Peter J. AdamsSchool of Population Health

SHOULD ADDICTION RESEARCHERS ACCEPT INDUSTRY MONEY FROM

TOBACCO, ALCOHOL OR GAMBLING?

WanderingHobbit

ADDICTIVECONSUMPTIONS

CONSUMPTIONS

DANGEROUSCONSUMPTIONS

LEGALADDICTIVE

CONSUMPTIONS

movies

Tobacco

pharma

fast foods

clothes

houses

alcoholcocaine

opioids

books

plasticsurgery

gambling

cannabis

accepting industry money

ADDICTIVE CONSUMPTIONS

ARE SPECIAL

PROFIT

NOT MUCH

HEAPS

NUMBER OF CONSUMERS

LOW HIGH

ADDICTIVE

NON-ADDICTIVE

When the money’s there….

Hard to resist Money exchange

establishes expectations & obligations

Reinforced by multiple exchanges

Ostrich Response

“I didn’t really see that!”

“We’ve done so much work already”

“Let’s just pretend”

Bargaining Response

“Maybe it’s not that bad”

“Gambling has its positive sides”

“Only a small number have problems”

Missionary Response

“Money is sitting there”

“This funding will save lives”

“If we don’t get it, somebody else less deserving will”

Macho Response

“Be realistic” “To get things

done you need to make some unpopular choices”

“You have to be in to win”

Desire vs Values Messages

favoured my ambitions

Ethical perspective minimised

Need an outside reference point to gauge my views

SIMPLETRANSACTIO

N

FUNCTIONS IN A WIDER

ARENA

Plugging in….

TobaccoAlcoholGamblin

gIndustrie

s

Political Chain of Engagement

Publiccommunicatio

nstrategies

Lobbying& PR

companiesProducer

& retailassociation

s

Relationship

buildingactivities

Politicians

POLICYMAKERS

Purposes:• Industry legitimate business• Key player in vitality of the economy• Long-term relationships with political

actors

LOW VIS

UK All-Party MP “Beer Group”

U-Turn on minimum unit pricing

BMJ study of infiltration of UK parliament

400 MPs from both houses of Parliament

Source: http://www.morningadvertiser.co.uk/General-News/Chancellor-George-Osborne-named-Beer-Drinker-of-the-Year

UK Chancellor, George Osborne awarded “Beer Drinker of the Year” (2013)

NZ Tobacco (Alcohol) Lobbyist

Carrick Graham PR lobbyist Nicky Hager alleged

he was paid by alcohol to engage Cameron Slater in attack on Doug Sellman

Source: http://sciblogs.co.nz/griffins-gadgets/2014/08/18/cash-for-comment-and-new-zealands-mod-squad/

Public Good Chain of Engagement

Corporate social

responsibility

Health & communit

y programsSocial aspects

& public relations

organisations

Media coverage

Public consultatio

n

TobaccoAlcoholGamblin

gIndustrie

s

POLICYMAKERS

Purposes: • Industry is a good corporate citizen• Industry is handling the harms• Individuals, not systems are

responsible

HIGH VIS

SAPROs“Social Aspects & Public Relations

Organisations”

DrinkWise Australia Industry funded Do something visible

about harm from alcohol

Binge drinking, public awareness, alcohol & pregnancy, drink driving, underage drinking

How to Drink Properly

Source: https://www.drinkwise.org.au/

Knowledge Chain of Engagement

Priority setting processes

Researchers & research

organizationsFunding &

commissioning processes

Communication &

dissemination

Government officials

TobaccoAlcoholGamblin

gIndustrie

s

POLICYMAKERS

Purposes: • Industry knows its own business• Industry shapes the research agenda• Credible pro-consumption knowledge

base

MOD VIS

Six steps to glory:

1. The handshake2. The pilot project3. The offer4. Ongoing funding5. Group membership6. Policy

communication

US Tobacco Researcher Ernst Wynder (1923 –

1999) Epidemiologist, in

1950 linked smoking to lung cancer

Research funded by Philip Morris 1961 – 1990

Opposed evidence for passive smoking

US Tobacco ResearcherHandshake: 1955 Philip Morris contacted himPilot: 1961 small fund for 3 yearsOffer: 1969 $50 mill in resourcesOngoing $: 1970s regular amountsMembership: 1973 key in Philip Morris stablePolicy Communicator: 1980s spoke out about passive smoking

Brazilian Alcohol Researcher

Arthur Guerra de Andrade

Industry funded at State University of São Paulo

Heads SAPRO “Center for Information on Health & Alcohol” (CISA)

Source: Biblioteca Virtuals

Brazilian Alcohol Researcher

Source: Biblioteca Virtuals

Handshake: 2002 AmBev invited him into discussionsPilot: Mid 2000s form CISA & few public education projectsOffer: Accepted $ for researchOngoing $: 90% from industryMembership: Late 2000s on international boards ICAP, ICAAPolicy Communicator: Advises state & federal governments

Harvard Gambling Research

Howard Shaffer Director, Division of

Addictions, Cambridge Health Alliance

Teaching affiliate of Harvard Medical School

Source: https://www.youtube.com/watch?v=KhbmdyIlI7w

Harvard Gambling Research

Source: https://www.youtube.com/watch?v=KhbmdyIlI7w

Handshake: 1996 discussions with American Gaming AssociationPilot: Accepted $140K Offer: 2000 director of industry- funded Institute (IRPGRD)Ongoing $: By 2008 $9 millMembership: Prominent researcher internationallyPolicy Communicator: Advises US and other governments

Division on Addictions(Cambridge Health Alliance, teaching affiliate of

Harvard Medical School)

Gamblers & Problem

Gamblers

Gambling Operators

Division of Addiction(US$7)

Institute for Research on

Gambling Disorders

National Centre for

Responsible Gambling

Other Gambling

Researchers

T1

T5 T4

T3

T2

Politicians

Public Consultation

GovernmentOfficials

TobaccoAlcoholGamblin

gCompani

es

INDUSTRY SECTOR

GOVERNMENT

SECTOR

Public Good Chain

Knowledge Chain

Political Chain

Profit Consumers Addictive consumption

industries Industry services (lawyers, PR,

lobbyists, media, events ……) Governments (& their

agencies) Politicians & their parties Health services Community groups, charities,

NGOs, sports, Researchers, universities…..

Supply control: Limit community benefit funding

Demand reduction:Improved information sourcesProduct labelling

Problem limitationAssist in ethical decision-making

Accepting Industry Money as a Dangerous Consumption

Accepting industry money generates conflicts of interest

Consuming profits contributes to increased demand

Once consumed once, more likely to consume again

On-going profit consumption could lead to dependency

5

Relationship

Risks

1

Ethical

Risks

4

Governance

Risks

3

Reputational Risks

2

Contributory Risks

1

Ethical

Risks

Benefiting from Deprived & Addicted

Benefiting from Deprived & Addicted

Exploiting VulnerableGroups

Exploiting VulnerableGroups

Money Derived From Harm

Money Derived From Harm

2

Contributory Risk

Contributing to Sales

Contributing to Sales

Improving Public ProfileImproving

Public Profile

Positive view ofPolicy Makers

Positive view ofPolicy Makers

3

Reputational Risks

Judgement ofColleagues

Judgement ofColleagues

Judgement of Funders

Judgement of Funders

Judgement ofStakeholdersJudgement ofStakeholders

4

Governance

Risks

Creeping Funding Reliance

Creeping Funding Reliance

PerceivedDependencePerceived

Dependence

Increasing Silence& Compliance

Increasing Silence& Compliance

5

Relationship

Risks

Conflict betweenColleagues

Conflict betweenColleagues

Conflict betweenSections

Conflict betweenSections

Silencing &Leaving

Silencing &Leaving

HOW TO WORK OUT WHEN A RELATIONSHIP IS TOO

RISKY?

PROBLEM LIMITATION

Intensity of Relationship

Continuum of Moral Jeopardy

OIL

LOTTERIES

ALCOHOL

TOBACCO

ARMAMENTS

POKIES

PORN

PHARMACEUTICALS

Low RiskModerate Risk

High RiskExtremelyHigh Risk

Primary Concern

Intensity Indicators

Purpose

Extent

Relevant-harm

Identifiers

Link

Purpose E R I L Degree to which

purposes between funder and recipient diverge

How do purposes match?

E.g. general practice accepts funding support from tobacco company

P Extent R I L Degree to which the

recipient is reliant on this source

What percentage of funding?

E.g. Community service unwilling to criticise when alcohol income increases from 5% to 10%

P E Relevant-harm I L Degree of harm

associated with this form of consumption

Some products are less harmful than others

E.g. researcher accepts money from lotteries but not pokies

P E R Identifiers L Degree to which the

recipient is visibly identified with the funder

Branding using names, logos, advertising & other promotional linkages

E.g. new laboratory with sign acknowledging brewery funding

P E R I Link Nature and directness

of the link between recipient & funder

Use of mediating bodies or contracts?

E.g. Earmarked alcohol revenue channelled through government department

Purpose Extent Relevant-harm Identifiers Links

LOWRISK

MODRISK

HIGHRISK

EXTR. H.RISK

Group 1: A public health researcher receiving funds directly from a tobacco company in a publicly visible way.Group 2: A genetics project receiving half its income directly from a brewery

Group 3: Research equipment funded partially from donations from a pokie trust

Group 4: An addiction symposium funded by a small grant from lotteries

WHY ARE THERE NO

SAPROS IN NEW ZEALAND?

PUBLIC GOOD

Hypothecated (earmarked) Taxation

90-95% spenddependent

smokers

90-95% spenddependent

smokers

50-70% spend risky/addictive

drinkers

50-70% spend risky/addictive

drinkers

30-50% spendproblem gamblers

30-50% spendproblem gamblers

CONSOLIDATED FUNDS

SAPRO Attractiveness Criteria:

Emphasis on personal consumption Emphasis on individual explanations

(e.g. biology) Not linked to public health No track record of reducing

consumption Convey impression of being serious

about harms Involve compliant partners (unlikely to

criticize)

Traffic Light of Risk

Class C (Monitor)Pornography, Plastic Surgery, Oil

Class C (Monitor)Pornography, Plastic Surgery, Oil

Class B (Manage)Psychotropics, Lotteries, Fast Food

Class B (Manage)Psychotropics, Lotteries, Fast Food

Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol

Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol

Final Thoughts Learnt much from tobacco Easy to plug-in without

realizing wider consequences

Promoting open dialogue about sources is key

Need ethical benchmarks & codes of practice