Is the alcohol industry doing well by 'doing good'? Findings from a content analysis of the alcohol industry's actions to reduce harmful drinking

The role of gifts in building influence with politicians: Thematic analysis of interviews with current and former parliamentarians

Gifts are a powerful way to acknowledge and strengthen interpersonal relationships. As with any relational space, gifting plays various roles in forming and maintaining relationships in political contexts, but its contribution to relationship-building has attracted little attention. This paper examines how politicians in Aotearoa New Zealand both engage with gifting and how they navigate the perceptions of others. Four current members of parliament (MPs) and six retired MPs participated in semi-structured interviews with questions on common practices and common understandings about political gifting. Their responses indicate their use of four different processes: formal processes are the guidelines provided by the government on gifting, but when these are insufficient, contextual processes regarding perceptions of the media, constituents or colleagues are used, or, alternatively, MPs rely on personal values or view gifting in terms of transactional processes with both parties receiving benefits. The paper explores perceptions and complexities of a sequence of gifts during events (event gifting). The authors recommend an improved awareness and understanding of the contribution of gifting practices to political relationship building.

Are we moving into a new era for alcohol policy globally? An analysis of the Global Alcohol Action Plan 2022-30

The Global Alcohol Action Plan 2022-30 (GAAP) represents an important milestone in policy implementation at the global level on alcohol and health. There has, however, been little attention paid to the GAAP in the research literature. With a focus on the alcohol industry, this analysis examines the content of, and prospects for, the GAAP. It is clear why stronger action on alcohol and health is needed. The health harming nature of alcohol and policy interference by industry are now clearly understood. The alcohol industry is now thus regarded primarily as a key part of the problem. The GAAP calls for action in six areas with specific roles for public health actors, and invites powerful industry actors to desist from harmful activities, within each area. The broad outline of what is expected of the alcohol industry is now clear. It remains unclear, however, how far countries will continue to face formidable opposition from the major alcohol companies and their surrogates, in adopting and implementing evidence-based measures. Governments must now act at speed, and it is unclear if the targets set for 2030 will be met. If this long-running public health policy failure continues, this will have dire consequences for low and middle income countries where the alcohol market is expanding. Stronger actions may also be needed.

Evolution of the major alcohol companies key global policy vehicle through the prism of tax records 2011-19

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.

The perceived impact that alcohol policy could have on Brazilian and British students' pre-drinking behaviour

BACKGROUND

Evidence on how pre-drinking (i.e., drinking in private or in unlicensed settings before going out) varies across cultures and its implications for defining policies and prevention strategies is needed. We explored the perceived impact that various alcohol policies could have on pre-drinking practices amongst Brazilian and British students that pre-drink.

METHODS

A cross-sectional, online survey amongst student drinkers aged 18-29 in England (N = 387) and Brazil (N = 1,048) explored sociodemographic, pre-drinking habits, and attitudes towards alcohol policies (increasing prices, regulating availability, and restricting promotions).

RESULTS

A greater proportion of British students were aged between 18 and 21 years old (67.2%) than Brazilian students (45.2%; p < 0.001). More British (ENG 85.8%) than Brazilian (BRA 44.8%, p < 0.001) students reported pre-drinking. Pre-drinkers' main motivation was to save money (BRA 66.5%, ENG 46.2%, p < 0.001). In multivariate analyses, in Brazil, male (Odds Ratio [OR]: 1.53, CI: 1.04-2.24) and white (OR: 1.60, CI: 1.03-2.49) pre-drinkers were more likely to believe that increasing prices policies could reduce their pre-drinking habits. In Brazil, white pre-drinkers (OR: 1.86, CI: 1.10-3.15) were more likely to believe that restricting alcohol promotions policies could reduce their pre-drinking habits. Regarding the perceived impact that the combined alcohol policies could have on students' pre-drinking practice, only in Brazil there were significant statistical results.

CONCLUSIONS

Whilst in Brazil none of the investigated alcohol policies are currently implemented, more Brazilian pre-drinkers believed that such legislation could reduce their pre-drinking practices (when compared with British pre-drinkers). These data may help legislators and stakeholders to better understand the characteristics of a more acceptable alcohol policy amongst university students.

Management of Conflicts of Interest in WHO's Consultative Processes on Global Alcohol Policy

BACKGROUND

The World Health Organization (WHO) has engaged in consultations with the alcohol industry in global alcohol policy development, including currently a draft action plan to strengthen implementation of the Global strategy to reduce the harmful use of alcohol. WHO's Framework for Engagement with Non-State Actors (FENSA) is an organization-wide policy that aims to manage potential conflicts of interest in WHO's interactions with private sector entities, non-governmental institutions, philanthropic foundations and academic institutions.

METHODS

We analysed the alignment of WHO's consultative processes with non-state actors on "the way forward" for alcohol policy and a global alcohol action plan with FENSA. We referred to publicly accessible WHO documents, including the Alcohol, Drugs and Addictive Behaviours Unit website, records of relevant meetings, and other documents relevant to FENSA. We documented submissions to two web-based consultations held in 2019 and 2020 by type of organization and links to the alcohol industry.

RESULTS

WHO's processes to conduct due diligence, risk assessment and risk management as required by FENSA appeared to be inadequate. Limited information was published on non-state actors, primarily the alcohol industry, that participated in the consultations, including their potential conflicts of interest. No minutes were published for WHO's virtual meeting with the alcohol industry, suggesting a lack of transparency. Organizations with known links to the tobacco industry participated in both web-based consultations, despite FENSA's principle of non-engagement with tobacco industry actors.

CONCLUSION

WHO's consultative processes have not been adequate to address conflicts of interest in relation to the alcohol industry, violating the principles of FENSA. Member states must ensure that WHO has the resources to implement and is held accountable for appropriate and consistent safeguards against industry interference in the development of global alcohol policy.

Addressing alcohol-related harms in the local night-time economy: a qualitative process evaluation from a complex systems perspective

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.

"Using information to shape perception": tobacco industry documents study of the evolution of Corporate Affairs in the Miller Brewing Company

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.

Policy influence and the legalized cannabis industry: learnings from other addictive consumption industries

BACKGROUND AND AIM

New Zealand has recently legalized medicinal cannabis and has explored the possibility of legalizing large-scale recreational cannabis supply. In the process, concerns have emerged regarding whether corporations involved in the large-scale production and sale of legalized cannabis will invest in tactics of influence with policymakers and the public. This paper aimed to examine the various ways a legalized cannabis industry could seek to influence governments and the public in the New Zealand reform context.

METHOD

Based on the study of industry tactics with alcohol, tobacco and gambling, we applied a three-chain model of industry influence that breaks tactics into the 'public good', 'knowledge' and 'political' chains.

RESULTS

Exploratory analysis of the nascent cannabis industry's activity in New Zealand provided signs of industry influence strategies related to all three chains. The medicinal cannabis industry has associated the establishment of a legal cannabis sector with regional economic development and employment, supported lobbying for recreational law reform, funded NGOs involved in lobbying for law reform, established research partnerships with universities, invited ex-politicians on advisory boards, and participated in government public sector partnerships.

CONCLUSION

There is emerging evidence that the legal cannabis industry is using strategies to influence the regulatory environment in New Zealand.

"When the Fun Stops, Stop": An analysis of the provenance, framing and evidence of a 'responsible gambling' campaign

When the Fun Stops, Stop, is a prominent 'responsible gambling' campaign in the UK, originally funded and delivered by the industry-initiated and funded Senet Group. Since the Senet Group's dissolution in 2020, the campaign has been overseen by the Betting and Gambling Council (BGC), the main gambling industry trade body. There has been no prior analysis of the activities, ideas and framing adopted by the Senet Group, who claimed to be acting as an industry 'watchdog' and oversaw what they characterised as a major public education campaign. We collated written and image-based material related to the Senet Group and its When the Fun Stops, Stop campaign from multiple sources. Guided by Entman's four functions of framing, we analysed the Senet Group's framing of the issues it sought to address, particularly harmful gambling, as well as its causes, and the solutions, focusing on the group's main activity: the delivery of the When the Fun Stops, Stop campaign. We also critically appraised an evaluation of the campaign funded by the Senet Group, using the findings to interrogate the stated claims about the campaign's effectiveness. The analysis showed that the Senet Group's framing of the problem, its causes, and proposed responses resemble those adopted by other industries and industry-funded groups. This involves portraying any harms caused by their products as limited to an atypical minority, rejecting upstream determinants of harm, and promoting individually-targeted voluntary measures, all contrary to the evidence of what works in health promotion, and what would characterise a public health approach. Neither the existing evidence base nor the evidence presented by the Senet Group support their claims about the campaign's effectiveness. These findings add to concerns about industry-funded campaigns in other areas. To minimise conflicts of interest, interventions intended to address gambling-related harms, such as public education campaigns, should be evidence-based and developed, implemented and evaluated completely independent of the industry and industry-funded organisations.

'We're in this together': A content analysis of marketing by alcohol brands on Facebook and Instagram during the first UK Lockdown, 2020

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.

Drink, but don't drive? The alcohol industry's involvement in global road safety

Drink-driving is a major cause of global road traffic fatalities, yet few countries have laws that meet international best practices. One possible reason is the alcohol industry’s opposition to meaningful policies that are perceived to directly threaten sales. Our primary objectives are to document alcohol industry involvement in global road safety policies and programmes and to critically evaluate the responses of public health and road safety communities to this involvement. Under the guidance of the Policy Dystopia Model, we used a mixed methods approach in which data were gathered from expert interviews and a mapping review of 11 databases, 5 watchdog websites and 7 alcohol industry-sponsored initiatives. Triangulation was used to identify points of convergence among data sources. A total of 20 expert interviews and 94 documents were analysed. Our study showed that the alcohol industry acknowledges that drink-driving is an issue but argues for solutions that would limit impact on sales, akin to the message ‘drink—but do not drive’. Industry actors have been involved in road safety through: (1) coalition coupling and decoupling, (2) information production and management, (3) direct involvement in policymaking and (4) implementation of interventions. Our study also shed light on the lack of cohesion within and among the public health and road safety communities, particularly with regard to the topics of receiving funding from and partnering with the alcohol industry. These results were subsequently used to adapt the Policy Dystopia Model as a conceptual framework that illustrates the ways in which the alcohol industry has been involved in global road safety. Several implications can be drawn from this study, including the urgent need to increase awareness about the involvement of the alcohol industry in road safety and to build a cohesive transnational alcohol control advocacy alliance to curb injuries and deaths related to drink-driving.

Co-regulation and alcohol industry political strategy: A case study of the Public Health England-Drinkaware Drink Free Days Campaign

This article examines the Drink Free Days (DFD) campaign run by Public Health England and the industry funded alcohol education charity, Drinkaware, in eight English regions in 2018-2019. More specifically, it examines uses, and usefulness, of the campaign to the alcohol producers which fund Drinkaware. It draws on 36 semi-structured interviews with policy actors and a framing analysis of industry social media accounts and news coverage of the campaign. Industry-associated bodies such as Drinkaware have been identified as key components of alcohol industry strategies to influence policy and shape the regulatory contexts in which they operate in three ways. First, funding such bodies forms part of corporate social responsibility programmes which allow companies to position themselves as legitimate policy actors and 'part of the solution' to alcohol related harms. Second, reliance on industry funding incentivises governments to co-operate with industry actors and provides leverage in policy debates. Third, their programmes absorb policy bandwidth and deflect from more effective, evidence based interventions (e.g. on pricing and advertising) which affect industry sales and profits. This is particularly effective if the perception of independence from the industry is created. The analysis presented below suggests that the DFD was not used explicitly by the industry actors for public relations purposes. However, it was useful to their broader strategic aims. It reinforced the position of Drinkaware as a key policy actor and promoted the particular, industry-favoured understanding of alcohol harms and their solutions which it promotes. This is in keeping with the previous insights from international research literature on corporate political activity in health harming industries which finds that policy influence is often subtle, indirect and designed to embed organisations within the policy architecture. It suggests that government agencies should proceed with great caution in entering into such partnerships with industry associated bodies.

A public health approach to gambling regulation: countering powerful influences

Often portrayed as a harmless leisure activity in the UK, gambling is being increasingly recognised as a public health concern. However, a gambling policy system that explicitly tackles public health concerns and confronts the dependencies and conflicts of interest that undermine the public good is absent in the UK. Although there is a window of opportunity to change the gambling policy system, with the UK Government's launch of a review of the Gambling Act 2005, the adoption of a comprehensive and meaningful public health approach is not guaranteed. Too often, government policy has employed discourses that align more closely with those of the gambling industry than with those of the individuals, families, and communities affected by the harms of gambling. In view of the well described commercial determinants of health and corporate behaviour, an immense effort will be needed to shift the gambling discourse to protect public health. In this Viewpoint, we seek to advance this agenda by identifying elements that need challenging and stimulating debate.

The Alcohol Marketing Landscape: Alcohol Industry Size, Structure, Strategies, and Public Health Responses

Objective:

The purpose of this study is to inform public health efforts to reduce alcohol-related harm by describing the alcohol marketing landscape. We review the size, structure, and strategies of both the U.S. national and global alcohol industries and their principal marketing activities and expenditures and provide a summary of public health responses.

Method:

Primary data were obtained from advertising and alcohol industry market research firms and were supplemented by searches of peer-reviewed literature, business press, and online databases on global business and trade.

Results:

Worldwide, alcohol sales totaled more than $1.5 trillion in 2017. Control of alcoholic beverage production and marketing is concentrated globally in the hands of a small number of firms. The oligopoly structure of the producing industry helps to generate high profits per dollar invested relative to other industries, which in turn fund marketing expenditures that function as barriers to entry by other firms. Advertising expenditures are high and advertising is widespread. Stakeholder marketing and corporate social responsibility campaigns assist in maintaining a policy environment conducive to extensive alcohol marketing activity. The most common regulatory response has been alcohol industry self-regulation; statutory public health responses have made little progress in recent years and have lagged behind industry innovation in digital and social marketing.

Conclusions:

Alcohol marketing is widespread globally and a structural element of the alcoholic beverage industry. Given the level of alcohol-related harm worldwide, global and regional recommendations and best practices should be used to guide policy makers in effective regulation of alcohol marketing.

The Commercial Determinants of Three Contemporary National Crises: How Corporate Practices Intersect With the COVID-19 Pandemic, Economic Downturn, and Racial Inequity

Policy Points  The United States finds itself in the middle of an unprecedented combination of crises: a global pandemic, economic crisis, and unprecedented civic responses to structural racism.  While public sector responses to these crises have faced much justified criticism, the commercial determinants of these crises have not been sufficiently examined.  In this commentary we examine the nature of the contributions of such actors to the conditions that underpin these crises in the United States through their market and nonmarket activities.  On the basis of this analysis, we make recommendations on the role of governance and civil society in relation to such commercial actors in a post-COVID-19 world.

Alcohol industry, corporate social responsibility and country features in Latin America

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.

News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland

OBJECTIVE

Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated.

METHOD

We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis.

RESULTS

Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43).

CONCLUSIONS

News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.

Comparing responses to public health and industry-funded alcohol harm reduction advertisements: an experimental study

OBJECTIVES

Conduct a head-to-head experimental test of responses to alcohol harm reduction advertisements developed by alcohol industry Social Aspects/Public Relations Organisations (SAPROs) versus those developed by public health (PH) agencies. We hypothesised that, on average, SAPRO advertisements would be less effective at generating motivation (H1) and intentions to reduce alcohol consumption (H2) but more effective at generating positive perceptions of people who drink (H3).

DESIGN

Online experiment with random assignment to condition.

PARTICIPANTS

2923 Australian adult weekly drinkers (49% high-risk drinkers) recruited from an opt-in online panel.

INTERVENTIONS

Participants viewed 3 of 83 advertisements developed by PH agencies (n=2174) or 3 of 28 advertisements developed by SAPROs (n=749).

PRIMARY OUTCOME MEASURES

Participants reported their motivation to reduce the amount of alcohol consumed; behave responsibly and/or not get drunk; and limit their drinking around/never supply to minors, as well as intentions to avoid drinking alcohol completely; reduce the number of drinking occasions; and reduce the amount of alcohol consumed per occasion. Participants also reported their perceptions of people who drink alcohol on six success-related items and four fun-related items.

RESULTS

Compared with drinkers exposed to PH advertisements, those exposed to SAPRO advertisements reported lower motivation to reduce the amount of alcohol consumed (β=-0.091, 95% CI -0.171 to -0.010), and lower odds of intending to avoid alcohol completely (OR=0.77, 0.63 to 0.94) and to reduce the amount of alcohol consumed per occasion (OR=0.82, 0.69 to 0.97). SAPRO advertisements generated more favourable fun-related perceptions of drinkers (β=0.095, 0.013 to 0.177).

CONCLUSIONS

The alcohol harm reduction advertisements produced by alcohol industry SAPROs that were tested in this study were not as effective at generating motivation and intentions to reduce alcohol consumption as those developed by PH organisations. These findings raise questions as to whether SAPROs should play a role in alcohol harm reduction efforts.

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 Alcohol Marketing Landscape: Alcohol Industry Size, Structure, Strategies, and Public Health Responses

OBJECTIVE

The purpose of this study is to inform public health efforts to reduce alcohol-related harm by describing the alcohol marketing landscape. We review the size, structure, and strategies of both the U.S. national and global alcohol industries and their principal marketing activities and expenditures and provide a summary of public health responses.

METHOD

Primary data were obtained from advertising and alcohol industry market research firms and were supplemented by searches of peer-reviewed literature, business press, and online databases on global business and trade.

RESULTS

Worldwide, alcohol sales totaled more than $1.5 trillion in 2017. Control of alcoholic beverage production and marketing is concentrated globally in the hands of a small number of firms. The oligopoly structure of the producing industry helps to generate high profits per dollar invested relative to other industries, which in turn fund marketing expenditures that function as barriers to entry by other firms. Advertising expenditures are high and advertising is widespread. Stakeholder marketing and corporate social responsibility campaigns assist in maintaining a policy environment conducive to extensive alcohol marketing activity. The most common regulatory response has been alcohol industry self-regulation; statutory public health responses have made little progress in recent years and have lagged behind industry innovation in digital and social marketing.

CONCLUSIONS

Alcohol marketing is widespread globally and a structural element of the alcoholic beverage industry. Given the level of alcohol-related harm worldwide, global and regional recommendations and best practices should be used to guide policy makers in effective regulation of alcohol marketing.

News Media and the Influence of the Alcohol Industry: An Analysis of Media Coverage of Alcohol Warning Labels With a Cancer Message in Canada and Ireland

OBJECTIVE

Media coverage of alcohol-related policy measures can influence public debate and is often more aligned with interests of the alcohol industry than public health. The purpose of this study was to examine the framing of news coverage of alcohol warning label (AWL) initiatives that included a cancer message on alcohol containers in two different countries. Policy contexts and industry perspectives were also evaluated.

METHOD

We identified and systematically reviewed news articles published between 2017-2019 covering an AWL academic study in Yukon, Canada, and labeling provisions in a Public Health (Alcohol) Bill in Ireland. Both included a cancer message. News stories were coded for media type and topic slant; inclusion of alcohol industry perspectives was examined using content analysis.

RESULTS

Overall, 68.4% of media articles covering the Yukon Study (n = 38) and 18.9% covering the Ireland Bill (n = 37) were supportive of AWLs with a cancer message. The majority of articles in both sites presented alcohol industry perspectives (Yukon, 65.8%; Ireland, 86.5%), and industry arguments opposing AWLs were similar across both contexts. In articles with statements from industry representatives, the label message was frequently disputed by distorting or denying the evidence that alcohol causes cancer (n = 33/43).

CONCLUSIONS

News coverage of AWLs with a cancer message was more supportive in Canada than Ireland, where alcohol industry perspectives were consistently foregrounded. Industry arguments opposing the cancer label bore similarities across contexts, often distorting or denying the evidence. Increasing awareness of industry messaging strategies may generate more critical coverage of industry lobbying activities and increase public support for alcohol policies.

Perceptions of Alcohol Health Warning Labels in a Large International Cross-Sectional Survey of People Who Drink Alcohol

Aims

This paper aimed to explore perceptions of alcohol health warning labels amongst a large international sample of people who drink alcohol.

Methods

The Global Drug Survey (GDS) is the world’s largest annual cross sectional survey of drug use. Seven health warning labels were presented (relating to heart disease, liver, cancer, calories, violence, taking two days off and the myth of benefits to moderate drinking). People were asked if they were aware of the information, believed it, if it was personally relevant, and if it would change their drinking. This paper included data from 75,969 respondents from 29 countries/regions who reported the use of alcohol in the last 12 months, collected during November–December 2017 (GDS2018).

Results

The fact that drinking less can reduce the risk of seven types of cancer was the least well known, and yet was demonstrated to encourage almost 40% of drinkers to consider drinking less. Women and high risk drinkers were more likely to indicate they would reduce their drinking in response to all labels. Personal relevance was identified as a key predictor of individual responses.

Conclusion

Findings highlight the potential of a range of health messages displayed on alcoholic beverages to raise awareness of alcohol-related harms and potentially support a reduction in drinking. Further research should explore what influences personal relevance of messages as this may be a barrier to effectiveness.

Alcohol Industry CSR Organisations: What Can Their Twitter Activity Tell Us about Their Independence and Their Priorities? A Comparative Analysis

There are concerns about the accuracy of the health information provided by alcohol industry (AI)-funded organisations and about their independence. We conducted a content analysis of the health information disseminated by AI-funded organisations through Twitter, compared with non-AI-funded charities, to assess whether their messages align with industry and/or public health objectives. We compared all tweets from 2016 from Drinkaware (UK); Drinkaware.ie (Ireland); and DrinkWise (Australia), to non-AI-funded charities Alcohol Concern (UK), Alcohol Action Ireland, and FARE (Australia). Industry-funded bodies were significantly less likely to tweet about alcohol marketing, advertising and sponsorship; alcohol pricing; and physical health harms, including cancers, heart disease and pregnancy. They were significantly more likely to tweet about behavioural aspects of drinking and less likely to mention cancer risk; particularly breast cancer. These findings are consistent with previous evidence that the purpose of such bodies is the protection of the alcohol market, and of the alcohol industry's reputation. Their messaging strongly aligns with AI corporate social responsibility goals. The focus away from health harms, particularly cancer, is also consistent with previous evidence. The evidence does not support claims by these alcohol-industry-funded bodies about their independence from industry.