From tobacco control to alcohol policy

The commentators are broadly in agreement with each other and with us, adding powerful and timely arguments to the high stakes challenge of arresting alcohol industry influence in the United Kingdom. They underline that this is also a global challenge, and that there are clear similarities between the case of alcohol and other unhealthy industries. It is important and welcome that those who have led the debate on tobacco control see the need to study and restrain corporate power more widely; they bring a wealth of experience, and have no illusions about the corporation's determination to protect its own interests 1, 2. Collin & Hill 3 make a strong case for non-engagement, arguing that national-level decisions about collaborations with industry must take into account the global ramifications of these decisions. Similarly, Moodie 4 supports the need for clear leadership by the World Health Organization (WHO). The alcohol industry retains a respectability that big tobacco has lost, and appears to still have a high level of influence in the United Kingdom 5. This, perhaps, explains why prominent figures in the alcohol field work with Drinkaware. This cooperation continues even after the minimum unit pricing (MUP) debacle 6, and the withdrawals of support for the collaborative Responsibility Deal approach to public health policy 7, 8. As Daube 9 emphasizes, a vicious circle is at play: engagement by the public health community underpins Drinkaware's spurious claims of independence, leading to increased credibility for industry engagement in the policy process, and policy becoming more industry-friendly. Specifically, the UK government has decided not to proceed with the planned implementation of MUP, after a consultation supposedly on the level at which it was to be set 8. The UK government's alcohol strategy is now devoid of both substance and strategic direction 10, 11. There is an urgent need for debate about how this can be rectified. Compared with big tobacco, we know far less about the alcohol industry, and there is an obvious need to strengthen this evidence base 12. It is interesting that the tobacco industry usually refers only to the producer organizations, whereas retailers are included in our definition of the alcohol industry 13. Similarities and differences between the activities of the two industries are a fruitful target for study and we should avoid concluding that they are identical twins on current evidence, however many similarities there may appear to be. Moodie 4 suggests that public health research capacity needs to be enhanced to address these issues and we also suggest that greater capacity for dissemination and advocacy of research findings is essential. Careful attention should be given to the formation of new alliances within and beyond the field of public health. We agree, too, that it is important to look beyond the activities of specific industries, and suggest that considerations of the alcohol industry take place in the context of broader thinking about the impact of corporate power on public health and societal wellbeing 2, 14. There is much we can learn not just from tobacco control research but also from other disciplines and literatures. None.