Citation: The PLoS Medicine Editors (2011) Let's Be Straight Up about the Alcohol Industry. PLoS Med8(5): e1001041. https://doi.org/10.1371/journal.pmed.1001041
Published: May 31, 2011
Copyright: © 2011 PLoS Medicine Editors. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors are each paid a salary by the Public Library of Science, and they wrote this editorial during their salaried time.
Competing interests: The authors' individual competing interests are at http://www.plosmedicine.org/static/editorsInterests.action. PLoS is funded partly through manuscript publication charges, but the PLoS Medicine Editors are paid a fixed salary (their salary is not linked to the number of papers published in the journal).
Provenance: Written by editorial staff; not externally peer reviewed.
The PLoS Medicine Editors are Virginia Barbour, Jocalyn Clark, Susan Jones, Melissa Norton, and Emma Veitch.
If medical journals and public health advocates are concerned with corporate conflicts of interest, inappropriate marketing to children, impotent self-regulation, and general flouting of the rules, why are we ignoring the alcohol industry?
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 .
So why are we soft on alcohol? One reason might be the enduring perception that drinking is normal, fun, and healthy, and that the damage caused by alcohol affects only a small group of people who can't handle their booze . But the independent statistics defy this rosy view: the Global Burden of Disease study places alcohol-related morbidity second only to tobacco in the developed world , teenage drinking problems have been shown to have long term effects on individuals and communities , and a recent European-wide study  found that 10% of cancers in men and 3% in women were linked to alcohol consumption.
While the statistics on alcohol's harms are troubling enough, it's the practices of the alcohol industry, including its influence on government policy, health research, and public perceptions, that really begs for more of our attention. Several recent examples signal a need for more scrutiny.
In the UK, there have been scathing allegations  that the current government is too close to the drinks industry, including its recent invitations allowing industry representatives to influence public health policy, which led to a withdrawal of support for a key alcohol policy by major organizations including the British Medical Association, Royal College of Physicians, and several alcohol control charities ,. Similar interference in government policy by the alcohol industry, in which scientific evidence was ignored and industry interests inserted into national alcohol policies, was recently documented for sub-Saharan Africa .
In the US, a recent review  of alcohol industry–funded health research found very little that could contribute to reducing alcohol-related illness. But, worryingly, Barbor did find a lot of potential for the alcohol industry's involvement in science—whether supporting individual scientists, research councils, conferences, or journals—to result in messages that obscure public perceptions of the true benefits and harms of alcohol and to support the industry's PR agenda, while also supplying industry with the opportunity to “demonstrate corporate responsibility in its attempts to avoid taxation and regulation” .
Recent analyses have also shown the alcohol industry's savvy in deflecting government controls aimed at protecting the public—for example, the industry's marketing innovations in the use of social media, sports sponsorships, and product placements in film are said to be designed to evade policies restricting broadcast and print ads . And, Hastings and colleagues  last month demonstrated how UK alcohol companies and their PR firms continue to market to youth, encourage drunkenness, and link drinking to sociability and social success despite explicit self-regulatory codes prohibiting this type of advertising.
None of this would surprise the Marin Institute (http://www.marininstitute.org/site/), the California-based alcohol industry watchdog, whose work has documented a laundry list of misdeeds by “Big Alcohol”: promoting the health benefits of alcohol while downplaying harms; deflecting attention away from scientific data that contradict industry exaggerations of benefit; tactically targeting specific markets of underage youth, people of color, and poor people; and engaging in philanthropy to promote brand loyalty.
If this questionable behavior is reminiscent of the strategies developed by the pharmaceutical, tobacco, and other industries to further their agendas, it should be a wake-up call to us all. And, as with the pharmaceutical and tobacco industries (whose marketing budgets far exceed the public funding of independent research), efforts to counter such dubious tactics face a formidable and well-resourced industrial opponent. However, experience with other industries, especially through tobacco control efforts, can also teach us a lot about how to critically examine and resist the alcohol industry's behavior and practices. Galvanizing the support of non-governmental organizations and governments, along with a solid base of independent evidence, led to the ratification of the Framework Convention on Tobacco Control, and there have been proposals for a similar Framework Convention on Alcohol Control ,—a move that would recognize the need for collective global action and could counter the alcohol industry's age-old attempts to individualize responsibility for problem drinking and deflect attention away from their own role in promotion.
Whether the solutions are stricter regulation over advertising and promotion, banning sports sponsorships, setting minimum pricing, restricting access, introducing mandatory safety labeling, or holding the industry to account for the harms associated with their products, there is a need now to target more attention to and research on the alcohol industry that can support and fuel legislative, regulatory, and community action to protect the public health. Let's be straight up about the alcohol industry.
Wrote the first draft: JC. Contributed to the writing of the paper: VB SJ EV MN.
- 1. The PLoS Medicine Editors (2010) A New Policy on Tobacco Papers. PLoS Med 7(2): e1000237.The PLoS Medicine Editors2010A New Policy on Tobacco Papers.PLoS Med72e1000237
- 2. Brennan RA, Rothman DF, Blank L, Blumenthal D, Chomonas SC, Cohen JJ, et al. (2006) Health industry practices that create conflicts of interest: A policy proposal for academic medical centers. JAMA 295: 429–433.RA BrennanDF RothmanL. BlankD. BlumenthalSC ChomonasJJ Cohen2006Health industry practices that create conflicts of interest: A policy proposal for academic medical centers.JAMA295429433
- 3. Jernigan DH (2009) The global alcohol industry: an overview. Addiction 104: suppl 16–12.DH Jernigan2009The global alcohol industry: an overview.Addiction104suppl 1612
- 4. European Centre for Monitoring Alcohol Marketing (EUCAM) (4 March 2011) The Seven Key Messages of the Alcohol Industry. European Centre for Monitoring Alcohol Marketing (EUCAM)4 March 2011The Seven Key Messages of the Alcohol Industry.Available: http://www.eucam.info/eucam/home/marketing-products-and-reports.html. Accessed 22 April 2011. Available: http://www.eucam.info/eucam/home/marketing-products-and-reports.html. Accessed 22 April 2011.
- 5. Rehm J, Mathers C, Povova S, Thavorncharoensap M, Teerawattananon Y, et al. (2009) Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet 373: 2223–2233.J. RehmC. MathersS. PovovaM. ThavorncharoensapY. Teerawattananon2009Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders.Lancet37322232233
- 6. McCambridge J, McAlaney J, Rowe R (2011) Adult Consequences of Late Adolescent Alcohol Consumption: A Systematic Review of Cohort Studies. PLoS Med 8(2): e1000413.J. McCambridgeJ. McAlaneyR. Rowe2011Adult Consequences of Late Adolescent Alcohol Consumption: A Systematic Review of Cohort Studies.PLoS Med82e1000413
- 7. Schütze M, Boeing H, Pischon T, Rehm J, Kehoe T, et al. (2011) Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study. BMJ 342: d1584.M. SchützeH. BoeingT. PischonJ. RehmT. Kehoe2011Alcohol attributable burden of incidence of cancer in eight European countries based on results from prospective cohort study.BMJ342d1584
- 8. Sheron N, Hawkey C, Gilmore I (2011) Projections of alcohol deaths—a wake-up call. Lancet 377: 1297–1299.N. SheronC. HawkeyI. Gilmore2011Projections of alcohol deaths—a wake-up call.Lancet37712971299
- 9. Boseley SNew drink code shunned by six key health bodies. S. BoseleyNew drink code shunned by six key health bodies.The Guardian, Monday 14 March 2011. http://www.guardian.co.uk/society/2011/mar/14/drink-code-shunned-health-bodies. The Guardian, Monday 14 March 2011. http://www.guardian.co.uk/society/2011/mar/14/drink-code-shunned-health-bodies.
- 10. Adetunji J (7 April 2011) Too close? The drinks industry's unsteady deal with government. J. Adetunji7 April 2011Too close? The drinks industry's unsteady deal with government.The Guardian. Available: http://www.guardian.co.uk/public-leaders-network/2011/apr/07/close-drinks-industry-unsteady-government. Accessed 22 April 2011. The Guardian. Available: http://www.guardian.co.uk/public-leaders-network/2011/apr/07/close-drinks-industry-unsteady-government. Accessed 22 April 2011.
- 11. Bakke O, Endal D (2010) Alcohol policies out of context: drinks industry supplanting government role in alcohol policies in sub-Saharan Africa. Addiction 105: 22–28.O. BakkeD. Endal2010Alcohol policies out of context: drinks industry supplanting government role in alcohol policies in sub-Saharan Africa.Addiction1052228
- 12. Babor TF (2008) Alcohol research and the alcoholic beverage industry: issues, concerns and conflicts of interest. Addiction 104: suppl 134–47.TF Babor2008Alcohol research and the alcoholic beverage industry: issues, concerns and conflicts of interest.Addiction104suppl 13447
- 13. Marin Institute (2008) Big Alcohol. Marin Institute2008Big Alcohol.Tactic: Advertising & Promotion. Available: http://www.marininstitute.org/site/big-alcohol/industry-tactics/24-tactic-advertising-and-promotions.html. Accessed 22 April 2011. Tactic: Advertising & Promotion. Available: http://www.marininstitute.org/site/big-alcohol/industry-tactics/24-tactic-advertising-and-promotions.html. Accessed 22 April 2011.
- 14. Hastings G, Brooks O, Stead M, Angus K, Anker T, et al. (2010) Failure of self regulation of UK alcohol advertising. BMJ 340: b5650.G. HastingsO. BrooksM. SteadK. AngusT. Anker2010Failure of self regulation of UK alcohol advertising.BMJ340b5650
- 15. The Lancet (2007) A framework convention on alcohol control. Lancet 370: 1102.The Lancet2007A framework convention on alcohol control.Lancet3701102
- 16. Zeigler DW (2008) The alcohol industry and trade agreements: a preliminary assessment. Addiction 104: Suppl 113–26.DW Zeigler2008The alcohol industry and trade agreements: a preliminary assessment.Addiction104Suppl 11326