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The alcohol industry and other ‘friends’

Article in Addiction · February 1993

DOI: 10.1111/j.1360-0443.1993.tb02756.x · Source: PubMed

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Richard Hammersley
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health at the fringe of the policy debate. Public
health workers are supposed to pick up the
pieces and urge "healthy lifestyles" in the face of
social environments and conditions that foster
disease, injury and death. We know that public
health problems are not isolated from one an-
other; neither are their solutions.
Before closing, I would like to comment on
two critical issues not addressed in Dr Wallack's
editorial. We in the public health field make the
common mistake of lumping all parts of the
alcohol industry into a single entity. To be suc-
cessful, we must understand the makeup of the
industry—its various divisions and internal ten-
sions. Experience has shown that the interests of
producers, wholesalers, and retailers are quite
distinct, as are the interests between the wine,
beer and distilled spirits sectors. Although un-
stated, Dr Wallack's editorial focuses primarily
on the tactics of the producers. The production
of alcohol beverages is controlled by a small
number of huge corporations—in the United
States, 10 companies control over half the entire
market. Other countries experience the same
concentration of profits and power in the alcohol
producing industry. Anheuser Busch alone had
almost 81 billion in profits in 1991, and 1992
profits promise to break the SI billion barrier.
Their financial power allows for massive market-
ing and lobbying campaigns, and allows them to
ignore the protestations of particular community
groups.
Retailers, on the other hand, rely on clientele
in particular communities. They share schools,
parks, clubs, social gatherings and neighbors.
The practice of a given retail establishment, even
one owned by a corporate giant, will change if
sufficient community pressure is brought to bear.
Retailers sell more than alcohol—they market
hospitality, which includes nonalcoholic bever-
ages, food, and an environment for socializing.
For these reasons, their interests are fundamen-
tally different than producers. Tactically, we
must learn to work within these and other divi-
sions in the alcohol industry, becoming effective
negotiators and tacticians.
Finally, we must recognize that the issues
Dr Wallack raises are not bound by local,
regional or even national boundaries. The alco-
hol producing industry now operates on an
international basis. As consumption levels fiatten
and decline in the industrialized world, the
developing world has become fair game for
Commentaries 19
aggressive marketing tactics. In the next decade,
we will become increasingly aware of the effec-
tiveness of the industry's marketing tactics, as
the alcohol-related death and misery indices of
developing countries increase. Public health
advocates must also work internationally. Part of
our national agendas must be to combat the
alcohol producing industry's efforts to suppress
meaningful study and action by WHO and other
international agencies addressing this coming
JAMES F . MOSHER
Executive Director,
Marin Institute for the Prevention of
Alcohol and Other Drug Problems,
San Rafael, California, USA.
The alcohol industry and other 'friends'
Richard Hammersley
While agreeing with the bulk of Lawrence Wal-
lack's editorial, it is only fair to point out that the
alcohol industry does not seem substantially less
friendly to health promotion than many other
interest groups involved in addiction. The phar-
maceutical industry can also be profit-oriented,
cynically exploitative of well-meaning scientists
and of loopholes in control mechanisms. But,
that industry is skilled at using medical profes-
sionals for PR purposes and is less often attacked
directly. So far, the industry has been reluctant
to admit any responsibility for the abuse of
prescription medicines like temazepam or
buprenorphine. A similar case against the to-
bacco industry has long been accepted. Other
industries with impact on population health, in-
cluding water, nuclear power and agriculture are
probably even less willing to admit their roles in
health problems. The illicit drug industry (and
the industry to counter that industry) does not
have to admit anything. The fact that the alcohol
industry has been coerced into a dim and
fiickering enlightenment about health seems
quite progressive in comparison to the alterna-
tives. It would be perverse to prefer Al Capone
or Gin Lane to the Portman Group on the
grounds of hypocrisy.
Are governments our friends? Health does not
20 Commentaries
sort out the economy, whereas industry might.
In the UK the alcohol industry is intertwined
with government and contributes substantial
funds to the Conservative Party. The industry
unions contribute to Labour. Even without this
relationship, bad health is bad news which gov-
ernments generally try to minimise. It is also
expensive. Finally, the assault on drugs often
looks like a smokescreen to conceal inaction over
relative poverty and other major social problems.
TTiis assault is often mounted under the banner
of health concerns.
Is religion our friend? While some religious
groups do excellent work with substance abuse
problems, others paint those problems in dog-
matic terms using a morality which would not be
accepted by many substance abusers. They also
attempt to dictate the agenda to health profes-
sionals on issues such as the distribution of
syringes to drug injectors or the need for
abstinence.
Are the health services our friends? The health
services too are expansionist industries with
power and profit motives. Often, it is in their
interests to play up health risks and insist that
they receive first priority. Passive smoking is an
interesting example: Apparently living with a
smoker increases ones risk of lung cancer from
about 10/100 000 to about 13/100 000. Faffling
on about this while millions elsewhere starve and
die of AIDS seems disgusting. The health risks
of illicit drug use also get exaggerated with the
unfortunate effect that drug experimenters often
regard anti-drug messages as biased, ignorant
and lacking credibility or relevance. Many
careers have been made from treating and
measuring substance abuse problems.
I do not think that many are purely inter-
ested in the health of others and even those
saintly figures tend to be overwhelmed by the
emotiveness of substance abuse issues. That,
I am afraid, is the world we live in. The question
is not friendship but can the alcohol industry be
persuaded or coerced into doing something
useful? At this time, maybe they can. Let's
negotiate carefully before they change their
minds.
RICHARD HAMMERSLEY
Behavioural Sciences Group,
University of Glasgow,
Scotland, UK.
Warning: the alcohot industry may not be
your enemy
Eric Single
Larry Wallack presents an impassioned editorial
criticizing the alcohol industry for its attempts to
enhance its image as a respectable industry
("WARNING: The alcohol industry is not your
Mend?"). He draws entirely on the experience of
the United States where there is clearly much
more acrimony between public health profes-
sionals and the alcohol industry than in Europe
or Canada. Nonetheless, it would be difficult to
quarrel with his basic thesis: the industry seeks to
portray alcohol problems in a manner which
exonerates alcohol itself as a significant factor,
and it seeks to portray itself as part of the solu-
tion rather than the problem.
But it is overreaching to imply that the indus-
try is the whole problem, or that it has no role to
play in the solution to alcohol problems. Let us
look a bit more closely at the issues.
The role of the industry in the development of alcohol
problems
Although alcohol availability is linked to prob-
lems,'"' the industry can hardly be faulted for
seeking to make their product more available.
Alcoholic beverages are legal products which can
be sold to adults under certain conditions.
Unlike tobacco, which has no safe level of con-
sumption, most drinkers experience few or no
problems with their use of alcohool and there
may even be some health benefits from moderate
consumption.^'
The alcohol industry advertises and promotes
its products to maximize profits. In Canada, a
continual controversy surrounds the use of
so-called "lifestyle" advertising which associates
alcoholic beverages with good times and sexual
success. As my colleague Robert Solomon has
put it: "They have more fun during a 60 second
beer commercial than I've had in my entire life".
But the key issue is not whether alcohol advertis-
ing is accurate or in good taste, but whether it
causes alcohol problems. The empirical evidence
is lacking.'"' We cannot demonstrate that indus-
try advertising has a major impact on alcohol
problems.
And in any case, there are clearly other causes
of alcohol problems as well. Even where produc-
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