The alcohol industry: taking on the public health critics

Abstract

The thriving alcohol industry wants its products associated with health and happiness—and is pulling out all the stops to defeat its critics, Michael Farrell finds

The worldwide alcohol industry is flying high. With economic growth, changes in lifestyles, and the erosion of traditional customs and mores in many developing countries, the commercial production and consumption of alcohol has been booming. New competition within the industry has seen unparalleled growth, especially in the Asia Pacific region. And the party has only just begun. Some marketing organisations predict major growth in the cognac, whisky, and other spirits niches as Chinese markets continue to expand. The one cloud on the horizon is the public health sector. The alcohol industry wants to learn and avoid the mistakes that other industries have made; thus it has examined carefully the current state of the tobacco industry, the ever tightening regulation of smoking in public places, and the falling prevalence of smoking in developed countries.

The alcohol industry has been keen to emphasise that alcohol is not a drug, that it confers benefits and pleasures, and that it should be thought of primarily as an aid to recreation and possibly as beneficial to health. The industry's second main message is that a small number of people experience major problems, unfortunately, but the vast majority do not. What the industry fears is any control of the overall level of alcohol consumption. Public health advocates are focusing on strategies aimed at reducing the total consumption of alcohol, and the industry's key aim is to promote overall consumption, albeit responsibly.

As part of a sophisticated public relations process the industry has established the International Centre for Alcohol Policy, which is supported by Allied Domecq, Asahi Breweries, Bacardi-Martini, the Brown-Forman Corporation, Coors Brewing Company, Diageo, Foster's Brewing Group, Heineken, Molson Breweries, and SAB Miller. It is based in Washington, DC, and led by Marcus Grant, a former World Health Organization expert on alcohol. The industry is determined to shape the public health debate and to protect its interests. To this end the centre has sought partners in varied parts of the public health field to endorse its position.

This central stated aim of the book—one of whose editors is Marcus Grant—is to argue that population measures alone are inadequate in combating alcohol related problems. The industry has for decades conducted an intensive lobbying campaign against population based measures to reduce consumption by increasing taxation or restricting access to alcohol. The industry argues that these measures don't suit different cultures and contexts and may not be relevant to those individuals and groups who are at risk of problems from drinking.

The book has an interesting section on the problem of illicit distilling in some developing countries, and it has a good review of the specific harms related to such activity and the problem of estimating overall levels of consumption where it exists. However, this section has virtually no mention of the growth in the commercial production of alcohol in some of these countries and doesn't cover particular alcohol related problems in such countries or the concerns being expressed by community advocates.

Time and again the book challenges any emphasis on population measure to reduce alcohol consumption, and to this end it aims specifically at WHO's global burden of disease project, which cites alcohol as a major contributor to mental and physical disease in developing countries. It predictably seeks to invalidate the broader public health perspective on estimating the overall burden of disease that is related to alcohol.

The book's final section makes a sophisticated case for partnership between industry and the health sector and very usefully reviews some of the moves afoot to ensure that international health organisations can constructively harness the resources of the private sector as part of joint community interventions. However, at no stage does it explore the dangers of the industry using non-governmental organisations to pursue its interests covertly.

This latest exercise has hooked in the International Harm Reduction Association, which has been advocating controversial and liberal policies concerning illegal drug use, emphasising the human rights of drug users and promoting harm reduction strategies to help prevent the transmission of HIV among injecting drug users. It is ill judged for the association to be linked to this lobbying exercise of the alcohol industry, and the best interests of the organisation are poorly served by the association of its executive director, Gerry Stimson, with this book. The harm reduction movement needs clear blue water between itself and the alcohol industry.

Despite its breadth of references and considered exploration of some topics, such as underage drinking and drink driving, this book chiefly serves the purposes of the global alcohol industry and offers little to those wishing to tackle the unrestrained growth in global alcohol consumption that is predicted for the coming decade.

The alcohol industry has been keen to emphasise that alcohol is not a drug and that it confers benefits and pleasures