The Beverage Alcohol Industry's Social
Issue 3 2002
The beverage alcohol industry’s social aspects organizations: A public health warning
G lobal A lcohol P olicy A lliance Contents Issue 3, 2002
4 Editorial 5 Summary and recommendations of Eurocare 23 Conclusions - relating to social aspects organizations
GLOBAL ALCOHOL POLICY ALLIANCE Design and production 2b Graphic Design
Editor in Chief Published by The Global Alcohol Policy Alliance Derek Rutherford 12 Caxton Street London SW1H 0QS Editor Tel: 020 7222 4001 Andrew McNeill Fax: 020 7799 2510 Assistant Editor Email: [email protected] Andrew Varley ISSN 1460-9142
2 Advocacy for the prevention of alcohol related harm in Europe
The beverage alcohol industry’s social aspects organizations: A public health warning
A paper prepared by Dr Peter Anderson for the EUROCARE Alcohol Policy Working Party*
* Throughout this paper, reference is made to the websites of a number of social aspects organizations. Please note that these websites change, and the documents referred to may no longer be accessible on the noted website. The documents referred to in this paper were downloaded and archived from the websites of the social aspects organizations during the period January 2002 to September 2002.
3 The beverage alcohol industry’s social aspects organizations: A public health warning* Editorial
This is a special and extended issue of The Globe. In a independence and objectivity of educational previous Globe (No. 1 2001) we reported that “A disturbing programmes. They should ensure that international contemporary trend is the growing importance of so- bodies such as the World Health Organisation are allowed called 'social aspects' organisations. The evaluation of the to do their work free from undue political pressures first European Alcohol Action Plan identified the growing exerted on behalf of commercial interests. Nationally and influence of the alcohol industry, as well as its more internationally, steps should be taken to prevent the aggressive approach to marketing, as an obstacle to the alcohol industry from gaining the dominant position in implementation of the plan. Increasingly, the influence of the field of prevention and research in alcohol problems. the alcohol industry is exercised through social aspects Governments should ensure that NGOs receive adequate organisations. These are created by the beverage alcohol financial support to perform their functions whilst industry to promote its interests, but are often presented allowing them to retain their independence and their to the public as impartial and objective bodies whose sole freedom to speak in the public interest. Governments concern is to tackle the problems of alcohol misuse. should also be aware that the independence and credibility needed by NGOs to be socially useful will be These organisations appear to have become a major seriously compromised if, for want of an alternative, they influence on policy making at international as well as are forced to seek financial support from the alcohol national levels. Compared to most NGOs, social aspects industry. organisations command huge financial resources and, next to Government, they may well be the principal source The dangers of excessive alcohol industry influence on of funds for alcohol education and research. This provides policy making are particularly obvious in relation to a strong basis on which to influence public policy on a alcohol and young people.” range of issues. It is for these reasons The Globe is pleased to publish a full The economic importance of the alcohol industry provides version of Eurocare’s recent critique ‘The Beverage Alcohol social aspects organisations with regular access to policy Industry’s Social Aspects Organizations: A Public Health makers in Government and facilitates its ability to resist Warning. public health and safety policies which it regards as against its interests. The hostility of the alcohol industry and its social aspects organisations to the European Alcohol Action Plan, and to the scientific research that underpins it, is a matter of record. While sometimes finding it convenient to speak the language of science and even to publish carefully selected 'research', they have made repeated attempts to discredit basic scientific findings. For example, in 1995 the Portman Group offered financial inducements to academics to write anonymous attacks on ‘Alcohol Policy and the Public Good', the book written by Professor G. Edwards and his colleagues to provide the scientific rationale of the WHO European Alcohol Action Plan. Governments have a responsibility to safeguard the integrity of the policy making process and the
4 The beverage alcohol industry’s social aspects organizations: A public health warning*
Summary and favours the commercial interest of the organizations that have a specific role with Over the last twenty years the beverage alcohol beverage alcohol industry rather than the regard to safeguarding effective alcohol industry has set up and funded social aspects public good. policy should inform and mobilize civil organizations to manage issues that may be The view that the marketing of alcoholic society with respect to alcohol-related detrimental to its business. Social aspects beverages should be regulated by the problems, lobby for implementation of organizations operate at the global level beverage alcohol industry itself is effective policy at government level, and (International Center for Alcohol Policies), the inherently unlikely to work, since the expose any harmful actions of the European level (The Amsterdam Group), and essence of self-regulation is that beverage alcohol industry. at the country level, in high, middle and low compliance with codes is voluntary and 6 In discharging their role, and in income countries. They aim to manage issues the industry has blatantly, consistently and maintaining their respect with civil society, by: extensively broken its own codes in all non-governmental organizations Attempting to influence the alcohol areas of the world, with no evidence that mentioned in point 5 above should remain policies of national and international this has improved over recent years. completely independent of social aspects governmental and integrational The view that alcohol, despite its potential organizations and any communications organizations; for abuse, confers a net benefit to society between such non-governmental Becoming members of relevant non- fails to acknowledge that, even allowing for organizations and social aspects alcohol specific organizations and the possible protective effects of alcohol organizations should be transparent, and committees to broaden policy influence consumption, alcohol ranks as one of the placed in the public domain. and respectability; highest causes of disease burden in the 7 All independent scientists that are paid by Recruiting scientists, hosting conferences world on a par with measles, tuberculosis or undertake work for social aspects and promoting high profile publications; and malaria combined, with a cost to organizations and the beverage alcohol Creating social aspects organizations in Europe of between 2% and 5% of gross industry should state their declarations of emerging markets and low income domestic product. interest in their scientific publications. countries; and 8 Research scientists in high income Preparing and promoting consensus Recommendations of Eurocare countries should consider their ethical responsibility not to profit from or statements and codes of practice. 1 Governments need to implement evidence contribute to the beverage alcohol based policies to reduce the harm done by Social aspects organizations hold five main industry’s actions in low income countries alcohol, with such policies formulated by viewpoints which on inspection confirm their which often lack the infrastructure to public health interests, recognizing that overall aim, which is to benefit their funding respond to and effectively regulate the the viewpoints of social aspects body, the beverage alcohol industry, rather beverage alcohol industries’ marketing organizations are not impartial and than to benefit public health or the public practices. represent the vested interests of the good. 9 Greater vigilance and monitoring of beverage alcohol industry. The view that patterns of drinking are the beverage alcohol industry behaviour is 2 Governmental organizations should be best basis for alcohol policies fails to needed, especially issues of intelligence- concerned at spending public money on recognize that the purpose of alcohol gathering; image management actions the programmes and policies put forward policy is to reduce the harm done by such as industry-initiated dialogues; active by the social aspects organizations, since alcohol and that this can only be effectively agenda-setting in the areas of research or such programmes and policies lack achieved by addressing both the volume of publishing, with a particular emphasis on evidence of effectiveness. alcohol consumed as well as the way in so-called beneficial patterns of drinking; 3 A proportion of alcohol taxes, which it is consumed. and the image transfer effect of industry hypothecated for the purpose, should be The view that responsible drinking can be connections with reputable scientists and used to fund relevant independent non- learned and that this should be the public health organizations. cornerstone of alcohol policy fails to governmental organizations to implement recognize that without addressing the evidence based campaigns to reduce the social environment in which the alcohol is harm done by alcohol. consumed (including policy on the price, 4 Governments should support availability and marketing of alcohol nongovernmental organizations that are products) alcohol policies based on independent of the beverage alcohol individual responsibility are ineffective in industry and that promote initiatives reducing harm. aimed at reducing the harm done by The view of social aspects organizations alcohol, recognizing that critical appraisal that they have an equal place at the policy of government policy should not call table fails to recognize that the evidence financial support for non-governmental that they bring to the table is not impartial organizations into question. 5 Independent non-governmental
5 The beverage alcohol industry’s social aspects organizations: A public health warning*
1. Introduction: a public health warning
Over the last twenty years the consensus-orientated dialogues and then such programmes all too easily merge into beverage alcohol industry has set using their participation to enhance the image marketing campaigns for the use of the up and funded social aspects of their own industry; and by discrediting beverage alcohol industry’s products. The role organizations to represent the critics by stereotyping them with such labels as of social aspects organizations in low income industry in the alcohol policy anti-alcohol, anti-business or prohibitionist. countries, with a clear objective of changing debate and in the social and the social climate around drinking, is an Whilst it may be very appealing for public discourse about the harm affront to the vast majority of people in such governmental and non-governmental sectors done by alcohol. Although countries who choose not to drink alcoholic and for educational, professional and scientific apparently acting with a view to products and a disregard for the harm that bodies to partner with the beverage alcohol benefit or improve the condition alcohol can add to the problems of already industry through its social aspects of society, it should be impoverished individuals, families and organizations, it should be remembered that remembered that the beverage communities. these organizations are not impartial. Such alcohol industry’s primary focus partnerships can compromise the is to maximize profits1: independence of public health with a risk of Standpoint three – “Every action taken by management is damaging the public good and of impairing the a place at the policy table guided by one overriding objective – trust of civil society in its public institutions. A Although believing that they have an equal enhancing shareholder value.” high level of human health protection should be place at the policy table, social aspects In setting up social aspects organizations the ensured in the definition and implementation organizations bring to the table a beverage alcohol industry has aimed to create of governmental policies and activities. Science misrepresentation of the evidence base for an image of a socially concerned business, based evidence should carry greater weight in effective policy, supporting only those policy whilst at the same time attempting to diffuse the formulation of public health policies options for which the evidence is of no or very criticism and to manage public debate on concerning alcohol than that of the special limited impact in reducing the harm done by issues that are sensitive to its business. Among pleading of the beverage alcohol industry. alcohol. the issues that the beverage alcohol industry Unfortunately, this does not often happen. would like to manage are alcohol policies that Five standpoints advanced by social aspects Standpoint four – are effective in reducing harm, such as organizations confirm their overall aim, which industry self-regulation taxation and limitations on the availability of is to benefit their funding body, the beverage The beverage alcohol industry has consistently beverage alcohol, phrases such as ‘the harm alcohol industry, rather than to benefit public demonstrated that it is unable to be impartial done by alcohol’, and marketing practices in health or the public good. in its self-regulation. It has blatantly, low income countries and to young people. consistently and extensively broken its own Social aspects organizations attempt to Standpoint one – advertising codes in all areas of the world and manage issues by gaining representation in a individual responsibility there is no evidence that this has changed over wide range of national and international recent years. Self-regulation is inherently The notion of individual responsibility put governmental and non-governmental unlikely to work, since the essence of self- forward by the social aspects organizations and organizations2; by working with national and regulation in most countries and in most the consequent individual based policy options international civil servants to create media is that compliance with codes is favoured by them ignore the social regulations that legitimize their marketing voluntary, and subject to changes and revision environment in which the use of alcohol takes practices and opportunities; by diverting public by the beverage alcohol industry itself. Most place and are thus positioned to fail in attention and controversy through focusing on self-regulatory codes also do not account in reducing the harm done by alcohol. issues of secondary importance; by their content for the way successful advertising sponsorship of respected academics to engage actually works. in research whose agenda is specified by the Standpoint two – changing the climate around beverage alcohol industry; by refocusing public Standpoint five – drinking controversy by initiating dialogues with the elimination of negative public that are needed to sustain industry The funding and implementation of drinking patterns viability; by inviting carefully selected educational programmes by social aspects It is not in the beverage alcohol industry’s supporters and critics to participate in organizations creates a conflict of interest, and economical interests to eliminate negative
1 Anheuser-Busch Co. Inc. Annual Report 1997, p. 3. 2 Richter, J. (1998) Engineering of Consent: uncovering corporate PR (Dorset, UK, The Corner House).
6 The beverage alcohol industry’s social aspects organizations: A public health warning* drinking patterns. The industry makes its irresponsible industry behaviour, such as This position paper will identify a number of profits from negative drinking patterns. If aggressive product marketing to vulnerable social aspects organizations, describe and social aspects organizations were successful in populations, has not changed. If anything, the discuss the five main standpoints that the their objectives in eliminating negative industry has accelerated its control over the organizations stand for, describe their five drinking patterns they would substantially manufacture, distribution and marketing of main methods of working and conclude by minimize the profits of their sponsors. alcohol in low income countries, and has been discussing how governmental organizations, active in high income countries in programmes non-governmental organizations and scientific Whilst many of the practices of the social ranging from the promotion of alcohol to young and public health bodies might respond and aspects organizations could be viewed as people to the sponsorship of research that fits relate to them. legitimate and sincere attempts by the beverage its own agenda. alcohol industry to be a good corporate citizen, 2. What are social aspects organizations?
Nearly twenty years ago, Tim Ambler of industry reacted to not dissimilar threats in income countries (see the annex). Grand Metropolitan set out what he a passive, inadequate manner and most of The aim of these organizations is to appear considered to be the principal dangers all too late ….. dead customers ring no tills socially responsible and public health friendly. facing the beverage alcohol industry3: ….. profit and social responsibility are However, a number of questions need “excise duties to be raised faster than entirely compatible.” answering. Is there common ground between inflation; Over the subsequent years, organizations were public health and the beverage alcohol more vigorous measures to be taken to set up and funded by the beverage alcohol industry, and, if so, where is it to be found and reduce drunken driving; industry to consider the social aspects of its where does control of the policy agenda lie? restrictions on retail hours, licenses etc.; product. Although the first such organization Can social aspects organizations be trusted funding rehabilitation for those suffering was the Dutch group STIVA, it was not until the and, were this to be the case, is some form of the effects of alcohol abuse; creation of the United Kingdom based Portman partnership possible? The answers to these advertising and other marketing restrictions; group in 1989 that social aspects organizations questions can best be determined by an warning labels on alcoholic drinks and began to raise their profile. Today, such examination of the industry’s standpoints and posters for all retail establishments; and organizations operate at the global level statements and its responses to different ingredient labelling.” (International Center for Alcohol Policies), the aspects of alcohol policy. He stated: European level (The Amsterdam Group), and “It is generally agreed that the tobacco at the country level, in high, middle and low 3. What do social aspects organizations stand for?
Social aspects organizations advance five Alcohol – despite its potential for abuse – International Center for Alcohol Policies Series’ on main standpoints, which have been most confers a net benefit to society. Alcohol and Society is Drinking Patterns and their clearly articulated by the International Consequences5. This publication advanced the Each of these standpoints will be described and Center for Alcohol Policies4: standpoint that patterns of drinking are the best the difficulties associated with them outlined. Patterns of drinking are the best basis for predictor of whether an individual will experience alcohol policies; positive or negative consequences of alcohol Responsible drinking can be learned; 3.1 Standpoint 1 consumption. Public/private partnerships will Patterns of drinking are the best basis for The standpoint led to the view of the increasingly influence alcohol policy alcohol policies Amsterdam Group6 that: development; Although it can include levels of drinking, the “The prevalence of alcohol-related problems The beverage alcohol industry will term patterns of drinking is usually taken to refer is not directly related to the average per strengthen self-regulatory mechanisms; to how people drink and the circumstances in capita consumption, but rather to and which they drink. The first volume in the problematic patterns of drinking.”
3 Ambler, T. 1984. Quoted in Rutherford, D. Social Aspects groups. Towards a global alcohol policy. The Globe. http://www.ias.org.uk. 4 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 5 Grant, M. & Litvak, J. Eds. Drinking Patterns and their Consequences London, Taylor & Francis. 1998. 6 The Amsterdam Group Report 2001. www.amsterdamgroup.org.
7 The beverage alcohol industry’s social aspects organizations: A public health warning* and to the view of the International Center for region” is consumed are related to the risk of harm. Alcohol7 policies that: For these conditions, the risk increases with The Action Plan supports the achievement of “Policy makers should shift their focus to the increasing levels of alcohol consumption and Target 12 of the health for all policy framework elimination of negative drinking patterns by is influenced by different patterns of drinking. for the WHO European region, also endorsed targeted strategies and to the promotion of by its Member States, which states that9: At the societal level, there is a direct beneficial patterns of drinking”. “By the year 2015, the adverse health effects relationship between levels of per capita The Amsterdam Group continued: from the consumption of addictive consumption and alcohol related harm. The “Policies aimed at the reduction of overall substances such as tobacco, alcohol and European Comparative Alcohol Study reviewed per capita consumption (in the form of psychoactive drugs should have been the post-war experience of alcohol and limiting the overall sales of alcoholic significantly reduced in all Member States.” mortality in the countries of the European beverages through marketing and production Union12. Time series analysis demonstrated Alcohol policy should be judged by its impact restrictions and high taxation) do not that there is a positive and significant in reducing harm. And the evidence is that address those who abuse the product. The relationship between changes in alcohol those policy options that address the economic notion of individual responsibility for consumption and changes in both overall and and physical availability of alcoholic products drinking behaviour needs to be stressed and alcohol related death for both men and are effective in reducing harm, whereas those that no collective regulation can ever replace women. The relationship applies to all types of policy options that address the responsibility of individual responsibility”. alcohol related harm, and is stronger in the individual, through programmes such as countries with lower overall alcohol The standpoint that patterns of drinking are education, are largely ineffective10. (This is consumption than in countries with higher the best basis for alcohol policies fails on three discussed in more detail in standpoint 3 overall alcohol consumption. For example, an main counts: the purpose of alcohol policy is below). extra litre of alcohol per person would result in to reduce the harm done by alcohol and the a 12.4% increase in homicides in northern effectiveness of alcohol policy needs to be Count two Europe, but only a 5.5% increase in southern judged in the light of its impact on harm; Alcohol related harm is determined by Europe. However, since consumption levels alcohol related harm is determined by the the volume of alcohol consumption, as are generally higher in southern Europe, the volume of alcohol consumption, as well as by well as by how it is drunk actual number of deaths attributable to alcohol how it is drunk; and the notion that alcohol is roughly equal in the northern and southern policy should be a matter of individual For the individual drinker, the harm done by regions. responsibility alone is a false choice. alcohol is related to both the volume of alcohol consumed and to how the alcohol is The drinking population in general has been 11 Count one consumed . For almost all of the physical found to behave as a collectivity. Increases or conditions related to alcohol, including decreases in overall consumption are likely to The purpose of alcohol policy is to reduce cirrhosis of the liver and alcohol-related result in shifts across the entire spectrum of harm and the effectiveness of alcohol cancers, the level of alcohol consumption is a drinkers, except when alcohol is rationed13. To policy needs to be judged in the light of more important determinant of harm than be effective, policy that reduces the harm done its impact on harm how the alcohol is consumed. The risk of these by alcohol will have an impact on both the The purpose of alcohol policy is to reduce the conditions increases with increasing levels of volume of alcohol consumed as well as on how harm done by alcohol. The European Alcohol alcohol consumption, and there is no clear cut the alcohol is consumed. Action Plan of the World Health Organization, off point between use, hazardous use and which has been endorsed by its Member harmful use. For conditions related to alcohol Count three States, has been criticized by the beverage intoxication, (including accidents, road traffic The notion that alcohol policy should be a alcohol industry for being a prohibitionist accidents, intentional violence both towards matter of individual responsibility alone document. However, the Action Plan is specific self and others, suicide, family violence, is a false choice in its aim8: violent crime, engaging in criminal behaviour, “to prevent and reduce the harm that can be and victimization, including robbery and rape) Social aspects organizations imply that individual done by alcohol throughout the European both the level of alcohol consumed and how it responsibility should be at the core of alcohol
7 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 8 European Alcohol Action Plan 200-2005. Copenhagen, World Health Organization Regional Office for Europe. 9 Health 21 – health for all in the 21st century. Copenhagen, World Health Organization Regional Office for Europe. 10 Edwards G., et al. Alcohol Policy and the Public Good. Oxford, Oxford University Press, 1994. 11 Edwards G., et al. Alcohol Policy and the Public Good. Oxford, Oxford University Press, 1994. 12 Norstrom, T. and Skog, O-J. Alcohol and mortality: methodological and analytical issues in aggregate analysis. Addiction 2001 96(Supplement 1), S5-S17. 13 World Health Organization. Alcohol and Health - implications for public health policy. Report of a WHO working Group, Oslo October 1995. Copenhagen; World Health Organization Regional Office for Europe.
8 The beverage alcohol industry’s social aspects organizations: A public health warning* policy. Social aspects organizations use the term is Learning about Drinking15. The publication children about alcohol. The Portman Group abuse, implying that this is an irresponsible use of advanced the standpoint that drinking is a states that although it is mainly aimed at the beverage alcohol industry’s product and is the learned behaviour, much like learning to drive. parents of teenagers, much of it is also relevant cause of harm. Social aspects organizations imply It is proposed that, if what influences this for parents of younger children. that it is the individual drinker who is responsible learning is better understood, programs that In low income countries, the International for whether or not the product is abused. The seek to reduce harm are likely to be more Center for Alcohol Policies has promoted World Health Organization has considered the effective. learning about drinking through its Growing term abuse as potentially pejorative and This standpoint led to the view of the Portman Up Life Skills Education programme19, which emotionally laden, and because of its ambiguity Group in the United Kingdom that16 was developed for all seven grades of selected no longer uses it in its ICD 10 classification of “Education is the key to tackling alcohol primary schools in South Africa and Botswana, mental and behavioural disorders when referring abuse and that responsible attitudes should during the period from 1996-1999. Rather to drugs of dependence14. The terms intoxication, be encouraged at a young age.” than providing health education by pointing harmful use and dependence take preference. out the dangers of certain behaviours, Life Harmful use is a pattern of alcohol use that is The International Center for Alcohol Policies Skills Education introduces children to a causing damage to health. The damage may be has emphasized the importance of number of skills such as decision-making physical (as in cases of liver cirrhosis) or mental responsibility and stated that17 it skills, communication skills and how to (for example, episodes of depressive disorder “Works with industry and public health handle emotions. The program included, but secondary to heavy consumption of alcohol). partners to promote responsible lifestyles in did not focus primarily upon, issues related to Alcohol is classified by the World Health industrialized and developing countries”, beverage alcohol. The International Center for Organization as a dependence producing drug, [noting that] “the concept of responsibility Alcohol Policies took the view (although with dependence on alcohol being a recognized differs widely depending on a range of provided no evidence for this) that: disorder. cultural factors. As consumption patterns “It is unlikely that primary school children change – especially in countries where Approaches centred on individual responsibility will be applying these skills immediately to drinking is not necessarily a traditional part and individual change fail to consider the social drinking alcohol beverages. Nevertheless a of the culture – it is important to constantly factors governing behaviour, including the Life Skills Education programme at this early redefine responsibility in culturally sensitive various environmental constraints and pressures age will provide the necessary foundation ways.” that limit individual choice. Individual based skills in ways that will enable them, as they strategies are far less effective than strategies Social aspects organizations implement and get older, to apply the skills in situations that aimed at controlling or altering relevant factors fund a number of programmes to support do involve drinking”. within the individual’s immediate environment, their understanding of responsible lifestyles, Designated driver campaigns, such as the such as the physical and economic availability of including, for example, educational Arnoldus Group’s Bob campaign are common alcohol, formal social controls on alcohol-related programmes at school and designated driver initiatives20. The United Kingdom Portman behaviour and initiatives aimed at changing campaigns to reduce drink driving. Group’s designated driver campaign promotes alcohol-related practices in the drinking In the field of education, the United Kingdom the message ‘If you drink, let others drive’21. environment through broad-based community based Portman Group, for example, has The campaign is aimed particularly at 18-40 action. Effective policy to reduce the harm done published resource materials for use in year old male drivers who are the group most by alcohol is about shaping the individual’s schools18. ‘We’ve Seen People Drinking’ is a at risk of being involved, injured or killed in a drinking environment to enable the healthy publication for use in primary schools and drink-drive accident. The campaign was choices to be the easy choices. ‘Finding Out About Drinking Alcohol’ is for use launched with support from professional by pupils in secondary schools. The Portman football, supported by a series of regional 3.2 Standpoint 2 group states that ‘Discussing Drinking With promotions delivered in partnership with local Responsible drinking can be learned Your Children’ is its most popular leaflet. It is communities, and supported by radio and bus promoted as a general guide for parents who advertising. In the Netherlands, the beverage The fifth book in the International Center for would like information on talking to their alcohol industry itself partnered with the Alcohol Policy’s Series on Alcohol and Society
14 World Health Organization. The ICD-10 Classification of mental and behavioral disorders. Geneva, World Health Organization, 1992. 15 Houghton, E. & Roche, A.M. Eds. Learning about Drinking London, Taylor & Francis, 2001. 16 The Portman Group www.portman-group.org.uk. 17 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 18 The Portman Group www.portman-group.org.uk . 19 International Center for Alcohol Policies. Life skills education in South Africa and Botswana 2000. www.icap.org. 20 The Arnoldus Group. [email protected]. 21 The Portman Group www.portman-group.org.uk.
9 The beverage alcohol industry’s social aspects organizations: A public health warning*
Ministry of Transport to launch a designated powerful than that of any alcohol information beliefs about alcohol in those societies driver campaign which was criticized because provided. where drinking is not necessarily a the non-drivers were clearly intoxicated and traditional part of the culture Unfortunately, there has been very little there was no scientific research on the research to test the effectiveness of the Education on alcohol is one aspect of public effectiveness of the campaign. designated driver campaigns that are communication, which is connected with These initiatives are wrongly conceived on two supported by social aspects organizations to alcohol advertising and other media counts: the educational initiatives proposed by reduce alcohol-related traffic accidents. From representations of alcohol25. Although the social aspects organizations have minimal the limited evidence that is available, it education as a means of reducing the harm or no impact in reducing the harm done by appears that designated driver campaigns are done by alcohol has limited success, this does alcohol and there is little or no evidence for largely ineffective and certainly not as effective not mean, however, that communication about the effectiveness of designated driver as a measure to prevent alcohol-related traffic alcohol plays no role in shaping people’s campaigns, the cornerstone of social aspects accidents as originally envisioned23. Whilst the beliefs and perceptions. As the range of most organizations’ policy to reduce alcohol-related public may be aware of the designated driver people’s direct experience with alcohol is traffic accidents and; learning responsible concept and there is an increased use of limited, many of people’s views and notions drinking as promoted by social aspects designated drivers, a large proportion of those are based on what is learnt from other people organizations can be interpreted as a familiar with the term do not require a or from the mass media. The media convey a marketing tool in all societies and as a way to designated driver to be identified before the steady flow of images and views on alcohol and influence the beliefs about alcohol in those planned drinking event or to avoid consuming drinking. These images mainly represent societies where drinking is not necessarily a alcohol during the event. Many who agree to alcohol consumption as a harmless practice, traditional part of the culture. serve as designated drivers renege after playing down the potential health risks and drinking, even though it means becoming an other negative consequences. When the media Count one intoxicated driver. Further, there is some do depict negative social, economic or health evidence that the presence of a designated consequences, they tend to present these as The educational initiatives proposed by driver encourages the non-drivers to drink occasional afflictions rather than as risks the social aspects organizations have more than they would otherwise, making them inherent in alcohol use. It is not surprising, minimal or no impact in reducing the a greater danger if either they or the designated therefore, that educational initiatives rarely harm done by alcohol and there is little drivers changed their minds. Unfortunately, succeed in bringing about behavioural change or no evidence for the effectiveness of the social aspects organizations are generally in the direction of reducing the harm done by designated driver campaigns, the opposed to those initiatives, such as reducing alcohol. They are simply swamped by the cornerstone of social aspects blood alcohol concentration (BAC) levels massive flow of messages conveying the social organizations’ policy to reduce alcohol- permitted for driving or high visibility random acceptability and high level of prevalence of related traffic accidents breath testing that have been demonstrated to alcohol use. A large part of these messages are The evidence is that whilst school-based be effective in saving deaths from alcohol commercial advertisements that portray the educational initiatives can change knowledge related road traffic accidents. Norway reduced use of alcohol as an essential component of and attitudes about alcohol, they are generally its legal blood alcohol concentration limit to desirable lifestyles. When alcohol education ineffective in changing behaviour in the use of 0.2g/L in 2001. Police data from road side funded and implemented by the beverage alcohol or preventing the harm done by tests showed a 22% drop in violations of the alcohol industry is viewed within this context, alcohol22. This is hardly surprising since limit compared with the year 2000, with the it is very difficult to avoid the blurring between school-based education competes against a decrease across the entire range of illegal education, advertising and the media portrayal barrage of messages that promote the use of blood alcohol levels24. of the use of alcohol. In other words, it is very alcohol. The primary source of pro-alcohol easy for such alcohol education to be messages is social reality itself, the widespread Count two interpreted as a part of a marketing strategy by and visible availability of alcoholic beverages, the beverage alcohol industry. Learning responsible drinking as and the presence and acceptability of alcohol promoted by social aspects organizations It is estimated that the growth areas for the use in a variety of everyday situations and contexts. can be interpreted as a marketing tool in of alcoholic beverages are the same emerging The influence of experience on people’s all societies and as a way to influence the markets that are considered in the second conceptions of alcohol issues tends to be more
22 Midford, R. & McBride, N. Alcohol education in school. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 785-804, 2001. 23 McKnight, A.J. & Voas, R.B. Prevention of alcohol-related road crashes. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 741-770, 2001. 24 Eurocare Newsletter. June 2002. www.eurocare.org 25 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001.
10 The beverage alcohol industry’s social aspects organizations: A public health warning* volume of the International Center for Alcohol “Set in motion a process of finding a less which there is no evidence either way) are Policies’ Series on Alcohol and Society, Alcohol emotional and value-laden way of supported by the social aspects organizations. and Emerging Markets26, that is Asia, Central communicating as a basis for a more and Eastern Europe, Latin America and sub- effective partnership.” 3.4 Standpoint 4 Saharan Africa. The International Center for The common language the International The drinks industry will strengthen self- Alcohol Policies27 is actively promoting what it Center for Alcohol Policies promotes is regulatory mechanisms calls ‘balanced alcohol policies based on pleasure, the social aspects organizations’ partnerships between the public and private The social aspects organizations take the view brand and means of policy influence, and the sectors’ in a number of low income countries that there is insufficient evidence to support an theme of the Center’s third book in its Series and emerging markets, introducing the association between advertising and levels or on Alcohol and Society, Alcohol and Pleasure: a ‘concepts of responsible drinking in countries patterns of drinking. They are opposed to Health perspective30. where drinking is not necessarily a traditional legislative marketing restrictions and believe part of the culture’. The balanced alcohol There is simply one problem with this that the marketing of alcoholic products policies that the International Center for Alcohol approach: social aspects organizations are should be regulated by the beverage alcohol Policies proposes are responsible promotional neither public health bodies nor scientific industry itself. and advertising practices and alcohol education organizations, but beverage alcohol industry The International Center for Alcohol Policies to promote sensible drinking, both of which are organizations which misrepresent the evidence summarizes the view of social aspects known to lack effectiveness. The effective base for effective policy to reduce the harm organizations in the following way31: environmental strategies are not adequately done by alcohol. “the right [of beverage alcohol industry addressed. The involvement of social aspects organizations] to advertise their brands is a organizations in emerging markets and low Problem one most important commercial freedom, but income countries can be understood as a Social aspects organizations are beverage [beverage alcohol industry organizations] marketing tool which shows little respect for the alcohol industry organizations which recognize that they must safeguard this vast majority of individuals in such countries misrepresent the evidence base for freedom by advertising in a responsible who choose not to consume alcohol, and with effective policy to reduce the harm done manner. [Beverage alcohol industry little regard for the harm that alcohol can add to by alcohol organizations] believe that industry self- the problems of already impoverished regulation through voluntary codes of individuals, families and communities28. The social aspects organizations’ practice is the most efficient means of misrepresentation of alcohol policy is regulating drinks advertising and demonstrated in the table, which summarizes 3.3 Standpoint 3 promotional activities, while at the same the evidence for the impact of policy options in Public/private partnerships will time protecting the rights of individual reducing the harm done by alcohol (classified increasingly influence alcohol policy companies to communicate with their as effective or ineffective), based on scientific development consumers and to compete for market share” reviews of the evidence, and the positions Social aspects organizations were set up and taken by the social aspects organizations The International Center for Alcohol Policies funded by the beverage alcohol industry to (classified as not supportive or supportive), also takes the view that self-regulation applies represent the industry in policy debate. based on their publications and web-sites. to all markets, including that of low income Therefore, it is no surprise, that social aspects countries: It is clear that there is a mismatch between the organizations regard themselves as having an “Emerging markets, especially in developing evidence for effective alcohol policy and the equal place at the policy table. countries, provide an opportunity for the policy options supported by the social aspects industry to work with the public health The International Center for Alcohol Policies29 organizations. In general, policy options that community to set new standards for abuse believes that social aspects organizations are: have been demonstrated to be effective in prevention and responsible marketing. “Public health organizations that should be reducing the harm done by alcohol are not Although the social environment may vary partners in influencing alcohol policy supported by the social aspects organizations, enormously from country to country, the development.” whereas policy options that have been International Center for Alcohol Policies demonstrated to be ineffective in reducing the In promoting its role in policy development, the identifies common factors that can be used harm done by alcohol (or policy options for International Center for Alcohol Policies has pro-actively around the world”.
26 Grant, M. Ed. Alcohol and Emerging Markets London, Taylor & Francis, 1998. 27 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 28 Saxena, S. Alcohol, Europe and the developing countries. Copenhagen, WHO Regional Office for Europe, 1995 (document EUR/ICP/ALDT 94 03/CN 01/32). 29 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 30 Peele, S. & Grant, M. Alcohol and Pleasure: a Health perspective London, Taylor & Francis, 1999. 31 International Centre for Alcohol Policies. A suggested Framework for responsibility, 1998 www.icap.org.
11 The beverage alcohol industry’s social aspects organizations: A public health warning*
Table. The impact of alcohol policy options to reduce the harm done by alcohol (effective or ineffective) and the position of social aspects organizations (not supportive or supportive)
Alcohol Policy Option Position of social aspects organizations Not supportive Supportive Taxation Negative elasticities Takes the view that taxation has no between price of alcohol and impact on alcohol-related harm; cirrhosis, fatal and non-fatal traffic takes the view that the solution to accidents and intentional injuries (as the problem of misuse does not lie in price goes up, harm goes down)1 restrictions which penalize everyone for the mistakes of a minority3
Legal drinking age Increased Suggests that there is no consensus drinking ages reduce traffic fatalities; as to whether or not minimal reduced drinking ages lead to drinking ages are desirable4; opposed increases in assaults2 to increasing legal drinking ages believing that it does not address those who abuse the product3
Effective Outlet density Increased outlet Opposed to limiting outlet density density associated with traffic believing that it does not address accidents, assaults and liver cirrhosis2 those who abuse the product3
Days and Hours of sale Closure of Believes that programmes that stores associated with reduced restrict days and hours of sale are alcohol related violence; extended ineffective and do not go to the heart Price and the availability of alcohol trading hours associated with of the problem of alcohol-related increases in road traffic accidents and violence; opposed to restricting days alcohol-related violence2 and hours of sale believing that they do not address those who abuse the product3
Proof of age schemes Evidence for Supports campaigns against underage the impact of policy measures such access, such as proof of age schemes5 as proof of age schemes is not
Ineffective available
1 Osterberg, E. Effects of price and taxation. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 685-698, 2001. 2 Stockwell, T. & Gruenewald, P. Controls on the physical availability of alcohol. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 699-720, 2001. 3 The Amsterdam Group Report 2001 www.amsterdamgroup.org. 4 International Centre for Alcohol Policies. Drinking Age. ICAP Policy Paper. www.icap.org. 5 The Portman Group www.portman-group.org.uk.
12 The beverage alcohol industry’s social aspects organizations: A public health warning*
Table continued
Alcohol Policy Option Position of social aspects organizations Not supportive Supportive Physical environment Changing the Takes the position that the vast physical environment of drinking majority of drinking episodes do not places reduces alcohol related involve violence, and most violence violence1 does not involve drinking, but recognizes that in some individuals Social environment Decreasing the and groups, a pattern of behaviour permissiveness of the environment may include both abusive drinking (better staff control; less discount and violence; offers no concrete drinks) reduces alcohol-related proposals2
Effective violence1
Server training with legal sanctions Opposed to legal sanctions; accepts Responsible server programs that server training leads to a supported by legal sanctions reduce reduction in licensee liability for harms from intoxication1 damages resulting from illegal service by trained servers3 .
Creating safer drinking environments Server training without legal Trains servers not to sell to underage sanctions Responsible server drinkers, but without legal programs not supported by legal sanctions4 sanctions do not reduce harms from Ineffective intoxication1
1 Homel, R., McIlwain, G. & Carvolth, R. Creating safer drinking environments. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 721-740, 2001. 2 The Amsterdam Group Report 2001 www.amsterdamgroup.org. 3 See Rydon, P. & Stockwell, T. Local regulation and enforcement strategies for licensed premises. In Plant, M., Single, E. & Stockwell, T. Eds. Alcohol:minimizing the harm-what works?. New York, Free Association Books. 1997. 4 The Portman Group www.portman-group.org.uk.
13 The beverage alcohol industry’s social aspects organizations: A public health warning*
Table continued
Alcohol Policy Option Position of social aspects organizations Not supportive Supportive Legal drinking age Increased Suggests that there is no consensus drinking age in US reduced traffic as to whether or not minimal accidents by 5%-28%1 drinking ages are desirable2; opposed to increasing legal drinking ages believing that it does not address those who abuse the product (i.e. drink driving) 3
Regulating the conditions of sale Believes that programmes that Extending trading hours increases restrict days and hours of sale are traffic accidents; targeted ineffective and do not go to the heart programmes at high risk premises of the problem of alcohol-related reduce accidents1 accidents; opposed to restricting
Effective days and hours of sale believing that they do not address those who abuse the product (i.e. drink driving)3
Random breath testing High Generally opposed to high visibility visibility can reduce deaths by random breath testing4 between one third and one half1
Reducing legal BAC limit Reduces Opposed to any reductions in legal Drink driving programmes drink driving and fatalities across all BAC limits5 levels of BAC1
Public education campaigns No Believes that educational evidence for a beneficial effect on programmes are the core component alcohol-related crashes1 of drink driving programmes6
Interventions by servers, hosts and Works with the hotel, restaurant, cafe peers Ineffective, although increased and bar sectors to develop anti-drink protection of drinking peers1 driving initiatives3 Ineffective
Alternative transportation Alternative transportation programmes Limited evidence programmes (designated river suggests ineffective1 campaigns) are priority projects6
1 McKnight, A.J. & Voas, R.B. Prevention of alcohol-related road crashes. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 741-770, 2001. 2 International Centre for Alcohol Policies. Drinking Age. ICAP Policy Paper. www.icap.org. 3 The Amsterdam Group Report 2001 www.amsterdamgroup.org. 4 Evidence given by The Amsterdam Group to the European Office of the World Health Organization, when commenting on the draft European Alcohol Action Plan 200-2005. Quoted in Quoted in Rutherford, D. The Amsterdam Group. The Globe. Alcohol industry’s social aspects groups exposed. www.ias.org.uk. 5 See Report of House of Lords European Committee 2002. Quoted in Alcohol Alert. www.ias.org.uk. 6 The Portman Group www.portman-group.org.uk.
14 The beverage alcohol industry’s social aspects organizations: A public health warning*
Table continued
Alcohol Policy Option Position of social aspects organizations Not supportive Supportive Community action based on both Opposed to environmental environmental and educational approaches, believing that they do approaches Comprehensive locally not address those who abuse the based community prevention product. programs have led to 10% reductions in alcohol involved car crashes, 25% Effective reductions in fatal crashes and 43% reductions in alcohol related violence1
Locally based community Describes school based alcohol Prevention programmes prevention programs based only on education, and drink driving educational approaches Have education programmes as community 1 6 Ineffective limited or no effect based programmes
Legal restrictions Although difficult Takes the view that there is to evaluate, there is evidence for a insufficient evidence to support an link between advertising and association between advertising and consumption at individual and levels or patterns of drinking; aggregate level; econometric analysis opposed to legislative marketing Effective suggest that advertising restrictions restrictions reduce motor vehicle fatalities2
Alcohol education in schools In Promotes and funds school based general no, or very limited impact on educational programme, in which use of alcohol; no evidence for an “the pleasure of drinking responsibly impact on harm3 is part of a balanced lifestyle” 7
Public education campaigns In Stresses the importance of general no, or very limited impact on educational programmes as the key use of alcohol; no evidence for an policy choice to reduce alcohol- impact on harm4 related harm6 Ineffective
Self-regulation Considerable The production and dissemination of evidence that self regulatory codes self-regulatory codes a core area of Education, communication and marketing restrictions are not adhered to5; no evidence as to work,8,9 whether or not self-regulation has an impact on behaviour or harm2
1 Treno, A.J. & Holder, H.D. Prevention at the local level. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 771-784, 2001. 2 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001. 3 Midford, R. & McBride, N. Alcohol education in school. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 785-804, 2001. 4 Boots, K. & Midford, R. Mass media marketing and advocacy to reduce alcohol related harm. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 805-822, 2001. 5 Marketing alcohol to young people; Eurocare, London, 2001. 6 The Amsterdam Group Report 2001 www.amsterdamgroup.org. 7 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 8 Commercial Standards for Commercial Communication 2002 www.amsterdamgroup.org. 9 International Centre for Alcohol Policies. Self-regulation and alcohol. A toolkit for emerging markets and the developing world 2002 www.icap.org.
15 The beverage alcohol industry’s social aspects organizations: A public health warning*
Thus, the International Center for Alcohol The Source: Source: www.clubbersguide.co.za Policies encourages: www.barmoist.co.uk “Strict industry compliance with all existing legislation or self-regulatory codes of practice relating to the advertising and promotion of alcohol beverages; Initiatives aimed at establishing self- regulatory codes in countries where they do not already exist; Efforts to ensure that such codes of practice adequately reflect local culture and values; and. The development of appropriate enforcement mechanisms to ensure that such codes are adhered to.” With the assistance of the European Advertising Standards Alliance, the International Center for Alcohol Policies has prepared a toolkit on self-regulation and Source: www.clubbersguide.co.za alcohol for emerging markets and the beverage alcohol industry members of the developing world, which includes a model social aspects organizations have blatantly, Code of Practice for the marketing and consistently and extensively broken their own promotion of alcoholic beverages32. advertising codes in all areas of the world33 and Some social aspects organizations were set up there is no evidence that this has changed over specifically to deal with self-regulation. For recent years. example, the Dutch organization, STIVA was The Amsterdam Group produced its first set of founded in response to alcohol policy Guidelines for Commercial Communications developments. The first task of STIVA was to on Alcoholic Beverages in 199434, which were manage the new self-regulation system as part updated in 200235. There are very many of a political compromise to prevent an examples in which the member organizations advertising ban. In subsequent years, its of the Amsterdam have broken and continue function was reformulated to broader issues. to break the Group’s self-regulatory codes, There are two arguments against self- including for example, Bacardi and regulation as a response to the marketing of Heineken36. Diageo, a member organization of alcoholic beverages: the beverage alcohol the Amsterdam Group, has its own code to activities should not give the impression that industry is unable to regulate itself and its self- define responsible marketing activities, which social acceptance or sexual success cannot regulatory codes are persistently and according to Diageo has “proved to be be achieved without consuming alcohol consistently broken; and advertising of particularly helpful in countries where beverages”. Yet despite this code, and despite alcoholic products does have a small but national laws or self-regulatory codes are an emphasis expressed by the beverage alcohol contributory effect to individual drinking and not sufficiently detailed to give an effective industry at a joint meeting of the Member levels of alcohol-related harm. framework for the regulation of alcohol States Working Group on Alcohol and Health of beverages”37. The Diageo code, like many of the European Commission and representatives the national and international codes, states Argument one of interest groups that was held in June 2001 that the “packaging of alcoholic products The beverage alcohol industry is unable to that it can regulate itself, the launch of should not suggest sexual success or regulate itself and its self-regulatory codes Diageo’s brand, Archers Aqua, clearly uses prowess”, and “advertising and promotional are persistently and consistently broken sexual words and sexual imagery that is
32 International Centre for Alcohol Policies. Self-regulation and alcohol. A toolkit for emerging markets And the developing world May 2002 www.icap.org. 33 Marketing alcohol to young people; Eurocare, London, 2001. 34 The Amsterdam Group. Guidelines for Commercial Communications on Alcoholic Beverages. 1994. 35 Commercial Standards for Commercial Communication 2002 www.amsterdamgroup.org. 36 www.alcoholreclame.nl 37 Code of marketing practice for alcohol beverages. www.diageo.com.
16 The beverage alcohol industry’s social aspects organizations: A public health warning* difficult to interpret other than an association must be adults. This part of the content of the advertising. Most effective among these is between the use of the product and sexual codes has little meaning, since studies of marketing through sporting activities that success. This is illustrated with its “Come out advertising for other products show that attract young males, the group most likely to to Play” “Moist theme” in the United Kingdom children generally desire what they see being be heavier drinkers. and through its club promotions in, for enjoyed by an older person. Similarly, while A considerable body of research has attempted, example, South Africa. codes explicitly prohibit the portrayal of using a variety of methodologies, to investigate intoxication, research suggests that Self-regulation is inherently unlikely to work, whether there is a discernible link between advertisements do communicate the concept since the essence of self-regulation in most advertising and consumption at either the of intoxication and young recipients perceive countries and in most media is that aggregate or the individual level43. A intoxication as a beneficial effect. compliance with codes is voluntary, and comparison of 17 high income countries for subject to changes and revision by the the period 1970-1983 found, for example, that beverage alcohol industry itself38. In theory, a Argument two the countries with a ban on spirits advertising voluntary code can be monitored by the public Advertising of alcoholic products does had 16% lower consumption and 10% lower and non-governmental organizations, but the have a small but contributory effect to motor vehicle fatalities than countries with no effectiveness of this will depend on widespread individual drinking and levels of alcohol- such ban44. Broadening the analysis to 20 knowledge of the code, a sufficiently related harm OECD countries over the years from 1970 to independent complaints body with powers of 1995, including prohibitions on print as well In a number of European countries, about sanction, and sufficient funds to monitor as radio and television broadcasting, and 10% of drinkers drink between one third to marketing practices and implement litigation if studying all classes of alcoholic beverages two thirds of the total alcohol consumed; it is necessary. Most advertising campaigns are concluded that an advertising ban would lead this sector that contributes most to the alcohol designed as short bursts to avoid saturation to a reduction in alcohol consumption of producers’ markets41. Young males are most effects, so complaints decisions must be fast. between 5% and 8%. A comparison of local likely to be recruited to be these heavy “Pre-vetting” may increase effectiveness, but data from 75 metropolitan areas in the United drinkers and are disproportionately beverage alcohol industry self-regulation States using quarterly data from 1986-1989 represented in the statistics for the harm done against its own interests not infrequently leads and controlling for numerous other relevant by alcohol, including intentional and to under-regulation and under-enforcement. variables, found an impact of advertising on unintentional injuries and premature death. Bodies that judge adherence to the codes tend motor vehicle fatalities which was significant, As young males age, the levels of alcohol to restrict their judgements to the intentions of although smaller than the impact of increasing consumption reduce. The logical implication is the advertisers, rather than to the real effects the price of alcoholic products. that the beverage alcohol industry continually of the advertisements on, for example, young needs to recruit new generations of young At the individual level, two analyses of people, even when the evidence shows that heavy drinkers in order to maintain its longitudinal data have found an impact of young people perceive the advertisements as profitability. The beverage alcohol industry response to advertising on consumption in being directed at them.39 spends heavily on advertising. Seven alcohol New Zealand45. In the first, the numbers of Most self-regulatory codes also do not account companies rank amongst the world’s 100 alcohol advertisements recalled at age 15 years in their content for the way successful leading advertisers, and their total advertising in response to a question about the portrayal advertising actually works40. For example, expenditures exceeded US$4.5 billion in of alcohol in the media significantly predicted codes on advertising standards commonly 200042. Probably this same sum is spent again heavier drinking among young men aged 18 state that actors in alcohol advertisements on forms of promotion other than direct years. In the second analysis, liking for
38 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001. 39 Van Dalen, W. Alcohol marketing in the Netherlands. Paper prepared for the WHO international technical meeting on Marketing and Promotion of Alcohol to Young People, Valencia, Spain, 7-9 May 2002. 40 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001. 41 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001. 42 Jernigan, D.H. Marketing alcohol to young people: Effects, responses, evaluations and prospects Paper prepared for the WHO international technical meeting on Marketing and Promotion of Alcohol to Young People, Valencia, Spain, 7-9 May 2002. 43 Wagenaar, A.C. & Komro, K.A. Marketing Alcoholic Beverages to Youth: Study Designs and Research Needs. Paper prepared for the WHO international technical meeting on Marketing and Promotion of Alcohol to Young People, Valencia, Spain, 7-9 May 2002. 44 See Jernigan, D.H. Marketing alcohol to young people: Effects, responses, evaluations and prospects Paper prepared for the WHO international technical meeting on Marketing and Promotion of Alcohol to Young People, Valencia, Spain, 7-9 May 2002. 45 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001.
17 The beverage alcohol industry’s social aspects organizations: A public health warning* advertising measured at age 18 years predicted drinking in television, radio, film and print. In There are three problems with this approach: heavier drinking and experience of more these ways the beverage alcohol industry acts despite what the beverage alcohol industry alcohol-related problems at age 21 years. as a “drug educator”, reaffirming drinking states, it is not in its economical interests to cultures and creating an environment promote what it terms responsible drinking; An Irish study found that that alcohol supportive of the beverage alcohol industry alcohol ranks as one of the highest causes of advertising has a strong attraction for when policy decisions are taken on the disease burden in the world; and drinking teenagers, as it portrays lifestyles and images regulation of beverage alcohol products and on alcoholic products is neither a pre-requisite, which are part of their social setting46. Most public health strategies. nor a necessity for a balanced lifestyle or a long believed that the alcohol advertisements were and healthy life. targeted at young people as the advertisements depicted dancing, clubbing, lively music and 3.5 Standpoint 5 wild risqué activities which they consider Alcohol – despite its potential for abuse – Problem one synonymous with their social activities. The confers a net benefit to society Despite what the beverage alcohol younger age group (12-14 years) perceived the industry states, it is not in its economical Alcohol and Pleasure: a Health perspective, advertising messages as saying that alcohol can interests to promote what it terms the third book in the International Center for help them have fun, make friends and become responsible drinking Alcohol Policies’ Series on Alcohol and Society, popular and those that don’t drink are missing promoted the view that for most people most of Whilst the social aspects organizations propose out. The message from the alcohol the time alcohol can confer considerable that their objectives are to promote moderate advertisements for the older age group (15-17 benefits, although it carries some risks48. The and responsible drinking, it should be years) was that social success and a good time fourth book in the Series, Drinking occasions: remembered that alcohol is essentially an results from alcohol use. Comparative Perspectives on Alcohol and intoxicating and dependence producing drug51. A basic strategy of alcohol promotion is not to Culture, an anthropological review of global It is drunk for its intoxicating effects, even by rely on a single message or a single campaign, drinking habits, put forward the view that most those who are light or moderate consumers of but on a synergy created by a variety of drinking occasions are normal parts of daily life wine. Many drinkers, and in particular younger messages and channels. Direct advertising and not associated with problems or excess49. men, deliberately and self-consciously use through mass media channels is only one alcohol to pursue intoxication, i.e. to get drunk. Both of these publications are part of the example of the range of promotional activities. Thus the pleasures of moderate or responsible International Center for Alcohol Policies’ Other methods used to secure the visibility of drinking occur in spite of, not because of, the strategy50 to: alcohol products include sponsorship of basic nature of the substance. The beverage “demonstrate that moderate drinking is cultural and sports events, on-site promotion alcohol industry is aware of alcohol’s likely to provide a net gain to society and in alcohol outlets, drinking paraphernalia and intoxicating effects. An examination of alcohol thus rehabilitate pleasure so that it can take other products carrying brand names or advertising especially that aimed at young people its legitimate place in human affairs” symbols, and product placement in the shows that its ability to intoxicate, and the entertainment media. arguing that alcohol is an essential component glamour and excitement with which intoxication of a productive life: is associated is the product’s main selling point. Marketing of beverage alcohol products is not “as quality of life indicators will be A small percentage of the population is just about recruiting new drinkers, but also increasingly used to determine health status, responsible for a greatly disproportionate about promoting a public discourse in which a balanced lifestyle – which can for most amount of the total alcohol consumed. Ten per alcohol is “normalized” as part of everyday life people include moderate drinking – will cent of the population may consume between and drinking is seen as a matter of individual probably prove the best predictor of a long 30% and 60% of the total amount consumed in choice and responsibility47. This choice is and healthy life. Both for developed and a society52. In the United States, hazardous informed and created by direct and indirect developing countries, the key issue may be drinking, defined as 5 drinks or more per day, means: not only advertisements and the redefinition of what constitutes a accounts for more than half the beverage alcohol promotions but the unproblematic portrayal of productive life and alcohol’s place in it”. industry’s market and 76 per cent of the beer
46 Dring, C & Hope, A. (2001). The Impact of Alcohol Advertising on Teenagers in Ireland. Department of Health and Children, Dublin. 47 Hill, L. & Caswell, S. Alcohol advertising and sponsorship: commercial freedom or control in the public interest. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 823-846, 2001. 48 Peele, S. & Grant, M. Alcohol and Pleasure: a Health perspective London, Taylor & Francis, 1999. 49 Heath, D.B. Drinking occasions: Comparative Perspectives on Alcohol and Culture London, Taylor & Francis, 2000. 50 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 51 Heather, N. Pleasures and pains. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 5-14, 2001. 52 Lemmens, P. Relationship of alcohol consumption and alcohol problems at the population level. In Eds. Heather, N., Peters, T.J. & Stockwell, T. International Handbook of alcohol dependence and problems. Chichester: John Wiley & Sons Ltd. pp 395-412, 2001.
18 The beverage alcohol industry’s social aspects organizations: A public health warning* market53. Thus if all hazardous drinkers and per capita alcohol consumption) it has been Problem three drinkers currently drinking above medically estimated that 1 in 4 men and 1 in 20 women will Drinking alcoholic products is neither a recommended levels were somehow experience at least one episode of alcohol pre-requisite nor a necessity for a transformed into moderate or responsible dependence in their lifetime58. Alcohol use balanced lifestyle or a long and healthy drinkers, the beverage alcohol industry’s profits increases the risk of cancers of the oral cavity, life as proposed by social aspects would be considerably minimized. pharynx, larynx, oesophagus, liver and breast, as organizations well as certain types of heart disease, high blood In the estimates of pleasure and a long and Problem two pressure and stroke and pancreatic inflammation, atrophy and fibrosis. For non- healthy life, much emphasis is placed on the Alcohol ranks as one of the highest causes drinkers, the harm from alcohol use may begin cardio-protective effects of alcohol. Although of disease burden in the world prenatally in the form of foetal alcohol syndrome there is evidence that alcohol use at levels as low Alcohol use causes significant harm to the and foetal alcohol effects. Both drinkers and non- as one drink per week may offer some degree of physical, psychological and social health of drinkers may suffer from the consequences of protection against coronary heart disease and individuals, families and communities in both alcohol use, for example by traffic crashes, burns, ischaemic stroke, it is an effect reported mostly high and low income countries. It was estimated drowning and suicide. While the causal from high income countries, where there has to account for 3.5% of the disability-adjusted life connection of alcohol to criminal behaviour is been considerable debate on the size of the 60 years (DALYs) lost in 1990, more than tobacco at complex, crimes of violence consistently show reduction in risk . Since coronary heart disease 2.6%54. It is a risk factor to global health on the strong relationships with alcohol use. Alcohol use primarily affects men aged over 35 years and same level as measles, tuberculosis and malaria may also be related to a variety of other social postmenopausal women, the effect has been combined. Twenty five per cent of all deaths of problems including marital breakdown, loss of primarily confined to older age groups. However, young people aged between 15 and 29 years are productivity and high rates of absenteeism, family while numerous studies have found an effect, attributable to alcohol, with 55,000 alcohol- violence and child abuse, and homelessness. several have not, and the former may have had related deaths occurring among young people in methodological failings. Any protective effect of Alcohol imposes a high economic cost to society59. Europe in 1999. Alcohol use can cause or drinking is likely to be very small in the many One estimate puts the yearly economic cost of the contribute to physical, psychological and social cultures in low income countries with low rates harm done by alcohol in the United States at harm for both drinkers and non-drinkers, and of coronary heart disease. In terms of years of US$148 billion, including US$19 billion for health can damage nearly every tissue and system in the life lost the adverse effects of drinking outweigh care expenditure. In Canada, the economic costs body55. Harm to the drinker includes alcoholic any protection against coronary heart disease, of alcohol amount to approximately US$18.4 psychosis, alcohol dependence syndrome, even in the most vulnerable national billion, representing 2.7% of the gross domestic alcoholic polyneuropathy, alcoholic populations. Globally, the estimate of 3.5% of product. In European countries, the total costs cardiomyopathy, alcoholic gastritis, alcoholic liver disability-adjusted life years lost is a net figure arising from the harm done by alcohol lie cirrhosis, ethanol toxicity and methanol toxicity. allowing for the possible protective effects of between 2% and 5% of gross domestic product. The risk of dependence increases with increasing alcohol consumption. A long and healthy life In a research study in The Netherlands, it was levels of alcohol consumption56 and its prevalence amongst those who consume small amounts of estimated that 9% of the adult population drink at is considerable. It is estimated that globally there alcohol may well be due to other factors, such as hazardous levels – a total of 1.1 million problem are 140 million people suffering from alcohol a healthier diet, greater physical activity and less drinkers. These drinkers cost the economy 2.6 61 dependence at anyone time57. In the United States cigarette smoking . billion. (a middle ranking country in terms of worldwide
53 Rogers, J. & Greenfield, T. Beer drinking accounts for most of the hazardous alcohol consumption reported in the United States. Journal of Studies on Alcohol 60(6): 732-739. 1999. 54 Murray CJL, Lopez AD, eds. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA, Harvard School of Public Health on behalf of the World Health Organization and the World Bank, 1996 (Global Burden of Disease and Injury Series, Vol. I). 55 Towards a global alcohol policy: alcohol, public health and the role of WHO Jernigan D.H., Monteiro M., Room, R. & Saxena S. Bulletin of the World Health Organization, 2000, 78 491-499. 56 Midanik L.T. et al (1996). Risk functions for alcohol-related problems in a 1988 US national sample. Addiction 91 1427-1437. 57 Murray CJL, Lopez AD, eds. The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries, and risk factors in 1990 and projected to 2020. Cambridge, MA, Harvard School of Public Health on behalf of the World Health Organization and the World Bank, 1996 (Global Burden of Disease and Injury Series, Vol. I). 58 Edwards G et al. Alcohol policy and the public good. Oxford, Oxford University Press, 1994. 59 World Health Organization. New Understanding New Hope. The World Health Report. Geneva, 2001. 60 Towards a global alcohol policy: alcohol, public health and the role of WHO Jernigan D.H., Monteiro M., Room, R. & Saxena S. Bulletin of the World Health Organization, 2000, 78 491-499. 61 Barefoot, J.C., Grønbæk, M., Feaganes, J.R., McPherson, R.S., Williams, R.B. & Siegler, I.C. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study Am J Clin Nutr 2002;76:466–72.
19 The beverage alcohol industry’s social aspects organizations: A public health warning*
4. How do social aspects organizations work?
Social aspects organizations manage issues Action Plan, endorsed by its Member States in Organization has established an alcohol policy that may be detrimental to the beverage 199262. In the preparation of the second Action scientific advisory committee, whose mandate alcohol industry in five main ways: Plan, which runs from 2000 to 2005, the includes being a forum for dialogue with the 1 Attempting to influence the alcohol relations with the beverage alcohol industry industry, suggested that66: policies of national and international were a concern, since the Plan contains some “The World Health Organization consider governmental and integrational references to the role of industry and inviting the International Center for Alcohol organizations; commerce63. It proposes, for example, that the Policies to interact with members of their 2 Becoming members of relevant non- beverage alcohol industry and the hospitality alcohol policy scientific advisory committee, to alcohol specific organizations and sector develop and implement programmes to prepare relevant documents for their committees to broaden policy influence reduce alcohol-related problems in the consideration, and to be invited to participate in and respectability; drinking environment. After the World Health discussions on relevant topics at one or more 3 Recruiting scientists, hosting conferences Organization held a meeting with the future meetings of the committee so that the and promoting high profile publications; Amsterdam Group, the Group delivered an International Center for Alcohol Policies could 4 Creating social aspects organizations in extensive critique of the Plan, explaining the contribute in a positive and collegiate way to emerging markets and low income industry’s standpoint and offering suggestions other and wider alcohol policy discussions.” countries; and for incorporating this into the text64. 5 Preparing and promoting consensus In attempting to influence the policy of the The Amsterdam group proposed, for example statements and codes of practice. European Commission through developing changing the terms ‘the harm done by alcohol’ common standards for commercial Each of these methods of working will be into ‘alcohol misuse’ and ‘the risk of alcohol communication, as part of the beverage illustrated with examples, in turn. related problems’ into ‘consequences of alcohol industry’s response to a European misuse’. They proposed to delete the statement Parliament Green Paper Sales Promotion in ‘alcohol is a psychoactive drug’. They proposed 4.1 Attempting to influence the internal market and to the Draft Proposal to delete the sentence ‘Alcohol use and alcohol the alcohol policies of national for a European Council recommendation on related harm, such as drunkenness, binge- and international the drinking of alcohol by Children and drinking and alcohol related social problems governmental and Adolescents, the Amsterdam Group laid down are common among adolescents and young integrational organizations the following principles for alcohol policy67: people in Western Europe’ and to delete the Since social aspects organizations were set up Recognise the limitations of regulation and phrase ‘place restrictions on the sponsorship by the beverage alcohol industry to represent that individuals need to take responsibility by the drinks industry on sports’. They the industry in policy debate and in social and for their drinking behaviour; proposed that the heading ‘Responsibilities of public discourse about the harm done by Address the particular needs of young the beverage alcohol industry and hospitality alcohol, it is not surprising that one of their people to enable them to make informed sector’ should be rephrased as ‘Industry- priority methods of work is to attempt to choices about drinking; society partnerships to reduce alcohol misuse’. influence the alcohol policies of national and Recognise the social, cultural and They were against high visibility random international governmental and integrational historical diversity of European societies, breath testing, but favoured drink driving organizations. Key targets for influence are the and therefore permit European countries educational campaigns. World Health Organization, and within Europe, to develop and implement alcohol the European Commission. At the global level, the World Health strategies that meet their own particular Organization has put forward proposals for a needs, consistent with the principle of The European Office of the World Health global alcohol policy65. The International subsidiarity; Organization was one of the first offices of the Center for Alcohol Policies noting that the Be proportionate, i.e. that the planned organization to develop a strategy to reduce the Director General of the World Health measures must be necessary for the harm done by alcohol, the European Alcohol
62 The European Alcohol Action Plan 1992-1999. Copenhagen, World Health Organization Regional Office for Europe. 63 The European Alcohol Action Plan 2000-2005. Copenhagen, World Health Organization Regional Office for Europe. 64 Quoted in Rutherford, D. The Amsterdam Group. The Globe. Alcohol industry’s social aspects groups exposed. www.ias.org.uk. 65 Towards a global alcohol policy: alcohol, public health and the role of WHO Jernigan D.H., Monteiro M., Room, R. & Saxena S. Bulletin of the World Health Organization, 2000, 78 491-499. 66 International Center for Alcohol Policies. Industry Views on beverage Alcohol Advertising and Marketing, with Special Reference to Young People. www.icap.org. 67 Commercial Standards for Commercial Communication 2002 www.amsterdamgroup.org.
20 The beverage alcohol industry’s social aspects organizations: A public health warning*
achievement of the intended aim and “The Dublin Principles, setting out ethical recognize intoxication among patrons, and the should not go beyond that which is standards for cooperation in alcohol availability of alternatives to driving, such as necessary to achieve their objective; and research; free taxi service. As noted above, though, these Involve all relevant stakeholders in both The Global Charter on Alcohol, which policy measures are those for which the the public and private sectors, including seeks to balance the responsibilities of evidence has been shown to be ineffective, the drinks industry, health professionals business, government, and academic and whereas the effective policy measures, such as and governments. research bodies as they relate to individual high visibility random breath testing and freedom and choice; lowering the legal limit of blood alcohol 4.2 Becoming members of First Vice Chairmanship of the Global Road concentrations are not proposed by the relevant alcohol and non- Safety Partnership; International Center for Alcohol Policies. alcohol specific organizations A life skills education project for primary and committees to broaden schools in South Africa and Botswana; 4.3 Recruiting scientists, policy influence and Dialogue with the UN Special Rapporteur hosting conferences and respectability on Violence Against Women; and promoting high profile Collaboration with the International Labor At important method of working is for officials publications Office and the International Council on and members of social aspects organizations A key work of social aspects organizations is to Alcohol and Addictions to train workers in to become members of relevant alcohol and gain credibility and respectability through the hospitality industry.” non-alcohol specific organizations and recruiting scientists and national and committees. Such membership gives social The Global Road Safety international public health officials as aspects organizations the appearance of Partnership partners, contributors to their publications, respectability and credibility and broadens members of their conferences and signatories The President of the International Center for their policy influence. to their policy statements. The institutional Alcohol Policies is the First Vice Chairmanship affiliations of recruited scientists are promoted of the Global Road Safety Partnership70, a joint by social aspects organizations to their best The Global Compact World Bank and Federation of Red Cross and advantage. The International Center for Alcohol Policies is Red Crescent Societies initiative under the a member of the Global Compact, which was coordination of the United Kingdom’s Business Scientists are used by social aspects launched by the United Nations Secretary- Partners for Development (BPD) project to organizations to promote their standpoints, General at the World Economic Forum in reduce the number of lives lost unnecessarily ideologies and viewpoints and to discredit January 199968. The Global Compact invited in traffic accidents, with the developing world scientific findings inconsistent with these the world’s business leaders to help build the being a special priority. standpoints. When the landmark publication social and environmental pillars required to Alcohol Policy and the Public Good was However, in its report number 11, Blood sustain the new global economy and make published, scientists were offered £2000 by the Alcohol Concentration Limits Worldwide, the globalization work for the entire world’s United Kingdom’s Portman Group to International Center for Alcohol Policies argues people. The Global Compact is a value-based “rubbish” the report and to permit their that, since most drinking drivers have blood platform designed to promote institutional criticisms to be published with or without their alcohol concentrations below the legal limit in learning. It utilizes the power of transparency names72. their jurisdiction, lowering the limits could be and dialogue to identify and disseminate good perceived as an unwelcome policy change, Considerable emphasis is placed on the role of practices based on nine universal principles infringing on the established drinking the World Health Organization and the drawn from the Universal Declaration of behaviour of a great many people71. The report recruitment and involvement of its staff Human Rights, the International Labor Office’s argues that focused measures aimed at those members in the conferences and publications Fundamental Principles on Rights at Work and drivers whose drinking patterns may result in of social aspects organizations. Taking stock in the Rio Principles on Environment and reckless behaviour are the effective measure 2000, when the International Center for Development. for harm reduction that should be Alcohol Policies (ICAP) was five years old, its In accepting its invitation to join the Global implemented, including increased public founder and president (and ex-staff member Compact, the International Center for Alcohol education on the risks associated with drink- of the World Health Organization (WHO) Policies listed the following good practices69: driving, training staff at licensed premises to responsible for alcohol policy) wrote73:
68 www.unglobalcompact.org. 69 www.icap.org. 70 http://www.grsproadsafety.org/ . 71 International Center for Alcohol Policies. Blood alcohol concentration limits worldwide. ICAP Reports 11. www.icap.org. 72 Rows over drinks industry attempt to rubbish alcohol report, Alcohol Alert, April 1995, 20, 2-3. 73 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/.
21 The beverage alcohol industry’s social aspects organizations: A public health warning*
“I believe that I have contributed more to Although many individual states do not follow help prevent the abuse of alcohol. Education public health in my five years at ICAP than prohibition, annual per capita alcohol programmes will be aimed at various levels in double that time with WHO. This is not an consumption remains very low, no more than so that they address the disparity between empty boast. Nor is it intended in any way to about 1.5 litres of absolute alcohol per capita76. urban/rural, rich/poor, literate/illiterate diminish the impressive contribution which Approximately 60% of the male population and divides that exist in India as well as address WHO makes to international health. Rather, almost all of the female population do not the differing issues that will be prevalent it is because I am now privileged to have the drink alcoholic beverages. With a view to amongst them. SASPI plans to work in the opportunity to bring together all those who changing the culture of consuming alcoholic area of advocacy to bring about an are willing to work together but have simply beverages and to be involved in the environment of trust and responsibility never before had a legitimate context within development of alcohol policy in India, the between policy makers, the industry and which to explore the extent of their capacity International Center for Alcohol Policies society towards the common goal of to cooperate. And what they find is that they supported the creation of a social aspects preventing alcohol abuse in the long run, can achieve much more together than any of organization, the Society for Alcohol and Social without adversely affecting the economy.” them could in isolation. Which is why I see Policy Initiative. ICAP as a new force for public health.” In the words of the International Center for 4.5 Preparing and promoting Alcohol Policies77: consensus statements, codes 4.4 Creating social aspects “Prohibition is enshrined as an aspiration in of practice and standards organizations in emerging the Constitution of the country, yet there is An important area of work for social aspects markets and low income now a vast emerging middle class eager to organizations is the preparation and countries extend their opportunities to drink. Here, the promotion of consensus statements, codes of It is no accident that Alcohol and emerging social aspects organizations’ first attempt to practice and standards. markets, the second volume in the replace that climate with mutual trust was International Center for Alcohol Policies’ Series apparently less than successful. A small The Dublin Principles on Alcohol and Society reviewed patterns of group of Indian public health experts, who In 1997, the president of the National College alcohol consumption, problems and responses had initially expressed cautious interest in of Ireland, a non profit higher education in the emerging markets of Africa, Asia, central dialogue with the social aspects college established in 1951 to facilitate access and eastern Europe and Latin America74. The organization, quickly realized how forcefully to education for all groups, published the publication provided a sound platform for the some of their colleagues disapproved of it. Dublin Principles of Cooperation among the marketing of alcoholic products in emerging The industry, too, remained sceptical of what Beverage Alcohol Industry, Governments, and markets by the beverage alcohol industry, might be achieved, and local Indian Scientific Researchers together with the which has been followed through by the companies in particular were reluctant to International Center for Alcohol Policies79. The creation of social aspects organizations in, for become involved. Yet now, four years after Dublin principles cover both alcohol and example, India and China (Taiwan). the first attempt to create dialogue in India, society and alcohol research. Item 1c of the there is a functioning Social Aspects Principles deals with the harm done by alcohol Organization (SAO) supported by the The example of India and the measures to reduce the harm: industry and numbering as advisors some of Article 47 of the Constitution of India75 “Consumption of alcohol is associated with a those same public health experts. What the incorporates prohibition among the directive variety of beneficial and adverse health and social aspects had done was to demonstrate principles of state policy: social consequences, both to the individual the possibility of dialogue and to help people “The state shall regard the raising of the level and to society. Governments, to start thinking in terms of partnership”. of nutrition and the standard of living of its intergovernmental organizations, the public people as among its primary duties and, in In India, the Society for Alcohol and Social health community, and members of the particular, the state shall endeavour to bring Policy Initiative (SASPI)78 is: beverage alcohol industry, individually and about prohibition of the use except for “Undertaking a project to gauge the in cooperation with others, should take medicinal purposes of intoxicating drinks perspectives on alcohol held by a diverse appropriate measures to combat and of drugs which are injurious to health”. cross section of society in order to design and irresponsible drinking and inducements to implement education programmes that will such drinking. These measures could include
74 Grant, M. Ed. Alcohol and Emerging Markets London, Taylor & Francis, 1998. 75 Arora, M. Alcohol in India The Globe Special Issue 4, 2001-02 www.ias.org.uk. 76 Global status report on alcohol. Geneva, World Health Organization, 2000. 77 Grant, M. A New Force for Health. International Center for Alcohol Policies. http://www.icap.org/. 78 www.education.vsnl.com/saspi. 79 The Dublin Principles of Cooperation Among the Beverage Alcohol Industry, Governments, Scientific Researchers, and the Public Health Community. www.ncir.ie/info/dubprin/welcome.html.
22 The beverage alcohol industry’s social aspects organizations: A public health warning* research, education, and support of involved in policy making” to draft a global partnership as a contribution to the global programs addressing alcohol-related charter, the Geneva Partnership on Alcohol, in debate on alcohol policy. This document breaks problems.” 200080. The Charter is new ground by identifying and promoting the “intended as a policy tool to assist in alcohol complementary interests of the public health It should be noted that the National College of policy development at the international, and scientific communities, the beverage Ireland, an educational and scientific body, national and local level”. alcohol industry, governments and the non- proposes in its Principles those policy options governmental sector. It builds upon the Dublin known to be ineffective and fails to include The Geneva Partnership on alcohol Principles and acknowledges the efforts of those policy options known to be effective in emphasizes the need to bring people together international organizations to develop alcohol reducing the harm done by alcohol. to forge a common language. policy. In its preparation, which has involved Its preamble states: an extensive process of consultation, including The Geneva Partnership on “There is a growing recognition of the regional and global meetings, input has been Alcohol importance of establishing stronger relations sought from a wide range of people involved in The International Center for Alcohol Policies between the public and private sectors at the alcohol policy development, with the objective of brought together “specialists from the alcohol international level. In this context, ICAP has formulating general principles mutually industry, the field of public health and others taken the initiative to develop an agenda for acceptable to all parties.” 5. Conclusions - Relating to social aspects organizations
In representing the beverage alcohol Governments will need to decide the extent to policies to reduce the harm done by alcohol. industry in policy debate and in social which they are partners or co-sponsors of the European Member State signatories to the and public discourse about the harm initiatives and programmes of social aspects 2001 Stockholm Declaration on Young people done by alcohol, social aspects organizations, such as school based and Alcohol83 agreed that: organizations will seek partnerships and educational programmes and designated “Public health policies concerning alcohol joint activities with governmental and driver campaigns. When considering need to be formulated by public health non-governmental sectors and scientific, partnership and co-sponsorship, it should be interests, without interference from research and professional bodies. How noted that the programmes and policy options commercial interests”. should these different sectors and bodies put forward by the social aspects organizations Article 152 of the Treaty on European Union relate to such organizations? lack evidence of effectiveness and are not states that a high level of human health impartial to the interests of the beverage protection shall be ensured in the definition alcohol industry. Governmental organizations 5.1 Governmental sector and implementation of all Community policies should be concerned at spending public In formulating their overall alcohol policies, a and activities84. The public health functions of money on ineffective programmes. An wide range of different government departments governments have a responsibility to ensure alternative means for these activities is to use a at the national and international levels will need independence in their assessments of the proportion of alcohol taxes, hypothecated for to receive information from and have dialogue impact of the policies of other governmental the purpose, to fund relevant non- with the beverage alcohol industry. However, in departments on health. When that governmental organizations to implement developing their policies, government independence is compromised, trust in public independent evidence based programmes and institutions need impartial information of the bodies is lost. Unfortunately, all too often it campaigns. evidence for effective alcohol policy and seems that public health policies concerning impartial information on the costs and benefits Governmental organizations need to be alcohol are compromised by the commercial of different policy options. It should be noted cognisant of their obligations for alcohol policy. interests of the beverage alcohol industry. that the information government institutions The European Member States of the World The government of the United Kingdom, which receive from social aspects organizations is not Health Organization are signatories to the had been mindful to reduce the drinking impartial and is inconsistent with the evidence European Alcohol Action Plan81 and the driving limit from 0.8g/L to 0.5g/L changed its base for effective policy that reduces the harm European Charter on Alcohol82 both of which position in 2002. Commenting on the change, done by alcohol. call for the implementation of evidence based
80 International Center for Alcohol Policies. The Geneva partnership on alcohol. Towards a global charter. www.icap.org. 81 European Alcohol Action Plan 2000-2005. Copenhagen, World Health Organization Regional Office for Europe. 82 The European Charter on Alcohol. 1995. Copenhagen, World Health Organization Regional Office for Europe. 83 The Stockholm declaration on young people and alcohol 2001. . Copenhagen, World Health Organization Regional Office for Europe. 84 ARTICLE 152 of the Treaty on European Union. http://europa.eu.int/eur-lex/en/index.html. 85 See Report of House of Lords European Committee 2002. Quoted in Alcohol Alert. www.ias.org.uk.
23 The beverage alcohol industry’s social aspects organizations: A public health warning* the House of Lords European Union government policy should not call financial about the relationship between public health Committee noted that85: support of non-governmental organizations science and the beverage alcohol industry88, “The Department of Transport’s position [on into question. the International Center for Alcohol Policies the drinking driving limit] coincides with was successful in recruiting a large number of that of the alcohol industry but is opposed by 5.2 Non-governmental sector scientists to contribute to the first five local authorities, the police, the British publications in its series on alcohol and A wide range of non-governmental Medical Association, the Automobile society. All independent scientists that are paid organizations deal with issues of alcohol policy. Association, the Royal Society for the by or undertake work for the social aspects The European Alcohol Action Plan called on Prevention of Accidents, the Transport organizations and the beverage alcohol countries to ensure that support is given to Research Laboratory and the Parliamentary industry should recognize their responsibility nongovernmental organizations and self-help Advisory Council for Transport safety”. in stating their declarations of interest in their movements that promote initiatives aimed at scientific publications. Research scientists in Thus in one country at least it would seem that preventing or reducing the harm that can be high income countries should also consider an drink driving policy is being formulated by the done by alcohol; to nongovernmental ethical responsibility not to profit from or commercial interests of the beverage alcohol organizations and networks that have contribute to the beverage alcohol industry’s industry, rather than by independent public experience and competence in advocating actions in emerging markets in low income health interests and the views of experts in policies at international and country levels to countries which often lack the infrastructure, road safety, law enforcement and alcohol reduce the harm that can be done by alcohol; resources and experience to respond to and policy, with, the consequence of failing to save and to organizations and networks that have a effectively regulate the beverage alcohol unnecessary drink driving related deaths. specific advocacy function within their remit, industries’ marketing practices89 such as associations of health care In his foreword to “Alcohol - Less is Better”86, professionals, representatives of civil society Writing in the year 2000, Babor proposed the the report of the 1995 World Health and consumer organizations. following guidelines for public health and Organization ministerial conference on alcohol scientific bodies90: held in Paris, Dr. Asvall, the then Regional Non-governmental organizations with a First, we must resist industry attempts to Director of the organization’s European Office specific role with regard to alcohol policy have manipulate public debate, and the crude expressed the opinion that taking up the been charged with87: attempts by some sources to legitimize the challenge of dealing with alcohol problems “informing and mobilizing civil society with irresponsible promotion of beverage requires “political courage”. In mobilizing respect to alcohol-related problems, lobbying alcohol. “political opinion” and the “political will” Dr for policy change and effective Greater vigilance and monitoring of Asvall recognized the important role of non- implementation of policy at government industry behavior is needed, especially governmental organizations: level, as well as exposing harmful actions of their issues management activities, which “A particularly important role can be played the alcohol industry.” are likely to include intelligence-gathering, by enlightened non-governmental In discharging their role, and in maintaining image management actions such as organizations, which can often speak with their respect with civil society, such specific industry-initiated dialogues, active agenda- passion and insight on the true impact of non-governmental organizations would do well setting in the areas of research or alcohol on individuals, families and to remain completely independent of any publishing; and the real or intended image communities. Such organizations can also association or partnership with social aspects transfer effect of industry connections with bring the commitment of energy to work even organizations. Any communications, dialogues reputable scientists and public health in the face of political risks.” or meetings between non-governmental organizations. In discharging their role, non-governmental organizations and the social aspects Promotion of a freedom of information organizations are bound to look to organizations should be transparent, and principle that calls for the sharing of governments for adequate financial support placed in the public domain. corporate data that deal with marketing, and they should not be expected to seek distribution and sales research. financial support from the beverage alcohol 5.3 Scientific, research and Taking steps to prevent industry from industry. The health and social departments of professional organizations enhancing its image by token amounts of governments ought to be flexible and mature funding for irrelevant research and Although there has been a considerable debate enough to recognize that critical appraisal of prevention activities. If these activities are
85 See Report of House of Lords European Committee 2002. Quoted in Alcohol Alert. www.ias.org.uk. 86 Alcohol Less is Better. Copenhagen, World Health Organization Regional Office for Europe, 1996. 87 European Alcohol Action Plan 2000-2005. Copenhagen, World Health Organization Regional Office for Europe. 88 Editorial Science and the drinks industry: cause for concern Addiction (1996) 91(1), 5- 9 89 Jernigan, D.H. & Mosher, J.F. Permission for profits Addiction (2000) 95(2), 190-191 90 Babor, T.F. Partnership, profits and public health Addiction (2000) 95(2), 194-195
24 The beverage alcohol industry’s social aspects organizations: A public health warning*
to be supported, this should be done through dedicated tax levies or unrestricted grants that contain no limits on the types or topics of research or prevention. Development of more broad-based coalitions of health, scientific and social organizations that are concerned about irresponsible industry behavior in marketing, product design, product safety and advertising, and which can pool resources to monitor adherence to international codes of conduct. Guidelines for disclosing conflicts of interest and the marketing of alcoholic beverages in the developing countries. Research on such issues as conflict of interest, publication bias and bias in choice of topic or study design. There is now enough evidence from the sponsorship of research by the pharmaceutical industry and the tobacco companies to suggest the possibility of bias. Finally, it is time to declare a moratorium on further dialogues with industry sources until alcohol scientists and the public health community can agree to what is in their legitimate interests, and how to avoid compromising our well-earned integrity. It is time for our addiction journals and professional societies to take the lead in examining their own connections with industry sources, and develop clear positions on the need for strict codes of ethics regarding the design and marketing of alcohol products. If industry sponsors do not adhere to them, then there can be no dialogue with, or support from, their third-party organizations. Although we do not by nature make it our business to engage in conflict and controversy, neither do we have a duty to engage in dialogue with organizations whose activities are inimitable to public health. Let the public debate clearly represent both sides of an issue, instead of having our issues managed by third party organizations whose agenda is approved by only one of the parties. ■
25 The beverage alcohol industry’s social aspects organizations: A public health warning*
Annex. Some examples of social aspects organizations, as identified by the International Center for Alcohol Policies and the Amsterdam Group
Organization The International Center for Alcohol The Amsterdam Group Distilled Spirits Industry Council of Policies Australia Inc Date created 1996 1990 Not stated Website www.icap.org www.amsterdamgroup.org www.dsica.com.au Geographical Global Europe Australia remit Mission ● To help reduce the abuse of ● To encourage responsible ● To create an informed political statement alcohol worldwide and promote consumption and contributing to and social environment that understanding of the role of combating abuse; recognises the benefits of alcohol in society. ● To promote understanding and moderate alcohol consumption, ● To encourage dialogue and pursue tracking research on biomedical encourages responsible partnerships involving the social and social issues; and community attitudes towards aspects, the public health ● To safeguard responsible alcohol, challenges the community and others interested commercial communications prejudices and inequities faced in alcohol policy through effective self-regulation by the spirits and liqueurs industry, enables our members to responsibly conduct their businesses free from unwarranted interference in a fair and competitive market place and protects the integrity, growth and profitability of the distilled spirits and liqueurs industry in Australia.
Funding Allied Domecq PLC Allied Domecq Allied Domecq Spirits & Wine bodies Asahi Breweries, Ltd. Bacardi-Martini (Australia) Pty Limited Bacardi-Martini Berentzen-Gruppe Brown-Forman Beverages Australia Brown-Forman Beverages Worldwide Deutschen Brauer-Bund (affiliated Pty Ltd Coors Brewing Company member) Bundaberg Distilling Company Diageo PLC Diageo Diageo Australia Limited Foster’s Brewing Group Limited Group Pernod Ricard Jim Beam Brands Heineken NV Heineken Australia Pty Ltd Joseph E. Seagram & Sons Interbrew Maxxium Australia Pty Ltd Miller Brewing Company Moet Hennessy Quality Brands International (Aust) Molson Prips Ringnes Pty Ltd South African Breweries Remy Cointreau Suntory (Aust) Pty Ltd Scottish & Newcastle Swift + Moore Spirits & Wine William Grant & Sons International Ltd
* Unless otherwise indicated, data are extracted verbatim from websites
26 The beverage alcohol industry’s social aspects organizations: A public health warning*
Organization Arnoldus Group Foreningen Gode Alkoholdninger, Entreprise & Prévention GODA Date created 1992 1993 1990 Website [email protected] www.goda.dk www.soifdevivre.com Geographical Belgium Denmark* France* remit Mission ● To promote a moderate beer ● To promote the good alcohol ● To contribute to the fight against statement consumption; culture the over-consumption of alcohol ● To contribute to the prevention of ● To help reduce the abuse of and its social consequences alcohol abuse; alcohol and harm ● To promote self-regulation and to ● To spread information on ● To promote a better continue to apply current moderate beer consumption; understanding of alcohol regulations in a responsible ● To favor the discussions and the consumption manner collaboration with all the ● To facilitate discussions between instances involved as well on a Public Bodies and the regional as an international level; professional partners ● To do research that might ● To develop prevention proposals contribute to an adequate that could become attractive to information of consumers; Public Bodies ● To elaborate a code on the marketing techniques in general, that is binding for all members of the Group.
Funding Belgian Brewers Danish Brewers Association Bacardi-Martini bodies Wine and Spirit Organizations in Ballantine’s Denmark (VSOD) Brasseries Heineken Association of Danish Distillers Brasseries Kronenbourg Cellier des Dauphins Interbrew France Karlsbraü France Groupe Marne & Champagne Societe des Produits Marnier Lapostolle Michel Picard Moët Hennessy Moët Hennessy Udv Pernod Ricard Remy Cointreau Rhums Reunion Vranken Monopole William Grant & Sons William Pitters-la Guilde du Vin * Translated from the Danish and the French
27 The beverage alcohol industry’s social aspects organizations: A public health warning*
Organization DIFA Society for Alcohol and Social Stiva Deutsche Initiative zur Forderung Policy Initiative Stichting Verantwoord eines verantwortungsvollen Alcoholgebruik Umgangs mit alkoholhaltigen Genussmitteln Date created 1992 1982 Website www.difa-forum.de www.education.vsnl.com/saspi www.stiva.nl Geographical Germany* India Netherlands* remit Mission ● To support a conscious, ● To promote education, knowledge ● To promote a responsible market statement responsible handling of alcohol and understanding about alcohol behaviour by coordinating and containing food and luxuries and its appropriate role in communicating about self- ● To shape awareness by contemporary Indian society, regulation of alcohol educational and information ● To initiate and implement advertisements measures programmes in the community to ● To promote scientific research ● To target specific actions for the address the problems associated about the consequences of the support of the fight against with the abuse of alcohol, working use of alcohol alcohol abuse towards its prevention through an ● To give information and understanding of its responsible education about responsible use use and prevention of misuse ● To operate independently from the alcohol beverages industry and advise them on standards, self- regulation and codes of conduct that impact on promoting responsible use of alcohol ● To gather objective data on the key issues pertaining to alcohol use and abuse in order to develop programmes that address the identified areas
Funding Bacardi GmbH The UB Group Heineken Nederland bodies Berentzen-Gruppe AG Shaw Wallace & Company Limited Maxxium BORCO-Marken-Import Allied Domecq Spirits & Wines India Bacardi – Martini Matthiesen GmbH & Co Bacardi-Martini India Limited Pernod - Ricard Eckes AG Brown-Forman Worldwide LLC Productschap voor Wijn Hardenberg-Wilthen AG International Distillers (India) Ltd. Productschap voor Gedistilleerde Guinness GmbH Groupe Pernod-Ricard Drank Heineken Deutschland GmbH Seagram Manufacturing Limited Interbrew Jacobi Allied Domecq Nederlands Gedistilleerd Unie Spirits & Wine GmbH & Co.KG Grolsch Karlsberg Brauerei KG Centraal Brouwerij Kantoor König-Brauerei GmbH & Co.KG Koninklijke Nederlandse Vereniging A. Racke GmbH & Co voor Wijnhandelaren Rotkäppchen Sektkellerei GmbH Albert Heijn Seagram Deutschland GmbH United Distillers & Vintners Deutschland GmbH Verpoorten GmbH & Co.KG *Translated from the German and the Dutch
28 The beverage alcohol industry’s social aspects organizations: A public health warning*
Organization Arnoldus Group Industry Association for Responsible The Alcohol and Society Foundation Alcohol Use Date created 1998 1986 Website www.modus.org.pl www.ara.co.za www.alcoholysciedad.org Geographical Poland South Africa Spain remit Mission ● To acquire and promote ● To promote the responsible use of ● To provide information on the statement understanding of the social and beverage alcohol, as part of a effects of beverages that contain health aspects of alcohol abuse healthy lifestyle, among those alcohol on society and health. and inaccurate consumption of who have already taken the ● To promote the fact that alcoholic beverages; decision to consume beverage moderate, sensible and ● To take actions that help reduce alcohol responsible consumption of alcohol abuse; beverages that contain alcohol is ● To make every effort to eliminate good for health. the health endangering structure ● To fight against alcohol abuse by of alcohol consumption in Poland. using prevention as the irreplaceable method for introducing responsible drinking habits. ● To obtain recognition for the fact that moderate, sensible and responsible consumption is a pleasure and a social and festive experience
Funding Ambra SA Distillers Corporation 33 funding organizations including bodies Bacardi-Martini Polska Sp. z o.o. Stellenbosch Farmers Winery the advertising organizations, soft Carey Agri International Poland Sp. z The South African Breweries Beer drinks industry and retail outlets. See o.o. Division website for a full list Dystrybucja Alkoholi Sp. z o.o. KWV Finlandia Ballantine’s Group Sp. z o.o. Douglas Green Guinness UDV Polska Ltd. Bellingham Wyborowa S.A. Gilbeys Distillers and Vintners Jonkheer Boerewynmakery Mooiuitsig Wynkelders Seagram South Africa
29 The beverage alcohol industry’s social aspects organizations: A public health warning*
Organization Taiwan Beverage Alcohol Forum The Portman Group Century council Date created 2000 1989 1991 Website www.tbaf.org.tw www.portman-group.org.uk www.centurycouncil.org Geographical Taiwan United Kingdom United States of America remit Mission ● To promote responsible decision- ● To help prevent misuse of alcohol ● To promote responsible decision- statement making in the consumption or non and to promote sensible drinking making regarding drinking or non- consumption of alcohol drinking of beverage alcohol and beverages, discourage all forms of ● To coordinate efforts to promote a irresponsible consumption responsible drinking environment, through education, ● To engage in alcohol policy communications, research, law debate in a way which enforcement, and other programs. satisfactorily addresses social concerns.
Funding Heineken Brouwerijen B.V. Taiwan Bacardi-Martini Ltd Allied Domeq Spirits and Wine North bodies Branch Pernod Ricard UK America Allied Domecq Spirits & Wine Taiwan Diageo plc Bacardi USA, Inc. Ltd. HP Bulmer Ltd Brown-Forman Pernod Ricard Taiwan Ltd. Interbrew UK Ltd DIAGEO Miller Brewing International Inc., Scottish & Newcastle plc Future Brands LLC Taiwan Branch Pernod Ricard USA. Moet-Hennessy Taiwan International Community Radio Taipei Winkler Partners Saatchi & Saatchi Joker International Co., Ltd. AmCham ECCT British Trade and Cultural Office
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G lobal A lcohol P olicy A lliance
Contacts
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