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Presentations from ESRC Seminar Three: Changing Alcohol, Drug and Smoking Behaviours
27th March 2015
The Royal Society, London
why disobedience is our best (only?) hope
ESRC Behaviour Change Seminar Three: Changing alcohol, drug and smoking behaviours
Gerard Hastings27th March 2015
ISM Institute for Social Marketing
Commercial Determinants of Ill-health
‘Marmot’s focus on the social determinants of ill health needs to be matched with an equal concern for the
commercial determinants of ill health’ (2)
A problem
Industrial Epidemics‘The concept of an epidemic associated with the
commercialization of a dangerous product ….diseases of consumers, workers and community residents caused by
industrial promotion of consumable products …. public health oriented policies run the risk of being opposed by
industrial corporations in a health versus profit trade-off.’ (1)
Tobacco, alcohol, food – the bedrock of public health
But much bigger than this:
• Inequalities
• Materialism
• Passivity
• Sustainability
Wicked problems – we do not have solutions
A problem
a) Containment of the pathogen (eg by regulation)
b) Counteracting its spread (eg by counter advertising)
c) Critical capacity building to boost population resilience (eg with media literacy)
Public health would suggest three logical responses:
A solution
ContainmentMarketing regulation in tobacco control shows that:• the key requirement is to reduce exposure. content
regulation, with one exception*, produces ineffective and resource wasting codes of conduct
• measures have to be comprehensive, taking in all forms of marketing communication as well as other elements of the marketing mix (inc product design, packaging, distribution and pricing)
• popular demand is a great driver of regulation• commercial operators have to obey these rules, but
otherwise must be excluded from the regulatory process
*the Loi Evin in France
A solution
Counteractionpro health counter-marketing has been shown to be effective. the Truth campaign in the US for example, significantly reduced teen smoking (3). in the UK CRUK’s ‘smoke this’ demonstrates how digital channels can perform a similar task (4)
counteraction can also involve a more direct attack on commercial marketing. in the 1980s a very successful campaign (BUGA UP) (5) was waged in Australia against tobacco advertising using irreverent graffiti. this tradition has also be used against energy dense food advertising…
A solution
Counteractionpro health counter-marketing has been shown to be effective. the Truth campaign in the US for example, significantly reduced teen smoking (3). in the UK CRUK’s ‘smoke this’ demonstrates how digital channels can perform a similar task (4)
counteraction can also involve a more direct attack on commercial marketing. in the 1980s a very successful campaign (BUGA UP) was waged in Australia against tobacco advertising using irreverent graffiti (5).
as with regulation, counteraction should address not just advertising, but the whole marketing mix
A solution
Critical capacityCitizens need to be engaged in the process of change that will bring about healthier societies. This means they need to know more about the methods of big business
This includes media literacy campaigns to explain the process of advertising and how to guard against them
But, as for containment and counteraction, should go further and explain the whole marketing mix (‘marketing literacy’):
• Why does Coke prioritise ubiquitous distribution? • How do pricing deals work? • Why are processed foods inevitably unhealthy?
A solution
Basic foods (eg milk)
Processing (eg into fruit
yoghurt)
Added value
Increased marketing spend
higher sales & margins
higher profits
Generic sales, low margins, little marketing (Often used as ‘loss leaders’ to support sales of
higher margin processed foods)
Why food marketing is unhealthy
Processing usually involves adding salt, sugar & fat and
maximising palatability
Critical capacityCitizens need to be engaged in the process of change that will bring about healthier societies. This means they need to know more about the methods of big business
This includes media literacy campaigns to explain the process of advertising and how to guard against them
But, as with containment and counteraction, it needs to go much further and explain the whole marketing mix
More widely still, people need to be taught abut the fiduciary imperative which requires corporations to put stockholder returns ahead of all other concerns (including public health) (6)
A solution
NB• these are not alternatives, but mutually reinforcing pillars of
a strategic response guided by clear targets and continuous monitoring
• each is a product of ongoing partnership working between citizens, public health professionals and civil society. The Coca Cola brand has been a century in the making; the public health response has to be equally long term
• each can take many forms and needs to be deployed strategically
• this thinking can be summarised in a diagram
A solution
Building the critical capacity of the population so they can respond effectively to marketing.
Includes media literacy, critical business training, self production, community co-ops etc
Regulation to constrain unhealthy marketing: the key
concern is to reduce exposure
counteraction
Pro-health counter marketing, including
media efforts like Truth Campaign and CRUK’s ‘Smoke This’ and direct action like
BUGA UP
cont
ainm
ent
critical capacity
unhealthymarketing
references1) Jahiel RI, Babor TF. Industrial epidemics, public health
advocacy and the alcohol industry: lessons from other fields. Addiction 2007;102:1335-9.
2) Hastings, G. 2012. Why corporate power is a public health priority, British Medical Journal, 345: e5124. doi:10.1136/bmj.e5124
3) Farrelly MC, Healton CG, Davis KC, Messeri P, Hersey JC, Haviland ML (2002). Getting to the truth: evaluating national tobacco countermarketing campaigns. American Journal of Public Health, 92(6): 901-907.
4) https://www.youtube.com/watch?v=a19KSaUueok
5) http://www.bugaup.org
6) Bakan, J. (2004) The Corporation: The Pathological Pursuit of Profit and Power. Toronto: The Penguin Group (Canada).
Alcohol marketing to young people via social media: Whose behaviour needs to change?
Professor Christine GriffinPsychology, University of Bath, UK
ESRC Seminar series onBehaviour Change
Royal Society27 March 2015
Young people and the culture of intoxication
Drinking to get (very) drunk Linked to alcohol availability,
price, targeted products, venues aimed at youth
More liberal alcohol policies, licensing regulation
Relationship between exposure to alcohol marketing & consumption
Public discourses: the policy context 2004: UK government
publishes ‘Alcohol Harm Reduction Strategy for England’
First cross-government statement on the harms caused by alcohol
2007: Follow up document ‘Safe. Sensible. Social’.
18-25 year old ‘binge drinkers’ a focus for concern in both documents.
The impact of alcohol marketing on young people’s alcohol consumption
Exposure to offline alcohol marketing and alcohol consumption
Exposure to online alcohol marketing and attitudes to drinking
Exposure to online alcohol marketing and alcohol consumption
…but what processes are involved?
Social networking and young people’s drinking
Rapid growth in use of social media & mobile technologies (smartphones) amongst young people
Facebook most popular - 1 billion users in October 2012 Drinking and getting drunk most common themes in
young people’s Facebook pages Sharing photos of self and others drinking (and drunk)
very common amongst young people
Marketing alcohol via social media
Digital marketing budgets increasing rapidly
Diageo: Social media marketing accounted for 21% of its marketing budget in 2010
In 2011 Diageo brands had collectively enjoyed a 20% increase in sales as a “direct result of Facebook activity”
Goal is “user engagement” (Socialbakers, 2013)
Young people’s drinking and online alcohol marketing:Key questions
1) What forms does alcohol marketing via social media take?
2) How does this engage with young people’s drinking practices & their social media use?
3) What do young people think about online alcohol marketing?
1) Forms of alcohol marketing via social media
a) Adverts on FB / twitter/ across social media >>>>
b) ‘Likes’, ‘comments’ and ‘shares’ on FB pages of drink brands, bars, clubs
c) Promotions, Events – ‘real world tie-ins’
d) Smartphone apps And much much more ….
Young people’s drinking and social media project
Aotearoa (New Zealand) Research Team Antonia Lyons, Ian Goodwin & Patricia Niland (Massey University, Wellington) Tim McCreanor, Helen Moewaka Barnes, Acushla Dee O’Carroll & Tuiloma
Lina Samu (Whariki Research Unit, Massey University, Auckland) Christine Griffin (University of Bath, UK) Fiona Hutton (Victoria University, Wellington, Aotearoa/NZ) Kerryellen Vroman (University of New Hampshire, USA) Supported by the Marsden Fund, administered by the Royal Society of New
Zealand (contract MAU0911).
New Zealand study: Research design
Stage 1: 37 friendship group discussions with 154 participants
Stage 2: 23 individual interviews with laptop/online access
Stage 3: Analysis of online representations of young people drinking, including advertising via social media
Dylan: I think the reason why we have the drinking photos is because it makes your life like more fun, so you're always doing something
Lo: It's memories as well and all your friends are out together on the piss and you do have fun. So you take photos and some of them
will be funny photos, and you'll just look at them and crack up and go oh my gosh, do you remember when you were that
wasted? [laughing]Extract 1 European/Pakeha Group 1; 4 females
Krystal: oh yeah, if you don’t really remember what happened the night before, like you will see a photo and it will trigger your memory and then you will remember what happened
Extract 2 Maori Group 24; 2 males 2 females
Trish: Do you see any alcohol advertising online?Alex: Yeah - no.Jack: There might be some somewhereMark: I don’t think - oh are they allowed to?Alex: I never see it online bro. Not on Facebook or anything. I always just see it on a
billboardTrish: Have you seen any Facebook profiles, like Tui or Cruiser or?Mark: Oh yeah [all nod].Alex: Yeah I have seen that. You can like them. And then oh it'll just be on Facebook
so often you'll come across a friend in the notification or the update his profile update it'll just say [name] likes XXX vodka and you click on it and it'll be like a description of what it's about. Stuff like that. What flavours. Where you can get it from.
Trish: Do you think that could be advertising? Jack: Yeah it's gotta be. Mark: Oh not necessarily. Alex: Not necessarily. Someone has to make it. They don't have to make it. We could
make one about vodka. Alex: Isn't advertising selling the product? Trying to get the public to see it's not
selling the product. It's not really selling the product. It's just saying what it is. It's not really saying this much here. It's this much there. Specials are here
Extract 3 European /Pakeha group Group 7; 3 males
Key research findings Young people exposed to a great deal of
alcohol-related marketing online Not just exposure –interactive
engagement Online alcohol marketing infiltrates
young people’s social lives and drinking practices
Young people do not necessarily view online alcohol marketing as advertising
Current regulatory & health promotion strategies outmoded
Behavioural change approaches too individualised
Regulation of alcohol marketing should include social media & digital / mobile technologies
Monitoring & ‘transparency reports’ on industry activities
Implications for public health
The sobriety test puts users through a series of “coordination and cognition” tests such as “drag your mouse in a straight line,” “type the alphabet backwards,” or “follow the finger.” A low score results in a friendly admonition to avoid sending that tweet or whatever the case may be and a recommendation for a taxi company based on your phone’s geo-location.The app allows users to customize which sites they wish to block and at what time of the day they are most likely to commit regrettable acts.
New Zealand study at: http://drinkingcultures.info/Follow on twitter: @drinkculturesUK Centre for Tobacco & Alcohol Studies at: www.ukctas.ac.uk Follow on twitter: @chris_griffin55 or @jemlennoxEmail: [email protected] or [email protected]
ReferencesGoodwin, I., Lyons, A., Griffin, C. & McCreanor, T. (2014). Ending up online:
Interrogating mediated youth drinking cultures. In: A. Bennett and B. Robards (eds.) Mediated Youth Cultures: The Internet, Belonging and New Cultural Configurations. London: Palgrave.
Griffin, C., Szmigin, I., Bengry-Howell, A., Hackley, C. & Mistral, W. (2013). Inhabiting the contradictions: Hypersexual femininity and the culture of intoxication among young women in the UK. Feminism and Psychology. 23(2): 184-206.
Griffin, C., Szmigin, I.T., Hackley, C., Mistral, W. & Bengry Howell, A. (2009). “Every time I do it I absolutely annihilate myself”: Loss of (self)-consciousness and loss of memory in young people’s drinking narratives. Sociology, 43 (3), 457-476.
Lyons, A., McCreanor, T., Goodwin, I. & Griffin, C. (in press). Social networking and young adults’ drinking practices: Innovative qualitative methods for health behavior research. Health Psychology. DOI: 10/1037/hea0000168.
McCreanor, T., Lyons, A., Goodwin, I., Moewaka Barnes, H., Griffin, C. & Hutton, F. (2013). Youth drinking cultures, social networking and alcohol marketing: Implications for public health. Critical Public Health. 23(1): 110-120.
• Hastings & Sheron…public health, AHA and a broader approach
• Nicholls & Griffin…stronger evidence
• Farrell…a different approach
“A new scientific discipline that investigates industrial diseases and the transnational corporations that drive them, should be developed”
Moodie et al. Lancet NCD Action Group, 2013
Farrell position statement
• “Greater stakeholder engagement is needed to boost trust and better self-regulation”
• “Formal codes of practice, rules and regulation are not effective in changing bad corporate behaviour”
• Managerial control in US-UK model
• Pursuit of shareholder value key goal
• New corporate elite post 1997 in UK
• Political science under-developed
CSR
• Who should define corporate social responsibility?
• CSR used by companies to further economic interests
• Do corporations have responsibilities to society for license to operate with limited liability?
Addiction industries
• Largest and most successful companies in addiction industries deliberately engineer addiction
• Fundamental to business models
• Vested interests in opposing policies that better manage addictive behaviours
“Special Brew was originally brewed by the Danes for Winston Churchill. His visit to Copenhagen in 1950 was commemorated with a 'special' brew produced in his honour…Churchill's favourite drink was cognac, so in brewing him a commemorative beer, the brewers at Carlsberg created a stronger lager with cognac flavours among its tasting notes”
Portman Group response
“This is another poorly evidenced piece of work produced by researchers with a track record of campaigning against public-private partnerships…We have to start questioning the motives of those….”
“The Portman Group is funded by the eight major UK drinks companies. Their motive is to protect the industry's long-term commercial interests”
Founding Director, Dr. John Rae, Addiction 1993
“I don’t think it’s appropriate that the drinks industry should be actively involved in campaigns around public health for the obvious reason”
Minister for Health Leo Varadkar commenting on Diageo CE resignation from campaign in Ireland this week
“The Public Health (Alcohol) Bill aims to reduce alcohol consumption in Ireland to 9.1 litres per person per annum (the OECD average) by 2020, and to reduce the harms associated with alcohol.”
• How do we manage addiction industry activities in the public interest?
• Some suggestions from an addiction industry studies perspective (looking at evidence across industries)
Some modest proposals
1. Start with the principle that regulation of all aspects of production and supply is necessary (as for gambling, alcohol & drugs)
2. Develop new provisions in company law for addiction industries (as for other industries)
Some modest proposals
3. Require all R & D data on product design and marketing to be available to regulators (as for dangerous commodities)
4. Require the licensing of all existing and new drugs and other addictive commodities (ditto)
Some modest proposals
5. Contribute windfall taxes (10% of profits?) to meet the social costs (as proposed for tobacco)
6. Preserve public health policies from interference by vested interests (a la FCTC)
Alcohol: Know (y)our limits?James Nicholls
Alcohol Research UKCentre for History in Public Health, LSHTM
What is this image actually saying..?!
“Alcohol: know your limits”
“You wouldn’t start a night like this, so why would you end it that way?”
‘Recognition of DH advertising was 66% … higher among 25-34 age group, at 85%, C1s C2s and harmful drinkers.
74% rating website as excellent or very good’
Department of Health (2010) Supplementary memorandum to Health Select Committee – Alcohol (AL 01B)http://www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/151/151we03.htm
‘Those adverts make me laugh … the one where they guy does some, he’s in a right state, and they say “You wouldn’t start a night off like this, so don’t end one like this”. And that makes you just think loads of people would just say “Oh, I would – yeah!”’ ‘I know one of my friends, she comes up to me and she goes, “I can see myself ending up like the girl in the adverts tonight!”’ Nicholls, J. (2009) ‘Young people, alcohol and the news – preliminary findings’. AERC Final Reporthttp://alcoholresearchuk.org/alcohol-insights/young-people-alcohol-and-the-news-preliminary-findings/
‘As well as becoming less likely to drink alcohol at all and less likely to drink frequently, young adults also became less likely to binge when they did drink’Office for National Statistics (2014) Adult Drinking Habits in Great Britain, 2013, 9.http://www.ons.gov.uk/ons/rel/ghs/opinions-and-lifestyle-survey/adult-drinking-habits-in-great-britain--2013/stb-drinking-2013.html
Trends in adolescent weekly alcohol use by region and demographic group
De Looze, M et al. (2015) Decreases in weekly adolescent alcohol use in Europe and North America: evidence from 28 countries from 2002 to 2010. European Journal of Public Health 25 Supp 2, 69-72. http://eurpub.oxfordjournals.org/content/25/suppl_2/69
‘Declines in youth drinking are unrelated to alcohol policies that are associated with reduced drinking such as changes in pricing, availability or advertising … they also appear unrelated to economic, cultural or geographical factors.’
Pennay, A., Livingston, M. and Maclean, S. (2015) Young people are drinking less: it’s time we found out why. Drug and Alcohol Review 34, 115-8. http://onlinelibrary.wiley.com/doi/10.1111/dar.12255/abstract
House of Commons Health Committee (2010) Alcohol HC151-I, 14 [data from Wilson, G (1940) Alcohol and
the Nation]
http://www.publications.parliament.uk/pa/cm200910/cmselect/cmhealth/151/15102.htm
House of Commons Health Committee (2012). DH Written Evidence (GAS 01)
http://www.publications.parliament.uk/pa/cm201213/cmselect/cmhealth/132/132we02.htm
Robin Room on changing drinking cultures
Change is typically about number of drinking occasions, not the style of drinking
Change occurs differently in different population subgroups (not collectively across whole populations)
Change often led by birth cohorts (‘wet’ and ‘dry’ generations)
How might policy enhance or attenuate trends?
Challenge: to develop and test more nuanced theories of sociocultural change in drinking
Room, R. (2014) Wet and dry generations: what happens with social change in drinking?. Presentation to Alcohol Research UK conference, 2014. http://alcoholresearchuk.org/further-resources/conference-2014/