Alcohol: The Global Challenge

Derek Rutherford writes:

Today hardly any region of the world remains unaffected by the present epidemic of social and health harm caused by alcohol. Globalisation, economic liberalisation, growing disposable income and aggressive marketing have all contributed to the industry’s global outreach.

This has resulted in the development of similarities in patterns of drinking in different cultures. Traditional protective cultures are on the wane. While protective factors have become weaker, pressures on young people to drink have increased. There is now a global drinking culture.

The editorial in the Kenyan Daily Nation( April 2009) commented: “A generation of young Kenyan people between the ages of 15 and 29 is in the grip of alcoholism. Across all provinces, with the exception of North Eastern, the prevalence of the epidemic paints a picture of a generation that is in serious trouble.”

The World Health Organization Regional Office for the Western Pacific (WIPRO) reports that drinking by young people is of growing concern throughout the Western Pacific Region. The general picture emerging in the Region is of growing and heavier use of alcohol by young people. In the Pacific Island countries binge drinking has been identified as a common practice.

In South East Asia the age of initiation of drinking is occurring at younger ages in many countries and binge drinking is on the rise as well. Consumption among girls in some countries (especially Latin America) has begun to approach or even surpass that of young men.

The 2007 World Development Report expressed concern about the range of health risks from non-communicable diseases:

“The developing world’s 1.3 billion young people aged 12- 24 are its next generation of economic and social actors. As a result of epidemiological transition from communicable to non communicable diseases young people are exposed to a different range of health risks than before.” It goes on to remind politicians of the “importance of building human capital in youth” and of the need to create the right climate since “missed opportunities to invest in and prepare this generation will be extremely costly to reverse, both for young people and society.”

Drink Industry representatives, at their meeting with the WHO in November 2008, maintained that they did not target under-age drinkers. Marketing strategies to ‘capture’ the legal youth market are bound to influence the drinking patterns of under-age drinkers.

Over the past decades the drink industry has viewed the youth market as a prime target. In the UK, Kevin Brain, in a paper for the Institute of Alcohol Studies entitled “Youth, Alcohol and the Emergence of the Post-Modern Alcohol Order”, has described how, from the 1980’s in the UK, the industry had to ‘remodel’ its product. The brewing industry was confronted with the possibility of losing a new generation of alcohol consumers to a post-modern consumer leisure order of raves, clubs and illicit recreational drugs. There was a need to target a new generation of youth drinkers, both male and female, who demanded a greater range of alcohol products.

Comments of senior brewing industry figures well illustrated the concern of the Industry. Fraser Thompson, then strategic development director at Whitbread, noted:

“Young people seem less prepared to sip beer for hours, culturally they like short sharp fixes … five years ago there were less alternatives to getting a buzz or getting high. The challenge for the industry is to make alcohol part of that choice’.

Richard Carr, chairman of Allied Leisure, the entertainment arm of Allied-Tetley-Lyons noted:

‘Youngsters can get Ecstasy for £10 or £12 and get a much better buzz than they can from alcohol ... it is a major threat to alcohol led business.’

Faced with losing its traditional market and losing out in the psychoactive youth consumer market, Brain comments:

“The industry’s response was to accelerate the process of recommodifying alcohol products that it had begun in the eighties. The term re-commodification is deliberately chosen to capture the fact that alcohol was being redeveloped as a ‘new’ consumer product. In effect, the brewing industry created a post-modern alcohol market.”

The key transformations were as follows:

A whole new range of alcohol products -ice lagers, spirit mixers, white ciders, alcopops and buzz drinks. They have become known as designer drinks;

The strength of alcohol products were increased in a direct attempt to compete in the psychoactive market and appeal to the new generation of psychoactive consumers;

Alcohol products have been increasingly advertised as lifestyle markers in sophisticated campaigns to appeal to and develop market niches

The journalist Jim Carey (1997) has described the attempt by the brewing industry to recapture the youth drugs market as a recreational drugs war. Brain in his paper writes “The ways in which the brewing industry has embraced youth drugs culture is obvious from the design and naming of a whole new set of alcohol products most notably represented by alcopops.

Early products in the alcopops range bore names such as ‘raver’, ‘blastaway’, DNA, (a play on the initials MDMA which denote the drug ecstasy). The form of alcopops as ‘soft drinks’, the design of labels with sleek graphics and characters all helped to secure the appeal of the drinks to a sophisticated youth consumer market steeped in contemporary club culture. “

In the USA, researchers from the Center on Alcohol Marketing and Youth, Georgetown University and Virtual Media Resources of Natick, Massachusetts analysed the placements of 2,033,931 alcohol product advertisements aired on television between 2001 and 2007 and placed at a cost of 6.6 billion dollars. The key findings of the research are:

In 2007, more than 40% of youth exposure to alcohol advertising on television came from ads placed on youth-oriented programming, that is, programs with disproportionately large audiences of 12-to-20-year-olds.

Almost two-thirds (63%) of these overexposing ad placements in 2007 were on cable television, which generated 95% of youth overexposure to alcohol advertising on television.

Of the youth overexposure on cable in 2007, 53% came from beer advertising, and 41% came from distilled spirits advertising.

In a comparison of individual brands on the basis of their abilities to comply with industry voluntary codes on advertising placement and to avoid youth overexposure in 2007, 10 brands stood out, accounting for 41% of youth overexposure and 52% of advertisements placed above the industry’s voluntary standard of a 30% maximum for youth in its audiences.

Between 2001 and 2007, alcohol companies aired 73,565 “responsibility” advertisements on television. Youth ages 12 to 20 were 22 times more likely to see an alcohol product advertisement than an alcoholindustry- funded “responsibility” advertisement.

Again in the USA a Rand study also found that children’s exposure to alcohol advertising during early adolescence appeared to influence both beer drinking and their intentions to drink a year later. This study of children in the sixth and seventh grades found that those exposed to alcohol advertising at high levels – from television, magazines, in-store displays and promotional items like T-shirts and posters – were 50 percent more likely to drink and 36 percent more likely to intend to drink than children whose exposure to alcohol advertising was very low.

The Global Alcohol Producers Group (GAPG) at the WHO roundtable stated: “Every single company in our group has a strong public track record of working to reduce the harmful use of alcohol…. we strongly oppose marketing or sale of our products to under-age youth”. But apparently not to all youth as can be seen from the 2004/2006 annual reports of UB (India) – a member of GAPG.

“The entire Indian map is changing. There has been a huge explosion of disposable income among the young; moreover, social drinking has increased. And today users are looking for products that are aligned with global trends; the demand for new age flavours is increasing The Indian market is ready for alcohol beverages with exotic fruit flavours.”

“RTD, being a low-alcohol beverage, will be a stepping-stone for SEC-A youngsters and women to enter the alcoholic beverages segment. Especially women, who are used to fruit juices and would readily make the transition to one with a low alcohol content.”

“Youngsters seeking western lifestyles typically begin by drinking beer and move into spirits. The brand positioning of UB Spirit Brands are designed to attract these upwardly mobile and aspirational customers.”

Led by Elizabeth Crossick of Brown Forman, the drinks industry has announced a £100M campaign to promote responsible drinking due to be launched in September 2009 in the UK.

The campaign is to run over five years, targets binge drinkers and includes advice such as eating before drinking and alternating alcoholic drinks with soft drinks. The tagline is ‘Why let a good night go bad?’

Don Schenker of Alcohol Concern said “This new initiative appears to be yet another example of the drinks industry trying desperately to avoid mandatory legislation to pass on health information to consumers”.

Professor Ian Gilmore, president of the Royal College of Physicians and chair of the UK Alcohol Health Alliance, said he was sceptical the campaign would work. “There is very little evidence that health messages work to prevent binge or harmful drinking.” “Instead, all the international evidence shows that increasing the price and reducing the availability of alcohol, together with bans on advertising, are the main methods of reducing alcohol-related harm.” “We need strong government action in these areas right now”

Sports sponsorship has a key role in the industry’s global outreach.

Freeke de Wette, Sport sponsorship manager Heineken International, reported in April 2006 that:

“We are delighted to have extended our sponsorship of the Rugby World Cup. The Heineken brand is enjoyed in almost every country throughout the world. As such, Heineken is the perfect partner for rugby’s premier global tournament. Over 3.5 billion people view the Rugby World Cup across 209 countries.”

Sponsors of the 2002 World Soccer Cup Tournament in Japan and Korea had direct access to 1 in 6 people on the planet.

In preparing for the World Cup, David Goadby, Custom Marketing Director at Scottish and Newcastle, remarked:

“Tournaments such as these are critically important for our customers…. Five times more people watch the World Cup than watch domestic football.”

Sports sponsorship drives a coach and horses through advertising codes that prohibit implications that alcohol consumption improves physical performance and the targeting of minors. It contradicts another statement of GAPG “recognizing that underage persons cannot be removed entirely from exposure to mass media advertising targeted to adult consumers, the GAP Group companies have, in many mass media markets, instituted prohibitions on advertising in media programming where the ads will reach a substantial percentage of viewers or listeners who are below legal drinking age. In most cases, these rules are also applied to live sponsored events.”

Earlier this year, Formula One Motor Racing champion Lewis Hamilton was engaged by Diageo to campaign against the Scottish Government’s proposal to raise the age for purchasing alcohol in supermarkets and off-licences from 18 to 21 years of age.

The Drinks Industry and its social aspect organisations are opposed to legislative action. Their mantra is education. Since 1977 the UK government regarding education about alcohol has relied largely on conveying ‘sensible limits’ of consumption.

The original limits set were for men not to drink more than 21 units and women no more than 14 units of alcohol per week (1 unit is about 8 grams). Any objective assessment of the outcome of the campaign over three decades must be that it failed. One reason for its failure must be that, when the limits were set, 29 million people drank below the limit and only 6 million drank above it.

In the UK the success story has been drink drive legislation.

The educational message of not to drink and drive was first used in the 1930s. It was not until the introduction of the breath test in 1967 that drink drive casualties were reduced.

The Commission on Social Determinants has seen the need for legislation and urges WHO to initiate a discussion with Member States on regulatory action for alcohol control.

As WHO prepares its global strategy to reduce alcohol related harm there is clear need to establish and sustain a global movement. A movement able to mobilize civil society to accept ownership of the alcohol problem and help to create a political will, free from commercial influence, to successfully reduce the global burden of disease caused by alcohol.