Thank you, Neil, for this important message. [ https://www.hifa.org/dgroups-rss/alcohol-use-disorders-62-q3-what-role-a... ]
But I think you have pointed out just one of the “tips of the iceberg” [the alcohol industry and breast cancer]. There are others, and above all, there is an immense part of the problem that is hidden “below the surface”.
I am sharing here the first part of my reflection on the subject.
Prof. Babor in the title of one of his books highlights something very important: Alcohol is not an ordinary commodity.
The most recent scientific evidence on the burden of disease attributable to alcohol indicates that it plays a causal role in a wide range of health conditions and social problems, including coronary heart disease, breast and other cancers, liver diseases, HIV/AIDS, suicide and interpersonal violence. In states of intoxication or dependence, people's ability to act rationally is hindered, and the likelihood of harming others is substantial. (1)
Why has the obvious conclusion that alcohol is not an ordinary commodity failed to convince policymakers to take effective measures to limit the harm it causes? (2)
This happens because it is not just about the product, the alcohol industry is not an ordinary industry, and because there is also an inherent and substantial conflict of interest between public health and the alcohol industry. (3)
The main objective of the alcohol industry, like any industry, is to increase profits for its shareholders. To do this, it must necessarily increase alcohol sales, it must attract new customers and make those who already consume, to consume more. By achieving its goal, it necessarily increases the health and social harms related to alcohol.
The goal of Public Health is to reduce the burden of death and disease related to alcohol consumption. To be successful, it is necessary to reduce the total amount of alcohol per capita consumed in a country. If Public Health is successful, alcohol sales will decrease.
Therefore, there cannot be a “meeting point” between both parties; measures and strategies that are effective for public health harm the alcohol industry. Measures that are effective for the alcohol industry's objectives harm public health.
What do we talk about when we talk about the alcohol industry? (4)
CONSOLIDATION. Like the tobacco industry, the alcohol industry is dominated by a small group of transnational companies that control more than half of the world market. Corporations of this magnitude present a significant challenge to governments seeking to implement evidence-based measures to prevent and reduce harm caused by alcohol.
The alcohol market and the alcohol industry are part of the commercial determinants of health, defined as “strategies and approaches used by the private sector to promote products and options that are harmful to health” and spread the non-communicable disease pandemic.
ALCOHOL ADVERTISING, PROMOTION AND SPONSORSHIP. The alcohol industry uses advertising to achieve two main objectives: attract and recruit new customers and normalize and promote alcohol consumption in new markets, thereby increasing overall consumption and profits.
Marketing and corporate social responsibility (CSR) programs also improve the industry's standing with the public and policymakers and can undermine efforts to regulate its activities. Alcohol corporations have huge marketing budgets, some of them larger than the GDP of some low- and middle-income countries.
THE INDUSTRY SAYS it uses marketing and advertising to build brand loyalty, but SCIENCE TELLS US that alcohol ads stimulate and encourage alcohol consumption and attract new customers by targeting two groups in particular: women and young people .
YOUTH. Research has shown that exposure to alcohol advertisements increases the likelihood, frequency, and volume of alcohol consumption among youth. Alcohol ads also create false expectations about how alcohol will make people feel and be perceived by others: The ads promise what is important to young people: to be happy, glamorous, successful, brave, mysterious, adventurous and funny, popular, sexy and modern. The industry also sponsors sporting events and teams, as a way to attract young people.
WOMEN. The industry aims to make alcohol use and consumption more socially acceptable among women, who consume less alcohol than men in most parts of the world. This strategy has proven successful and, as a result, alcohol consumption by women, especially those of higher socioeconomic status, is catching up to alcohol consumption by men.
CORPORATE SOCIAL RESPONSIBILITY .Another creative marketing strategy employed by the alcohol industry is corporate social responsibility (CSR), which ranges from “responsible drinking” school programs for children, to transportation services for intoxicated adults. These tactics have been found to have limited effectiveness in reducing alcohol harm, but offer a highly visible branding strategy.
Alcohol corporations are also seeking to partner with civil society to improve their standing with the public and policymakers. An example is the 2017 “Beers for Africa” campaign, which positioned alcohol as an aid against poverty.
SELF-REGULATION. Globally, self-regulation is the most common method of regulating the promotion and sale of alcohol, but voluntary codes have been shown to have limited effectiveness. For example, the industry has its own codes against marketing to young people, but alcohol ads often feature elements that appeal to young people
INDUSTRY SAYS : Voluntary codes and guidelines and responsible alcohol campaigns can be used instead of regulatory policies.
SCIENCE TELLS US: Voluntary codes, guidelines and responsible use campaigns are insufficient and do not replace legally enforceable measures.
Another important strategy, which we will address in the second part of my comments, is about how the alcohol industry controls “the narrative” about alcohol consumption.
For all these reasons, the former director general of the WHO, Margaret Chan, in 2013, expressed: “The alcohol industry cannot sit at the table or have a voice when the WHO defines its standards and preventive strategies, and cannot supplant the role of the government in formulating policies for alcohol control.”
What do you think about these topics?
What is the situation regarding them in your countries?
Kind regards,
Eduardo
Referencias
(1) https://academic.oup.com/book/45328
(2) https://academic.oup.com/book/45328/chapter/389221591
(3) https://www.jsad.com/doi/full/10.15288/jsad.23-00070
(4) https://troublebrewingreport.org/the-alcohol-industry
Dr. Eduardo Bianco
Director, Addiction Training Program for Health Professionals (ATHP)
Email: ebianco@nextgenu.org
Web: NextGenU.org
HIFA profile: Eduardo Bianco is a medical doctor and Cardiologist, Certified Tobacco Cessation Expert with a Masters in Prevention and Treatment of Addictive Disorders. Currently, he is Chair of the World Heart Federation Tobacco Expert Group. Dr. Biancos research examines tobacco control and cessation, and he is a prominent member of several organizations that address tobacco control in Latin America. Dr. Bianco has worked for 25 years in Uruguay and Latin America to promote and train in smoking cessation treatment and tobacco control policies. He is also the former Regional Coordinator for the Americas of the Framework Convention Alliance and former Technical Director of the MOH Center for International Cooperation for Tobacco. ebianco AT nextgenu.org
