Thursday, 22 September 2011

Is the alcohol industry taking over the world?

A major survey of teenage drinking was published in June by the usually trusty and worthy Joseph Rowntree Foundation as part of its three year project on young people and alcohol.  It concludes with the astounding 'policy' advice that there is 'little benefit' in aiming to prevent young people from drinking alcohol. How did we get to this point?

'Doubt is their Product' is an excellent analysis by David Michaels of how the American tobacco (and asbestos) industry managed to stave off restrictions to sales and marketing that would naturally have followed from the alarming discovery that their product kills you.  The facts were known in the early part of the last century, a good 50 years before the courts and government took action.  Why were governments so slow to act?

As Michaels shows, the manufacturers created phony science to counter the good science.  As a tobacco company executive put it, they 'manufactured doubt' by flooding the market with 'studies' putting the emphasis away from the health disbenefits of tobacco and onto, for example, the genetic predisposition of some smokers to get cancer, or the social failings of addictive smokers, or the benefits of relaxing with a cigarette.  'The Orwellian strategy of dismissing research conducted by the scientific community as "junk science" and elevating science conducted by product defense specialists to "sound science" status also creates confusion about the very nature of scientific inquiry and undermines the public's confidence in science's ability to address public health and environmental concerns'.

Looking at the research flooding the journals it is clear that the alcohol industry, with the benefit of hindsight, is playing the same game, but better. The 'world's largest alcohol research organisation' the Foundation for Alcohol Research, for example, is funded by the alcohol industry to the tune of over 2,000,000 per year. It boasts the top alcohol manufacturers on its board, but also has a host of  academics from many leading universities rubbing shoulders with them.   Fine you say, but its output is very clearly stated: 'your donation will support our mission to discover the benefits and risks of alcohol consumption'.  And so it does. As the Public Library of Science editors wrote in May:
"The crisis of confidence that surrounds the behavior and practices of Big Tobacco and Big Pharma bias in funded research, unsupported claims of benefit, and inappropriate promotion and marketing, among others—should be enough to provoke in us all a high degree of skepticism with any industry involvement in health research and policy. But the evidence and critical voices highlighting the practices of the alcohol industry—a massive and growing US$150 billion global business—have not yet received adequate prominence in medical journals. Indeed, attention to and scientific research on the alcohol industry have not kept pace with the industry's ability to grow and evolve its markets and influence in the health arena"
“Powerful sway” of industry ahead of UN health summit

The influence doesn't end with research.  Big Alcohol is also infiltrating governments, and at very senior levels.  Astoundingly, the UK governments 'independent' health advisory panel on alcohol has been reconstituted in order to make way for a 50% alcohol industry representation (see the Guardian report on advisory panel 'heavily stacked' with industry insiders).  Worse, the British Medical Journal last month published details of how the world health agenda itself has been hijacked in advance of the world summit on non-communicable disease in New York this September.  The BMJ has evidence that alcohol industry representatives in several nations have used influence to change or delete aspects of the agenda.  'Indeed, draft documents show that effective, evidence-based measures on alcohol (controlling price, availability and marketing) are being deleted, and industry favoured measures (partnership working, community actions and health promotion) being substituted... with Japan, the EU, US and Canada resisting all language on taxation'.

Parents take the blame

Following the once-succcesful route taken by tobacco manufacturers, Big Alcohol has looked for scapegoats for the massive rise in alcoholism in the past decade, much of which is attracting negative publicity. In the UK and US and Australia the chosen soft targets are parents, deflecting attention away from the vacillations of government and a persistent failure to regulate an increasingly powerful industry. Led by the alcohol industry's 'responsibility' wing drinkaware in the UK, and the PDFA (outed as alcohol and pharamceutical industry funded) in the USA, a number of 'help' websites and 'research' papers have sprung up examining and advising on the role of parents who fail to manage teenage drinking. Of course parents have a role, and an important one, but the new 'research' serves to deflect or counter the many studies showing that the real drivers of our new drinking cultures are the massive advertising and marketing campaigns funded at enormous cost by the alcohol industry itself.  Western alcoholism is consequently flying under the radar as 'normal healthy drinking'.  As the JRF itself has noted in its pursuit of the cause of drinking cultures, 'international research, as well as research conducted in the UK, has led to debates regarding the emergence of a youth drinking culture which transcends gender, socio-economic differences, nationality and locality differences and is breaking away from traditional drinking cultures of older generations'.  Exactly - advertising and marketing reaches everyone.

Following on from the recent Drinkaware campaign advising 'when to talk to my children about alcohol' the Joseph Rowntree Foundation has published a series of studies into drinking amongst teens.  Its' September study of celebrity culture was preceeded in June 2011 by a 'major survey of early teen drinking patterns in England' conducted not by independent researchers but by the political census for hire group Ipsos MORI.  The report claims that
"For the first time in the UK, this study ranks what most influences young people’s drinking behaviour. It found that the behaviour of friends and family is a strong influential factor in determining a young person’s relationship with alcohol.... and are stronger influences than some other factors – such as individual well-being, celebrity figures and the media".
This would be valuable information if the report had evidence for this comparison, but it doesn't.   The study asked 5,700 teenagers to self-complete a survey which records their drinking habits, but doesn't attempt to assess or survey the effects of advertising and media.  It has many interesting findings - 'the odds of a teenager having ever had an alcoholic drink are greater if their parents allow their child to watch 18-rated films unsupervised...or if they have seen their parents drunk'.  Useful to know, but there is a slight of hand in concluding that the blame for our drinking culture must therefore fall solely on parents, and away from alcohol marketing and advertising. The report itself, effectively in an aside, acknowledges the power of marketing.
Young people are likely to say that adverts make alcohol look appealing and will encourage people to drink (Ipsos MORI, 2007). A review of seven international studies (Smith and Foxcroft, 2007) demonstrated an association between exposure to alcohol advertising and marketing and drinking behaviour in young people. Young people are influenced by television and magazine commercials, films, music videos and celebrities who explicitly or implicitly convey positive associations with alcohol (Christenson, et al., 2000; Roberts, et al., 1999, 2002).et al., 2000; Roberts, et al., 1999, 2002).
Having got that off their chest though, the surveyors ignore the whole issue of advertising and sponsorship until it comes to boldly making 'policy' recommendations.  Much like the Ipsos MORI report in 2007 which, against the findings of its own very loaded poll, claimed that there was 'no clear support for minmum pricing of alcohol in Scotland', the new report has no modesty about making strong recommendations not remotely supported by the survey itself.  Unlike the specific and tentative recommendations usual in research, this report confidently advises that 'there appears to be little benefit at this point in time in policy aiming to prevent young people from trying alcohol or encouraging an alcohol-free childhood'. Excuse me? Instead, it continues, policy should only target and 'set clear messages to parents, local policy-makers and front line services. National policy must focus on the strongest predictors that can be influenced - parental influence".  No minimum pricing, no regulation, no legislation.

So a study which has found that far too many teenagers drink far too much is letting the government and the alcohol industry completely off the hook.  In opposition to evidence-based recommendations worldwide from Alcohol Concern up to the World Health Organisation, the report  fails to recommend curbing sales, price, marketing or even drinking itself in favour of a few wise words to parents.  If you didn't know better, you might think it was written by the alcohol industry itself.

Demos shares the credits

No need to ask the same question of a remarkably similar study by the Demos think-tank 'focused on power and politics'. Publishing their report in August 2011 Demos trumpets unequivocally that 'poor parenting increases likelihood of binge drinking at ages 16 and 34'.  More than that, this study 'shows parenting style is one of the most important and statistically reliable influences on whether a child will drink responsibly in adolescence and adulthood'.  And policy implications?  “While levels of binge drinking have fallen for five years running, there is a minority of extreme, publically visible, drinkers. No matter how high minimum pricing on alcohol is, there will be a hardcore of binge drinkers who will find a way to pay for it'.   So again, no need for governments to act.  Its the parents and its the hardcore drinkers at fault, and nothing we can do about it.  No, what we should look to are “very practical measures like spreading the school summer holiday throughout the year which will go some way to preventing boredom and avoiding risky behaviour like under-age drinking.”

For goodness sake.

Two things undermine this very famiilar sounding report. Firstly the reliability of the data.  Demos claims to have reached its conclusion by categorising the families of 15,000 children into good and bad parents. How exactly, by looking through the window?  Not really. Actually they 'ran logistical regressions' on data from the 1970 British Cohort Study'.  No explanation of how.  Not what you might call good science.

And secondly, who actually paid for this logistical regression analysis of 40 year old data?  Step forward SABMiller.  'We're one of the world's leading brewers, operating across six continents, making a difference through beer'. 

I rest my case.

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