliation(s)
- Peter C Rockers
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Richard O Laing
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,School of PublicHealth, Faculty of Community and Health Sciences, Universityof Western Cape, Cape Town, South Africa
| | - Nancy Scott
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Paul Ashigbie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Erin H Lucca
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Chukwuemeka Anthony Umeh
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Veronika J Wirtz
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
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Rossow I, McCambridge J. 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. BMC Public Health 2019; 19:44. [PMID: 30626353 PMCID: PMC6327455 DOI: 10.1186/s12889-018-6348-y] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 12/19/2018] [Indexed: 12/31/2022] Open
Abstract
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.
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Affiliation(s)
- Ingeborg Rossow
- Department of Alcohol, Drug and Tobacco Research, Norwegian Institute of Public Health, POB 4404 Nydalen, N-0403 Oslo, Norway
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Mialon M, McCambridge J. Alcohol industry corporate social responsibility initiatives and harmful drinking: a systematic review. Eur J Public Health 2018; 28:664-673. [PMID: 29697783 PMCID: PMC6051456 DOI: 10.1093/eurpub/cky065] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background 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. The aims of this systematic review were to summarize and examine what is known about CSR initiatives undertaken by alcohol industry actors in respect of harmful drinking globally. Methods We searched for peer-reviewed studies published since 1980 of alcohol industry CSR initiatives in seven electronic databases. The basic search strategy was organized around the three constructs of 'alcohol', 'industry' and 'corporate social responsibility'. We performed the searches on 21 July 2017. Data from included studies were analyzed inductively, according to the extent to which they addressed specified research objectives. Results A total of 21 studies were included. We identified five types of CSR initiatives relevant to the reduction of harmful drinking: alcohol information and education provision; drink driving prevention; research involvement; policy involvement and 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. Conclusions This research literature is at an early stage of development. 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.
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McCambridge J, Mialon M, Hawkins B. Alcohol industry involvement in policymaking: a systematic review. Addiction 2018; 113:1571-1584. [PMID: 29542202 PMCID: PMC6100095 DOI: 10.1111/add.14216] [Citation(s) in RCA: 132] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 01/30/2018] [Accepted: 02/28/2018] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
| | | | - Ben Hawkins
- Department of Health SciencesUniversity of YorkYorkUK
- Faculty of Public Health and PolicyLondon School of Hygiene and Tropical MedicineLondonUK
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