CONSEQUENCES OF INDUSTRY RELATIONSHIPS FOR PUBLIC HEALTH AND MEDICINE

Joe Camel in a : , the Brand, and the Transformation of the Youth Market

I have documented the James F. Mosher, JD shift in youth alcoholic bev- erage preference from THE ALCOHOLIC BEVERAGE to distilled spirits between the same market share (based market at the expense of the dis- 2001 and 2009. market has experienced 2 dra- on absolute alcohol consump- tilled spirits industry. Philip Mor- I have assessed the role of matic shifts in the past 4 decades. tion), and the markets for both ris, the world’s largest tobacco distilled spirits industry mar- Between 1970 and 1997, beer products grew rapidly for the company at that time, bought keting strategies to promote became the dominant beverage of next several decades.1 Beginning Miller Beer and adapted its to- this shift using the Smirnoff choice, taking substantial market around 1970, however, an im- bacco marketing strategies to the brand marketing campaign share from distilled spirits. This portant shift occurred; beer sales beer industry, transforming the as a case example. trend was precipitated by young kept increasing whereas distilled beer market. Television advertis- I conclude with a discus- consumers, who began choosing spirits began a steady, steep ing expenditures soared, youth- sion of the similarities in beer and over distilled spirits decline.2 oriented advertisement copy be- corporate tactics across as they came of age. Distilled Distillers faced 3 major hurdles came common, and Miller and consumer products with adverse public health im- spirits became identified with in keeping pace with beer. At the Anheuser Busch, who came to pacts, the importance of older generations. end of , distilled spirits dominate the beer market, be- 6,7 studying corporate mar- Market forecasters predicted the were considered the most hazard- came fierce competitors. During keting and public relations slow demise of the distilled spirits ous of the 3 types of beverages this same period, the population practices, and the implica- category, in part because of these because of their high alcohol con- was shifting rapidly to the suburbs, tions of those practices for shifting demographics. These pro- tent and their link to organized spurring the proliferation of con- public health. (AmJPublic jections proved to be premature. crime and moonshining. Beer and venience stores. Beer and tobacco Health. 2012:56–63. doi: Beginning in the late 1990s, young wine were seen as beverages of became key staples of these new 10.2105/AJPH.2011.300387) people’s beverage preferences be- moderation.3,4 To encourage con- retail outlets. Brewers also cen- gan shifting again, beer’s growth sumers to shift their alcoholic tralized the process, flattened, and the distilled spirits beverage preferences, policy- establishing high-tech breweries market grew rapidly, with most makers established 3 key policies: that greatly reduced the per-unit growth concentrated in particular cost of production. Beer prices brands of ‘‘white goods’’––, 1. Tax distilled spirits at much dropped steadily relative to infla- rum, and . higher rates per . tion.7 What accounts for this change 2. Make distilled spirits much less A June 1991 federal study in fortunes for the distilled spirits available by strictly limiting documented the new dominance industry? The short answer is the types of retail outlets where of beer in the youth market. Beer youth marketing innovation. I they can be sold. was by far the alcoholic beverage have described this market trans- 3. Allow beer and wine, but not of choice among junior high and formation, focusing on the mar- distilled spirits, to advertise on high school students who reported keting strategies associated with electronic media including tele- ; these individuals the Smirnoff Vodka brand as vision and radio. were averaging 13.3 servings of a case study. I conclude by ana- beer per week compared with only lyzing the public health implica- The electronic media ban was 1.2 servings of distilled spirits per tions of this transformation. a voluntary agreement between week.8 distillers and electronic media sta- Distillers could not compete THE DECLINE OF THE tions instituted as a response to 9 effectively for the youth market DISTILLED SPIRITS congressional hearings between in this policy climate. Unable to MARKET 1947 and 1958. The voluntary use the media most popular with ban helped convince Congress not young people, their products be- Distilled spirits were the alco- to pass a legislative ban.5 came increasingly identified with holic beverage of choice during The beer industry exploited older and aging consumers and Prohibition. After Repeal, beer and these regulatory advantages, in- were not considered youth friendly distilled spirits had approximately creasing its share of the alcohol because of their relatively harsh

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flavor. Convenience stores typically brands, which did not have the associated with the beer industry. number of television advertise- do not sell distilled spirits, so the harsh tastes associated with ‘‘brown’’ Public health groups, concerned ments placed on programs that gap between the number of beer distilled spirits (whiskeys and that the product was designed overexposed youths.16 and distilled spirits retailers grew. bourbons) and .2,11 The white for the youth market, used the Although beer remained the Distilled spirit prices were higher brands could be mixed with fruit term ‘‘’’ for Smirnoff Ice dominant type of alcohol adver- than were those of beer because of flavors and to create a bev- and other sweet, -based prod- tised on television, Diageo avoided tax differentials. erage more akin to soft drinks. ucts because of their similarity to the voluntary ban on distilled Beer’s advantage among under- This was an important character- soda pop.12 spirits by advertising on electronic age drinkers had important finan- istic because during the previous Smirnoff Ice quickly became media and thereby competed with cial implications for distillers be- 2 decades, soft drinks had become the dominant beverage in the beer companies to reach youth cause of the critical role underage the most popular commercial alcopop category. It invested audiences with its Smirnoff brand. drinking generally plays in the beverage in the US market, cap- nearly $40 million in 2001 and Diageo spent approximately $45 alcohol market. The average age turing an increasing ‘‘stomach $50 million in 2002 for advertis- million on electronic media ad- of first use among youths younger share’’ from alcoholic beverages, ing in measured media (television, vertising to launch Smirnoff Ice in than 21 years is 15.8 years, and coffee, teas, milk, and tap water, radio, magazines, newspapers, 2002, for example; only the 4 those who begin drinking before particularly among young people.6 and outdoor platforms), mostly most popular beer brands (Bud age 15 years are significantly more Other types of commercial bever- television.2,13 Smirnoff Ice adver- Light, Miller Lite, Budweiser, and likely to become heavy consumers age producers viewed soft drinks tising shot up from 2% to 50% of Coors Light) had higher electronic and to experience a wide range as competitors and sought ways all alcopop advertising between media advertisement spending of alcohol problems than are those to imitate their tastes and market- 2000 and 2001. that year.17 who wait until age 21 years.9 Ac- ing strategies. Diageo placed its Smirnoff Ice Other alcopop producers fol- cording to a National Research Diageo developed a sophisti- advertising in media venues with lowed Diageo’s lead. Measured Council/Institute of Medicine re- cated marketing strategy to relatively large youth audiences. media advertising expenditure for port, underage drinkers consume reenergize its Smirnoff Vodka The Center for Alcohol Marketing all alcopop brands went from between 10% and 19% of the al- brand using 3 key components: and Youth (CAMY) conducted $27.5 million to $196.3 million cohol on the market (almost all of a series of studies documenting between 2000 and 2002, signifi- whichisconsumedinbingedrink- 1. Develop a beverage that tasted the extent to which alcohol ad- cantly increasing the total amount ing episodes), producing between like soft drinks. vertising was placed in television of youth exposure to alcohol ad- $10 and $20 billion in annual reve- 2. Use the Smirnoff Vodka brand programming with disproportion- vertising and contributing to nues.10 Underage drinkers’ increas- name but market the product as ately youthful audiences ( > 15% a rapid growth in consumption ing preference for beer, therefore, a malt beverage to compete of the audience being aged 12---20 from 105.1 million gallons in meant that distillers were losing effectively with beer in terms of years, despite this age group com- 2000 to nearly 180.0 million gal- revenues to beer in the short term price, availability, and advertis- prising only 15% of the total lons in 2002.2,14,18 Smirnoff Ice and facing a shrinking market in the ing in electronic media. viewing audience). For 2002, accounted for 68.0% of the in- long term as underage drinkers 3. Reorient Smirnoff Vodka itself CAMY reported that Smirnoff Ice crease, producing 52.0 million became adults. as a young person’s brand by placed more than 1500 alcohol gallons in 2002. Between 2000 adding new fruit flavors and advertisements on television pro- and 2002, Diageo increased its THE DISTILLERS using other marketing innova- gramming with disproportionately market share in the alcopop mar- RESPOND: THE SMIRNOFF tions. youthful audiences. A substantial ket from 0.6% to 29.0%.2 BRAND CASE STUDY number of the advertisements Young people, particularly girls, Smirnoff Ice: The Transition were on television shows with contributed substantially to alco- In 1997, Beverage youth audiences of greater than pops’ surge in popularity. Accord- and merged to form Diageo introduced Smirnoff Ice 30%, violating the industry’s own ing to the 2009 federally funded Diageo, a British-based multina- in 1999 and initiated an aggres- voluntary standard.14 In 2005, Monitoring the Future survey, tional corporation. Diageo has sive marketing program in 2000. there were more than 1300 9.5% of 8th graders, 19.0% of been the largest distilled spirits The company claimed that it was Smirnoff Ice and Smirnoff Twisted 10th graders, and 27.0% of 12th producer in the world since that a ‘‘flavored malt beverage’’ and V alcopop television advertise- graders had consumed time. A top priority for the new therefore should be regulated as ments that violated the industry’s at least once in the past month, company was to reverse the a beer because the production 30% standard, placing it among with girls’ rates substantially downward sales trend of its core process started with beer. Both the worst alcohol brands for higher.19 Moreover, these figures brands in the . federal and state regulators ac- overexposing youths.15 In 2007, underestimate the impact of alco- The company’s primary focus cepted this representation. Dia- CAMY reported that Smirnoff Ice pops as a transition beverage. turned to its white distilled spirits geo adopted marketing strategies was the brand with the highest When examining only youths who

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report regular alcohol consump- Is Smirnoff Ice Properly 99%) of the alcohol in alcopops.24 Smirnoff Ice’s Link to Smirnoff tion (defined as at least 1 drinking Classified as Beer? In 2005, the TTB required pro- Vodka episode in the past 30 days), As noted in the previous sec- ducers to limit the added distilled The alcopops beverage cate- 64.0% of 8th graders reported tion, a key to Diageo’s marketing spirits to 50% of the total alcohol gory did not sustain the rapid regular use of alcopops.19 The use strategy was having alcopops in the product.25 The TTB sum- growth it experienced between of alcopops among drinkers de- classified as beer instead of dis- marized its findings by stating 2000 and 2002. Starting in 2003, clines sharply with age, with only tilled spirits under applicable that ‘‘flavored malt beverages sales slumped significantly and 24.0% of drinkers aged 29 to 30 federal and state laws. Without exhibit little or no traditional continued to decline through years reporting regular consump- this classification, Smirnoff Ice beer or malt beverage charac- 2008.13 Smirnoff Ice sales were 20 24(p14 293) tion of alcopops. Alcopops are would have been taxed at much ter.’’ no exception; although its sales more popular than is beer among higher rates and been unavailable This production process puts climbed through 2004, they teenage girls even though alco- in most convenience stores, and into serious question whether dropped 36% between 2005 and pops constitute a mere 2% of the Diageo would not have been alcopops are ‘‘beer’’ under federal 2008, according to the most re- 13,19 12, 26 beer market. able to advertise the product on and most state laws. The cent data available.13 As with wine Diageo’s marketing tactics electronic media. To achieve Bureau of Alcohol, Tobacco and coolers in the 1980s, alcopops contributed disproportionately this end, the company had to Firearms, TTB’s predecessor appear to have been something to this youth appeal compared overcome a serious barrier: the agency, held in 1996 that beer of a fad, gaining popularity when with tactics used by other alcopop malt base had an unpleasant, containing distilled spirits was first introduced but then fading 23 producers. For example, Wolfson bitter taste. To address the taste properly classified as a distilled and reaching a plateau. They et al. conducted a multistate spirit under federal law.27 How- problem, alcopop producers in- continue to be popular among survey of alcopop use among ever, the holding was never en- cluding Diageo developed a young drinkers, however, and 6800 youths in 2005 and found complex manufacturing process. forced, and TTB reversed it in continue to play the transition that Smirnoff Ice was the brand According to a study conducted 2005 when it set the 50% limit, role of introducing younger teen- of choice for 54% of respondents in 2003 by the US Department citing potential financial hardship agers, particularly girls, to alco- who reported alcohol consump- of Treasury’s Alcohol and To- for producers to justify its deci- holic beverages.19 tion––making it 2.5 times more bacco Tax Trade Bureau (TTB),24 sion.12,25,26 Unfortunately, data are not popular than its nearest competi- alcopop producers filtered the The TTB action does not affect available to assess shifts in brand- tor and substantially more popu- malt beverage base to remove state laws, which in many cases level awareness, comprehension, lar among youths than among the most or all taste, odor, carbon- appear to require that alcopops be and persuasion among young general population (Figure 1).21 ation, and fermented alcohol. Ei- regulated as distilled spirits, thus people. Nevertheless, an examina- Another study conducted in the ther before or after this filtering taking away the regulatory bene- tion of sales and marketing data San Francisco Bay area asked process, most of the beer base fits that Diageo and other manu- suggests that the drop in Smirnoff 6th, 7th, and 8th graders about was drained (typically 75% or facturers are seeking.26 Four state Ice sales may have been antici- their familiarity with various more of the original liquid) and attorneys general (in California, pated by Diageo and may have alcopop brands; it reported that replaced with other liquids, in- , Maine, and Mary- been part of a long-term strategy Smirnoff Ice was 3 times more cluding ‘‘flavoring’’ that contained land) have taken action or issued for reaching the youth market. likely to be named than any of its distilled spirits. Until 2005, dis- letters or opinions concluding that competitors.22 tilled spirits made up most (up to alcopops should be regulated as As previously noted, Diageo used distilled spirits in their states.28 In Smirnoff Ice to introduce the Nebraska, a court reversed the Smirnoff brand to young con- attorney general’s opinion reach- sumers, thereby overcoming the ing the opposite conclusion, al- slide in Smirnoff Vodka sales. though the court’s decision has Available data suggest that Diageo since been appealed.29 In re- appears to have achieved this sponse, the industry has spon- goal; since the introduction of sored state legislation to redefine Smirnoff Ice in 2000, Smirnoff beer to include alcopops, suc- Vodka sales have experienced ceeding in at least 8 states thus a steady increase in sales (61% far.28 In short, regulating Smirnoff between 2000 and 2008; Figure 13 21 Source. Impact Databank and Wolfson et al. Ice and other alcopops as beer–– 2). This stands in sharp contrast FIGURE 1—Alcopop brand preferences among underage drinkers: a critical element of the marketing to the previous decade, during United States, 2004. plan––appears to violate many which the brand experienced state laws.26 a 9% decline in sales.13

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Rum.31 Diageo announced that in Smirnoff contrasted sharply with 2010, digital marketing will ac- its marketing strategies for its count for 21% of its marketing other and the vodkas of budget.32 This form of marketing most competitors. Although the is largely unregulated and has vodka category generally in- a high likelihood of reaching un- creased in the past 10 years, derage youths, who are frequent a large percentage of that increase participants in these interactive is attributable to the Smirnoff marketing activities.31 brand.13 A called ‘‘icing’’ illustrates the potential reach and Distilled Spirits and the Youth impact of this type of marketing. Market Today Started at a fraternity, the game Diageo’s and other distillers’ involves an ‘‘attacker’’ who hands marketing innovations over the a bottle of Smirnoff Ice to a friend past decade have had a dramatic Source. Impact Databank.13 who must drink it all at once un- impact on the alcohol market. The less he has a bottle in his posses- Smirnoff example is not unique. FIGURE 2—Smirnoff Vodka sales: United States, 1990–2008. sion. The game usually involves For example, Diageo’s Captain men and is a spoof of the sugary Morgan Rum and Jose´ Cuervo taste and female appeal of the Tequila brands received similar Diageo coordinated the mar- often on programming with a dis- beverage. It rapidly became a na- marketing treatment and have ex- keting strategies for Smirnoff proportionate number of under- tional phenomenon, gaining great perienced similar gains in sales. Vodka and Smirnoff Ice to en- age viewers. For 2005, CAMY notoriety on Web-based social Barcardi Rum, Skyy Vodka, and courage the linking of the 2 prod- reported that 11.8% of its adver- networks and significant press are among the ucts in the minds of consumers. It tising (338 advertisements total) coverage, apparently without any other brands with notably inno- created numerous fruit-flavored was placed in shows with 30% or direct involvement by Diageo.33 vative youth-oriented market Smirnoff Vodka Twist flavors that higher youth audiences, violating Industry observers agree that strategies. had similar tastes, containers, ad- the industry’s own voluntary ad- these marketing efforts to reposition Distillers have reversed the vertising, and flavorings as the vertising placement standard.15 No Smirnoff Vodka as a youth-oriented trends and are now gaining on Smirnoff Twisted V alcopop other vodka brand came close to product appear to have been suc- beer in terms of market share. brands. Perhaps most significant, this level of violation, and only 2 cessful. In 2003, a commentary in Although beer remains the domi- starting in 2003, Diageo began an other distilled spirits brands had Impact Magazine (a premier indus- nant beverage of choice among all aggressive television advertising a higher number (one of which try periodical) observed, drinkers, distilled spirits have ex- campaign for Smirnoff Vodka as was Diageo’s tequila brand, Jose´ perienced a 16% increase in per- Diageo rolled out Smirnoff Ice in well as other Diageo brands. The Cuervo). CAMY rated Smirnoff the US market ...it suddenly put capita alcohol consumption since distilled spirits industry had lifted Vodka television advertising the once-stodgy Smirnoff name 1999, whereas beer has shown its voluntary ban on television and among the 10 worst performing on the tips of millions of echo a 2% decline. The gains have boomers’ tongues.34(p4) radio advertising in 1996. This alcohol brands in 2007 in terms of occurred almost exclusively initially did not have much effect overexposing youths. It was the (Echo boomers were born be- among vodka, rum, and tequila because network television sta- only vodka brand on the list and 1 tween 1977 and 1994, and most brands, which together experi- tions continued their own volun- of only 3 distilled spirits brands were underage at the time this enced a 56% increase in sales. tary ban. However, cable net- included.16 quote was made.) Smirnoff was Sales of whiskey, bourbon, and works opened the airways to the Diageo’s television advertising named the most powerful alco- gin, despite ending their steep industry, and television distilled strategy was augmented with an holic beverage brand in 2010 by decline from the previous 2 de- spirits advertising subsequently aggressive push into the digital Intangible Business in its Power cades, were flat, and specialties underwent a rapid increase, from marketing arena. Creating inter- 100 report, citing Smirnoff’s mod- (cordials, , , and 1973 advertisements in 2001 to active Web sites; positioning on ern, cool image.35 mixed drinks) showed only modest 62 776 advertisements in 2007, social network sites such as Face- The Smirnoff brand case study increases.13 The growth within the with Diageo playing a leading book, Internet games, YouTube clearly highlights the importance white goods category is attribut- role.30 videos, and viral marketing; and of branding; different brands are able to a small number of brands As with Smirnoff Ice, Diageo’s other strategies are now staples for marketed to reach distinct audi- and parallels the marketing ex- placements of its Smirnoff Vodka Smirnoff and other Diageo brands, ences. For example, Diageo’s penditures and innovations used television advertisements were most notably youth marketing strategy for by successful brands. Market

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analysts anticipate this trend con- Risk Survey show that, among 9th- tinuing over the next decade.13 through 12th-grade girls who have Surveys of underage drinking consumed alcohol in the past 30 document a similar shift in alco- days, distilled spirits and alcopops holic beverage preference among are more popular than is beer. In 3 young people in the past decade of the 4 states, this beverage pref- that parallels the overall market erence is pronounced (Figure 4). shift, particularly among girls. The Unfortunately, there are no Monitoring the Future national brand-specific data to measure survey of 8th, 10th, and 12th these shifting tastes among young graders found that 12th-grade girls people. As noted previously, every 36 were significantly more likely to brand has its own marketing niche, Source. Centers for Disease Control and Prevention. drink beer than distilled spirits in and most brands are not designed FIGURE 4—Beverage choice among 9th- through 12th-grade girls 2000; by 2008, their drink of for the youth and young adult (30 day prevalence): United States, 2005. choice had shifted to distilled market. Aggregate data will dilute spirits.19 The shift in preference was the effects of brand-specific youth more pronounced among 12th- marketing tactics. With brand-spe- grade girls who engaged in binge cific data, the link between youth- policymakers, public health and United States marketing code. drinking (Figure 3). Boys reported oriented market innovations for medical groups, and the public Diageo’s and the ’s an increased preference for distilled specific brands such as Smirnoff that the company was committed self-regulatory practices generally spirits as well, but beer remains Vodka could be documented. to deterring underage drinking suffer from several weaknesses, their most preferred beverage. Without it, the connection cannot and other social harms associated including lack of independent The Monitoring the Future data be described definitively. with its products. Diageo hired compliance monitors; a 30% are limited because they do not Guy Smith, a former vice president youth audience standard, which include data for younger teens. Re- Diageo’s Public Relations of Philip Morris, a veteran of the allows for extensive youth expo- ports from the Centers for Disease Campaign tobacco wars, and a former advi- sure to measured media; weak Control and Prevention suggest that Diageo initiated a sophisticated sor to President Clinton, to head controls on youth access to digital the beverage preference shift public relations program during up its marketing public relations and Internet marketing; and weak among younger cohorts may be the same period that it launched division, which would design and standards of advertising content, 36 much more significant. Data from the Smirnoff brand campaign. implement the campaign. The fol- that is, allowing advertising so long 4 states from the Youth Behavioral Its purpose was to convince lowing strategies were used. as it does not ‘‘primarily’’ appeal to 18, 31, 39 1. Establish a self-regulatory underage drinkers. structure to monitor the company’s 2. Broadcast ‘‘responsibility’’ ad- . Diageo estab- vertisements. Between 2001 and lished its own responsible mar- 2005, Diageo spent 17.7% of its keting code, which it describes as advertising budget on responsibil- ‘‘a beacon for responsible market- ity television advertising, which is ing and brand innovation’’ ac- focused primarily on educating cording to DrinkIQ.37 The code, viewers about how to prevent un- established in 1997, is periodically derage drinking and drunk driv- updated and states that the com- ing––far more than any other al- 18 pany’s advertising must coholic beverage producer. Even so, underage youths were far Be aimed only at adults and more likely to see a Diageo prod- never target those younger than the legal purchase age for alcohol uct advertisement than a responsi- [and] be designed and placed for bility advertisement during this an adult audience, and never be period.18 The effectiveness of in- designed or constructed or placed in a way that appeals dustry responsibility advertising primarily to individuals younger has been questioned,10,18 and at 19 Source. Johnston et al. than the legal purchase age for least 1 study has suggested that alcohol.38(p4) FIGURE 3—Beverage choice among 12th-grade girls who engage in the advertisements are designed binge drinking (‡ 5 drinks per sitting): United States, 1991–2008. Diageo also complies with the to reinforce brand advertising Distilled Spirits Council of the messages.40

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3. Fund prevention programs that the Federal Trade Commission’s The short- and long-term con- a wide variety of consumer prod- focus on education, public awareness, ‘‘We Don’t Serve Teens Cam- sequences that arise from un- ucts that have potentially adverse derage alcohol consumption are and responsible retail practices. paign.’’ The company’s coopera- astonishing in their range and effects on public health, including According to Diageo’s 2009 Cor- tion with governmental agencies magnitude....[It]isaleading tobacco, prescription drugs, auto- porate Citizenship Report, on prevention efforts dovetail with contributor to death from in- mobiles, firearms, and unhealthy juries, which are the main cause Diageo’s extensive political lobby- foods.47---51 The dynamics are re- We support practical pro- of death for people under 21 grammes in many of our markets ing activities. Diageo and other and plays a significant role in markably similar in terms of cor- to tackle particular examples of distillers have also sponsored sci- risky sexual behavior, physical porate marketing strategies, use and sexual assault, academic harm from alcohol misuse... . entific research and sought to in- of public relations, and reliance This year we led or supported failure, and illicit drug use, over 130 such initiatives in over fluence public perceptions re- among other adverse conse- on political lobbying. 45(p10) 40 countries. The Diageo Re- garding research findings.43 quences. Case studies of corporate prac- sponsible Drinking Fund, which 5. Establish industry-based ‘‘so- tices that use qualitative research had resources this year of Thereisnowarobustresearch cial aspects’’ organizations.Overthe methods but do not include con- £400,000, provided financial literature documenting the effec- support, backed up by expert past decade, Diageo has helped trol groups or baseline measures 41( p 9 ) tiveness of various alcohol poli- guidance. organize and fund 14 social as- cannot support causal inferences cies in preventing these public pects organizations worldwide, in- regarding public health effects.52 Examples include DrinkIQ, health harms, including raising cluding the Century Council and In particular, this case study does a Web site providing information alcohol prices through increased the International Center on Alco- not provide a basis for concluding on alcohol and alcohol problems, alcohol taxes and reducing alco- hol Policy in the United States.41 that overall youth consumption programs focused on responsible hol availability.10, 43 Counterad- These industry-member organiza- increased as a result of Diageo’s alcohol retail practices, and drink- vertising (public service adver- tions sponsor programs similar Smirnoff campaign. Nevertheless, ing and driving and underage tisements designed to discredit to those funded by the Diageo case studies can provide insights drinking awareness programs. As product advertising messages) Responsible Drinking Fund and into the dynamics of the interac- with most alcohol industry respon- and other controls of alcohol further the goals of the Diageo tion between those practices and sibility efforts, Diageo’s sponsored advertising and promotions are public relations campaign. Social public health outcomes and can programs are seldom evaluated also promising policy interven- aspects organizations serve the serve as a foundation for identi- and predominantly focus on pro- tions.10, 43 Applying these strate- viding information to consumers. long-term marketing interests of fying priorities for research stud- 44 gies to alcopops, which have a The National Research Council/ their industry members. ies using more sophisticated particular appeal for youths, is an Institute of Medicine report con- These components fit a strategy methodologies and for designing importantaspectofreducing cluded that such programs ‘‘have used by several industries that and implementing advocacy cam- problems associated with under- 53 been demonstrated to be ineffec- have products with potential - paigns. Case studies of tobacco age drinking. tive at reducing alcohol use and lic health harms: they promote industry marketing practices, As the Smirnoff case study should be avoided.’’10(p13 2) ineffective self-regulatory pro- such as those examining R.J. documents, the alcohol industry 4. Build partnerships with medi- grams, discourage governmental Reynolds’s Joe Camel marketing is involved in an intense competi- cal and public health organizations regulation, broadcast a message of campaign, illustrate this point: tion for the youth market. The and government agencies. Accord- corporate responsibility, fund they served as a foundation for industry’s ability to engage in this ing to Diageo, most of its funded programs with public relations significant public health gains in competition is dependent on en- 47 programs are value that do not interfere with tobacco control. marketing, recruit potential oppo- gaging in and expanding the very Experiences in related fields undertaken in partnership with nents with corporate funds, and practices that these alcohol poli- can serve to guide alcohol policy other organizations including cies would restrict. This fact sug- governments, non-governmental seek opportunities to cooperate research and advocacy. Unfortu- organizations, universities, re- with governmental agencies that gests the importance of Diageo’s nately, the alcohol industry’s searchers, physicians, [and] law might otherwise interfere with public relations and lobbying ac- practices are understudied relative enforcement.41(p10) marketing goals. tivities. The industry’s success is to many other corporate sectors. Medical and public health particularly noteworthy, given The Smirnoff case study, there- groups are a high priority for ANALYSIS the fact that surveys repeatedly fore, addresses an important gap building partnerships; govern- show that the public supports in the research literature. It points mental agencies are equally im- Underage drinking constitutes these and other alcohol policy in- to several important research portant. For example, Diageo42 a public health crisis in the United terventions.46 questions, such as has reached out to the Federal States. As stated in the 2007 The practices documented here Trade Commission, which regu- Surgeon General’s Call to Action to are not unique to Diageo or the d How do alcohol industry prac- lates alcohol advertising and Prevent and Reduce Underage alcohol industry. They are com- tices compare with the actions called for the industry to support Drinking, monly used by corporations to sell of other corporate players?

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d What lessons can be learned An earlier version of this article was marketing campaign that targets youth. Bureau. Flavored malt beverages and re- from tobacco control efforts? delivered at the Industry-Medicine Con- J Public Health Policy. 2005;26(3):326--- lated regulatory amendments. Fed Regist. d Has the increased popularity of ference sponsored by IMAP, Columbia 342. 2005;70:194---237. University, November 2, 2009. specific distilled spirits brands 13. Impact Databank. Impact Databank 26. Mosher JF. Litigation and alcohol influenced youth consumption Human Participant Protection Review and Forecast: The U.S. Spirits policy: lessons from the US tobacco wars. Market. New York: M. Shanken Commu- Addiction. 2009;104(suppl 1):27---33. and related problems and, if so, No protocol approval was needed be- nications; 2009. how? cause no human research participants 27. US Department of the Treasury, d were involved. 14. Center on Alcohol Marketing and Bureau of Alcohol, Tobacco, and Fire- Are Diageo’s lobbying and pub- Youth. Youth Exposure to Alcohol Ads on arms. ATF Ruling 96---1; March 1996. lic relations activities integral to References Television, 2002. Washington, DC: Geor- 28. Mosher J. Special Report: Status of its marketing plans, and what 1. Moore M, Gerstein D, eds. Alcohol getown University; 2003. State Campaigns to Restrict the Availability effect do they have on alcohol and Public Policy: Beyond the Shadow of 15. Center on Alcohol Marketing and of Alcopops. Felton, CA: Alcohol Policy policy development and public Prohibition. Washington, DC: National Youth. Still Growing After All These Years: Consultations; 2009. Available at: http:// health advocacy? Academy Press; 1981. Youth Exposure to Alcohol Advertising on www.alcoholpolicyconsultations.com/ 2. Impact Databank. Impact Databank Television, 2001---2005. 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Confronted by compelling Allan M. Brandt, PhD peer-reviewed scientific evi- dence of the harms of smok- ANY SYSTEMATIC INVESTIGA- ing, the tobacco industry, perception, both within science and diseases, leading to death. These beginning in the 1950s, used tion of the modern relationship of among the public, that scientific findings appeared in major, peer- sophisticated public relations medicine and science to industry endeavors constituted a set of ac- reviewed medical journals as well approachestoundermineand must consider what has become tivities that were in large measure as throughout the general media. distort the emerging science. the epiphenomenal case of the insulated from ‘‘interests.’’ Institu- As a result, the tobacco industry The industry campaign tobacco industry as it confronted tions have struggled over recent would launch a new strategy, worked to create a scientific new medical knowledge about the decades to discern new policies and largely unprecedented in the his- controversy through a pro- risk of cigarette smoking in the mid- approaches to mitigate the increas- tory of US industry and business: gram that depended on the 20th century. This, of course, is not ingly powerful influence of indus- it would work to erode, confuse, creationofindustry–academic to argue that the approach and tries as they affect scientific inves- and condemn the very science that conflicts of interest. This strat- strategy undertaken by big tobacco tigation and the public good.2 now threatened to destroy its egy of producing scientific uncertainty undercut public are necessarily typical of conven- prized, highly popular, and exclu- health efforts and regulatory tional industry---science relation- THE TOBACCO INDUSTRY sive product. But this would be no interventions designed to re- ships. But the steps the industry IN CRISIS MODE simple matter. After all, in the duce the harms of smoking. took as it fashioned a new rela- immediate postwar years––the A number of industries tionship with the scientific enter- By late 1953, the tobacco in- dawn of the nuclear age––science have subsequently followed prise have become a powerful and dustry faced a crisis of cataclysmic was in high esteem. The industry this approach to disrupting influential model for the exertion proportions. Smoking had been could not denigrate the scientific normative science.Claimsof of commercial interests within sci- categorically linked to the dra- enterprise and still maintain its scientific uncertainty and ence and medicine since that time. matic rise of lung cancer. Although public credibility, so crucial to its lack of proof also lead to As a result, industrial influence health concerns about smoking success. the assertion of individual on scientific research and outcome had been raised for decades, by The tobacco industry already responsibilityforindustrially produced health risks. (Am has been a powerful legacy of the the early 1950s there was a pow- had a long history of innovative J Public Health. 2012:63–71. tobacco story. In this sense, the erful expansion and consolidation advertising, marketing, and public doi:10.2105/AJPH.2011. tobacco industry invented the of scientific methods and findings relations that had centered on 300292) modern problem of conflicts of in- that demonstrated that smoking making smoking universal. Start- terest at midcentury.1 Before that caused lung disease as well as other ing in the late 19th century, the time, there had been a widespread serious respiratory and cardiac industry transformed itself to

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