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Public Health England accused of links with drinks industry

Agreement with Drinkaware slammed by experts

Jo Carlowe

Thursday, 20 September 2018

Public Health England (PHE) has failed to learn the lessons over its partnership with the drinks industry, warn public health experts in The BMJ.

Last week, Ian Gilmore, a senior government adviser on alcohol policy, stepped down from his role at PHE after the agency partnered with Drinkaware, an alcohol education charity that receives funding from industry, for a new campaign encouraging middle-aged people to have more alcohol-free days per week.

In an editorial* for The BMJ, Gilmore and colleagues Linda Bauld and John Britton, of the UK Centre for Tobacco and Alcohol Studies, University of Nottingham, state that voluntary agreements with the tobacco industry in the second half of the 20th century served to “undermine, dilute or constrain measures designed to curtail their activities.”

By entering into a voluntary agreement with Drinkaware, “PHE appear to have fallen victim to the delusion that a new partnership with the alcohol industry will somehow avoid the same fate,” they write.

“In so doing they tread a path that, at least to those who have worked in tobacco policy, is depressingly familiar,” they add.

The press release for the new campaign encourages people to have "more alcohol-free days a week” (PHE quote) or “a few alcohol-free days” (Drinkaware quote), following the historical strategy of defining the problem in terms of the minority of people who drink every day, explain the authors. It does not make direct reference to harmful level of drinking on other days of the week, or endorse the chief medical officer's recommendation on the advised upper limit of 14 units a week for both sexes.

And they note that the campaign is badged as part of the broader One You campaign, which includes advice on smoking, physical activity and other "lifestyle" determinants of health, “thus linking an alcohol industry-funded body with wider health messaging.”

Finally, they state that senior PHE managers "do not appear to have asked themselves" why the alcohol industry is happy to fund a campaign that ostensibly aims to reduce alcohol consumption. Had they done so, they say the answer would be because it thinks the campaign will be ineffective, or will divert attention from other more effective policies to reduce alcohol consumption that the industry fears more, such as minimum unit pricing.

Through Drinkaware, “the alcohol industry gains valuable engagement with PHE, establishes working relations with PHE staff, and may even secure a seat at the table when other alcohol harm initiatives are planned and executed,” they say.

It is right that the alcohol and other harmful commodity industries pay to prevent and treat harm caused by their products, they say, but payment “must be made through statutory levies, not voluntary agreements.”

This new campaign backed by high profile individuals telling drinkers to drink less “is all well and good,” says Tony Rao, visiting researcher at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London, in a linked article**, “But skirting around and dumbing down the specifics of existing guidelines does not bode well for providing a consistent health message to the public.”

He warns that, if we cannot maintain our government to observe the principle of being at "arm’s length" from the drinks industry, “we wander into a storm that has the potential to capsize public health and all that it represents.”

However, Professor John Newton, director of health improvement at PHE, told OnMedica: “Our duty is to protect and improve public health. Reducing harm from alcohol requires action not inaction.This new campaign’s advice on drink free days is easily understandable, pragmatic and sensible.

The BMJ is wrong and inaccurate to say that PHE is working with the alcohol industry. Drinkaware is an independent charity. PHE is steadfast in its ambition to reduce the harms that drinking too much alcohol can cause and we will work together with partners that speak to the evidence and share the same commitment.”

*Gilmore I, Bauld L, Britton J. Public Health England’s capture by the alcohol industry. BMJ 2018;362:k3928
**Tony Rao: Calling time on dumbing down our drinking culture. BMJ Opinion, 20 September 2018

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