Public health campaigners who work on alcohol and tobacco are often told that the two are different – usually in tones implying that this is a novel hypothesis.
Both are major causes of preventable death, ill health, suffering and costs to the community.1 Both cause harm to non-users: tobacco through passive smoking, alcohol through road crashes, violence, crime and antisocial behaviour.1
But the differences are clear. Tobacco is harmful when used as intended. Used in moderation, alcohol plays a well-recognised role in society. The measures recommended by health authorities recognise that for tobacco the objective is to end all use, for alcohol to ensure that it is not used harmfully.1,2
Assertions that tobacco and alcohol differ are, however, often accompanied by a sub-text implying that the industries are so dissimilar that they should be treated differently.
Tobacco is now recognised as a pariah industry. Descriptions such as ‘evil’ and ‘merchants of death’ are commonplace; it is the world's least reputable industry3 and there is broad acceptance of the principle that governmental dealings with tobacco companies should occur only if unavoidable and while holding one's nose.
Millions of tobacco industry documents accessible following the US Master Settlement Agreement (MSA) show that the companies are even more cynical and dishonest than their critics had thought.4
Nobody could now argue credibly that tobacco companies should be part of policy-making processes, can be trusted with voluntary agreements on advertising, or should run public education programs.
The alcohol industry is different – or is it?
There is no alcohol MSA, but there is a substantial literature on the industry. The UK House of Commons commissioned a report based on internal alcohol industry marketing documents;5 and tobacco documents provide access to confidential alcohol industry documents over periods when alcohol companies were owned by tobacco companies.6
Tobacco companies have known about the dangers of smoking for 60 years; alcohol companies have known about the harmful consequences of their products for centuries.
Tobacco companies have denied the evidence, undermined research and researchers critical of their product, and sought disproportionate attention for research hinting at any benefits. Companies in the alcohol industry have similarly sought to deny and undermine evidence of harms attributable to their products, while promoting attention to evidence that might imply health benefits. Tobacco companies have recruited politicians, opinion-leaders, scientists and researchers. So have alcohol companies.
Tobacco companies developed their own product labelling regimens and education programs (now long discredited, with research showing that they were at best worthless).7 Alcohol companies have done the same.
Both tobacco and alcohol companies devote substantial attention to corporate social responsibility (CSR) activities – described from the tobacco industry documents as providing ‘air cover’ to distract governments and the community.8
Tobacco companies have promoted substitute targets for action – arguing, for example, that illicit drugs merit more attention. Alcohol companies and their allies have done the same.9,10
Tobacco companies have spent massive amounts on marketing, with legislated constraints a trigger for innovative new approaches, including sports sponsorship, cartoon characters in advertising and social media. Alcohol companies have followed a similar approach, albeit with ever-more extensive and creative promotions, sponsorships, and other forms of marketing, including cartoon characters and social media popular with children and young people such as Facebook and YouTube.
Tobacco companies developed products and packaging likely to appeal to young people. The alcohol industry has developed attractively packaged alcopops and sweet, sugary products which will “get young people drunk faster”.11
Tobacco companies sought to avert advertising curbs with voluntary self-regulation. The alcohol industry follows the same path, with weak, limited codes that fail to cover the entire industry or promotional activities such as sports and music sponsorship. Both industries assert that children should not use their products but advertise in media appealing to young people.
Tobacco companies have sought to negotiate with governments, to be involved in policy processes, and to play a role in public education. The alcohol industry has done the same, while exposing children and young people to a tsunami of promotion. Both industries have enlisted the support of those who profit from sales or promotion of the product – including advertisers, retailers and sporting groups.
Both industries fund lobbyists, political parties and public policy groups. Both have established organisations designed to show them as responsible, and even to determine health messages. Both accuse their critics of being killjoys.
Both industries in Australia are largely owned or controlled by multinational companies, with overall policy directions set outside the country.
Both industries, locally and globally, have consistently opposed action in virtually all areas recommended by health (and for alcohol law enforcement) authorities to reduce harms arising from use of their products.
So how ‘different’ is the alcohol industry?
This industry has contributed to the development of a youth drinking culture. Eighty per cent (80%) of the alcohol consumed by young drinkers is consumed in ways that put them or others at risk,12 and 43% of 16–17 year old drinkers drink to get drunk.13
Alcohol companies run massive marketing campaigns, normalising the drinking culture, and associating alcohol with sporting or music celebrities. Alcohol advertising is placed where young people are heavily exposed – television, social media, sporting and musical events, and locations such as buses, bus shelters and train stations.
The companies are fiercely competitive, but united in their opposition to measures recommended by expert bodies as necessary if we are to change our youth drinking cultures.
Major players in the industry oppose volumetric tax (which would end the sale of wines at $2 per litre – cheaper than bottled water). They oppose restrictions on access, preferring to increase the numbers of sales outlets – which they then promote.
They oppose alcohol labelling shown by research to have an impact, preferring small, low-impact messages such as ‘enjoy responsibly’, ‘get the facts –Drinkwise.org.au’ or ‘It is safest not to drink while pregnant’.14
Alcohol is advertised in association with giveaways for products attractive to young people, such as lip gloss, nail polish, sports equipment and branded merchandise including clothing.15 Promotions are directed to locations frequented by young people, such as university campuses.16
In recent years, alcohol companies have increased the range of products that apparently target young drinkers. Adults are unlikely to be targets for many alcopops or RTDs such as ‘Hot Pink’ (“A loud and sweet blend of hot pink confectionery soft drink and Mishka vodka”),17‘Electric Pink’ (a vodka cruiser described as “Intense candy flavoured”),18‘Mango Pash’, ‘Blue Crush’, ‘Carnivale’ (“A twist on the much loved toffee-apple classic”)19 and ‘Shot Buckets’ with flavours included Choc Éclair and Banana Split.
Such sugary alcoholic confections are now available in two-litre casks, making it even easier for young people to get drunk.
Marketing documents from UK alcohol producers and their advertising agencies show that young people were a key target for recruiting new drinkers and establishing brand loyalty.5 The report on these documents was entitled ‘They'll drink bucket loads’– the words of a marketing executive discussing alcohol promotion and young people.5
Remarkably, the alcohol and tobacco industries are even joined at the hip.
The Phillip Morris tobacco company owned Miller Brewing for more than 30 years.6 Altria (the Philip Morris parent company) has a substantial shareholding in SAB Miller20 (which now owns Fosters and Carlton United Breweries)21 and owns a major wine company.22 The SAB Miller Board includes at least five past or present tobacco company executives and board members, including the former long-time Philip Morris chairman and CEO, Geoffrey Bible.20 The Pernod-Ricard Board includes two Imperial Tobacco Board members.23 The Bacardi leadership team includes executives who previously worked for Philip Morris International and Dunhill.24 The Beam Global Group Board includes a former Gallaher Tobacco chairman.25 The Brown-Forman Board includes a former senior executive in the then Philip Morris-owned Kraft company.26 The Sapporo Group, which works in association with Coopers Brewing, is active in the Vietnam tobacco market.27,28
The major tobacco companies in the Australian market all include leading alcohol industry figures on their boards (three for Philip Morris/Altria,22,29 three for British American Tobacco,30 four for Imperial Tobacco31). The leading alcohol retailer organisations are also associated with the tobacco industry – BAT is a partner on the Australian Hotels Association website,32 and a sponsor for the Liquor Stores Association of Australia.33
Do tobacco industry leaders instantly lose their ruthlessness and pariah status when they walk into alcohol company boardrooms? It would be surprising if there were not some discussion about common approaches and concerns.
Per capita alcohol consumption and alcohol-related harm in Australia have increased in recent years,34 especially in those aged 16–24.35 Every day in Australia children as young as 12 are so blind drunk that an ambulance is called.36 Children pre-load, drink to get drunk and cause damage to themselves and others.
There are many responsible companies and individuals in the alcohol industry, from vineyards to hotels, but these are generally the small players.
Companies that play an active role in promoting the binge drinking culture and opposing action to reduce harm from alcohol are not socially responsible. Their expressions of concern are no more sincere than those we once heard from tobacco companies – sometimes with the same leaders – about youth smoking. They know that there is an under-age market; they create and promote products that are attractive to young people; they only support action that will achieve little, and oppose measures that might have a serious impact.
Companies and executives that develop and market alcohol products for the youth market are no better than their tobacco counterparts. Like tobacco companies, they and their organisations will never police their own advertising effectively. Their insipid warning labels and education programs should be seen as no more than ‘air cover’. They should not be permitted any role in the development of public policy. Organisations and individuals in the health community should follow WHO's reported practice of “no collaboration with the various sectors of the alcohol industry”.37 Companies engaged in the youth alcohol market should be treated with as much disdain as the tobacco industry.