Alcohol industry misleading the public about alcohol-related cancer risk – Research Report from LSHTM

The study identifies “denying, distortion and distraction” as main strategies!

The alcohol industry (AI) is misrepresenting evidence about the alcohol-related risk of cancer with activities that have parallels with those of the tobacco industry, according to new research published in the journal Drug and Alcohol Review.

Led by the London School of Hygiene & Tropical Medicine with the Karolinska Institutet, Sweden, the team analysed the information relating to cancer which appears on the websites and documents of nearly 30 alcohol industry organisations around the world between September 2016 and December 2016. Most of the organisational websites (24/26) showed some sort of distortion or misrepresentation of the evidence about alcohol-related cancer risk, with breast and colorectal cancers being the most common focus of misrepresentation.

The most common approach involves presenting the relationship between alcohol and cancer as highly complex, with the implication or statement that there is no evidence of a consistent or independent link. Others include denying that any relationship exists or claiming inaccurately that there is no risk for light or ‘moderate’ drinking, as well discussing a wide range of real and potential risk factors, thus presenting alcohol as just one risk among many.

According to the study, the researchers say policymakers and public health bodies should reconsider their relationships to these alcohol industry bodies, as the industry is involved in developing alcohol policy in many countries, and disseminates health information to the public.

Alcohol consumption is a well-established risk factor for a range of cancers, including oral cavity, liver, breast and colorectal cancers, and accounts for about 4% of new cancer cases annually in the UK1. There is limited evidence that alcohol consumption protects against some cancers, such as renal and ovary cancers, but in 2016 the UK’s Committee on Carcinogenicity concluded that the evidence is inconsistent, and the increased risk of other cancers as a result of drinking alcohol far outweighs any possible decreased risk².

This new study analysed the information which is disseminated by 27 AI-funded organisations, most commonly ‘social aspects and public relations organisations’ (SAPROs), and similar bodies. The researchers aimed to determine the extent to which the alcohol industry fully and accurately communicates the scientific evidence on alcohol and cancer to consumers. They analysed information on cancer and alcohol consumption disseminated by alcohol industry bodies and related organisations from English speaking countries, or where the information was available in English.

Through qualitative analysis of this information they identified three main industry strategies. Denying, or disputing any link with cancer, or selective omission of the relationship, Distortion: mentioning some risk of cancer, but misrepresenting or obfuscating the nature or size of that risk and Distraction: focusing discussion away from the independent effects of alcohol on common cancers.

Mark Petticrew, Professor of Public Health at the London School of Hygiene & Tropical Medicine and lead author of the study, said: “The weight of scientific evidence is clear – drinking alcohol increases the risk of some of the most common forms of cancer, including several common cancers. Public awareness of this risk is low, and it has been argued that greater public awareness, particularly of the risk of breast cancer, poses a significant threat to the alcohol industry. Our analysis suggests that the major global alcohol producers may attempt to mitigate this by disseminating misleading information about cancer through their ‘responsible drinking’ bodies.”

A common strategy was ‘selective omission’ – avoiding mention of cancer while discussing other health risks or appearing to selectively omit specific cancers. The researchers say that one of the most important findings is that AI materials appear to specifically omit or misrepresent the evidence on breast and colorectal cancer. One possible reason is that these are among the most common cancers, and therefore may be more well-known than oral and oesophageal cancers.

When breast cancer is mentioned the researchers found that 21 of the organisations present no, or misleading, information on breast cancer, such as presenting many alternative possible risk factors for breast cancer, without acknowledging the independent risk of alcohol consumption.

Professor Petticrew said: “Existing evidence of strategies employed by the alcohol industry suggests that this may not be a matter of simple error. This has obvious parallels with the global tobacco industry’s decades-long campaign to mislead the public about the risk of cancer, which also used front organisations and corporate social activities.”

The researchers say the results are important because the alcohol industry is involved in conveying  health information to people around the world. The findings also suggest that major international alcohol companies may be misleading their shareholders about the risks of their products, potentially leaving the industry open to litigation in some countries.

Professor Petticrew said: “Some public health bodies liaise with the industry organisations that we analysed. Despite their undoubtedly good intentions, it is unethical for them to lend their expertise and legitimacy to industry campaigns which mislead the public about alcohol-related harms. Our findings are also a clear reminder of the risks of giving the AI the responsibility of informing the public about alcohol and health.

“It has often been assumed that, by and large, the AI, unlike the tobacco industry, has tended not to deny the harms of alcohol. However, through its provision of misleading information it can maintain what has been called ‘the illusion of righteousness’ in the eyes of policymakers, while negating any significant impact on alcohol consumption and profits.

“It’s important to highlight that if people drink within the recommended guidelines they shouldn’t be too concerned when it comes to cancer. For accurate and accessible information on the risks, the public can visit the NHS website.”

The authors acknowledge limitations of their study including that there are many other mechanisms and organisations through which industry disseminates health-related information which they did not examine, although it is unlikely that the messages would be different.

The researchers also say there is an urgent need to examine other industry websites, documents, social media and other materials in order to assess the nature and extent of the distortion of evidence, and whether it extends to other health information, for example, in relation to cardiovascular disease.

 

Publication:
Mark Petticrew, Nason Maani Hessari ,Cécile knai and Elisabete Weiderpass. How alcohol industry organisations mislead the public about alcohol and cancer. Drug and Alcohol Review. DOI: 10.1111/dar.12596
1Cancer Research UK: Statistics on preventable cancers.
2Committee on Carcinogenicity of chemicals in food, consumer products and the environment (COC). Statement 2015/S2.
About the London School of Hygiene & Tropical Medicine:
The London School of Hygiene & Tropical Medicine is a world-leading centre for research and postgraduate education in public and global health, with more than 4,000 students and 1,000 staff working in over 100 countries. The School is one of the highest-rated research institutions in the UK, is among the world’s leading schools in public and global health, and was named University of the Year in the Times Higher Education Awards 2016. Our mission is to improve health and health equity in the UK and worldwide; working in partnership to achieve excellence in public and global health research, education and translation of knowledge into policy and practice. http://www.lshtm.ac.uk
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Report conducted at the University of Sheffield provides ‘clear and compelling’ new evidence on the effectiveness of minimum unit pricing.

Alcohol consumption will cause 63,000 deaths in England over the next five years according to a new report from the University of Sheffield Alcohol Research Group.

alcoholThe report, published by the Foundation for Liver Research, predicts that 32,475 of the deaths – the equivalent of 35 a day – will be the result of liver cancer and another 22,519 from alcoholic liver disease.

In its new report, Financial case for action on liver disease, endorsed by the independent Lancet Commission on Liver Disease, the Foundation for Liver Research urges the Government to implement a suite of policy measures designed to mitigate the rising health and financial burden of alcohol, including the introduction of minimum unit pricing (MUP), re-institution of alcohol duty escalator and advertising restrictions.

  • Between 2017 and 2022 the total cost to the NHS of alcohol-related illness and deaths will be £17 billion.
  • Study shows introduction of minimum unit pricing for alcohol could significantly reduce the burden.

Providing evidence in support of Government intervention, new modelling shows that within five years of its introduction in England, a 50p MUP alone would result in:

  • ian gilmore quote21,150 fewer alcohol-related deaths
  • 74,500 fewer alcohol-related hospital admissions
  • Savings of £325.7m in healthcare costs
  • Savings of £710.9m in crime costs

The total financial savings to the public purse of MUP is forecast to be £1.1 billion – the equivalent cost of the Government’s recently announced investment package for Northern Ireland.

Colin Angus, Research Fellow at the University of Sheffield and part of the Sheffield Alcohol Research Group who conducted the research, said:

“These new findings show there will be 35 deaths and 2,300 hospital admissions due to alcohol every day in England over the next five years. We estimate this will cost the NHS £17 billion at a time when healthcare resources are already overstretched. Our research also shows that policies such as Minimum Unit Pricing have the potential to significantly reduce this burden.”

Liver disease is one of Britain’s biggest killers, claiming about 12,000 lives a year in England alone. The number of deaths associated with it has risen by 400% since 1970. It is estimated that 62,000 years of working life are lost every year as a result of it. People who develop serious liver problems also suffer some of the worst health outcomes in western Europe.

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Enough alcohol was sold in Scotland in 2016 for every adult to significantly exceed safe drinking levels each week

New figures published this week reveal that enough alcohol is being sold in England and Wales for every drinker to consume 21 units of alcohol a week – far more than the low-risk level of 14 units per week for both men and women recommended by the UK’s chief medical officers. The figures reveal that the situation is even worse in Scotland, with enough alcohol being sold for every drinker to consume 24 units a week. The data was released by NHS Health Scotland, who also looked at consumption in England and Wales in order to compare patterns across the UK. In 2016 10.5 litres of pure alcohol were sold per adult in Scotland, equivalent to 20.2 units per person per week!

“As a nation we buy enough alcohol for every person in Scotland to exceed the weekly drinking guideline substantially” Lucie Giles (author of the report)

The annual report from NHS Health Scotland brings together data on alcohol retail sales, price and affordability, self-reported consumption and alcohol-related deaths, hospital admissions and social harms. It found that in 2015 an average of 22 people per week died in Scotland due to an alcohol-related cause, a figure 54 per cent higher than that recorded in England and Wales. In the most deprived areas of Scotland alcohol-related death rates were six times higher than in the wealthiest areas. Rates of alcohol-related hospital stays were also nine times higher.

However, the report said there were some signs that Scots were curtailing their drinking habits, with self-reported data showing that the proportion of tee-totallers has also risen.

“This has harmful consequences for individuals, their family and friends as well as wider society and the economy. The harm that alcohol causes to our health is not distributed equally; the harmful effects are felt most by those living in the most disadvantaged areas in Scotland.” Lucie Giles

To tackle high levels of alcohol-related deaths and illness, Scotland is set to introduce a minimum unit price for alcohol; designed to target cheap, high-% alcohol drinks favoured by vulnerable and harmful drinkers.. The Scottish government passed minimum unit pricing over 5 years ago, though implementation of the measure has so far been delayed due to legal challenges from the alcohol industry. Minimum unit pricing formed part of the Westminster government’s alcohol strategy in 2012, though has yet to be implemented in England and Wales. 

“This report shows that, whilst some progress has been made in tackling alcohol misuse, we need to do more. Over the last few years, more than half of alcohol sold in supermarkets and off-licences was sold at less than 50p per unit, and enough alcohol was sold in the off-trade alone to exceed the weekly drinking guideline by a considerable amount. That is why we need minimum unit pricing, which will largely impact on the off-trade and will increase the price of the cheap, high strength alcohol.”  Public Health Minister Aileen Campbell

Responding to the publication of the figures, Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said: 

“These figures are shocking and show why minimum unit pricing is needed in Scotland, as well as in the rest of the UK. As a result of the legal challenges from the alcohol industry, lives will undoubtedly have been lost in Scotland. We hope and expect minimum unit pricing to be ruled legal in the final court hearing in this case in July, so that implementation in Scotland can follow.

“If minimum unit pricing is ruled legal in Scotland, a decision by Westminster to delay would be a death sentence for some, including many from the lowest income groups. The evidence is already clear – minimum unit pricing saves lives, prevents illness and lowers hospital admissions.”

The NHS Health Scotland figures are available here.

For more information on Minimum Unit Pricing, check out a report from the University of Sheffield’s Alcohol Research Group.

More posts related to this one:
Alcohol-related Hospital Admissions are at a Record High!
“Government has ‘no sense of direction’ in reducing devastating alcohol harm” Lord Brooke
Experts call for action on HIGH STRENGTH CIDER to protect the homeless and the vulnerable.

 

 

Introducing a new International Workshop: The Ubiquity of Alcohol – 20/09/2017

We are delighted to announce the launch of a brand new international workshop focusing on the ubiquity of alcohol.

Addressing Marketing, Availability and Industry Influence:

Alcohol is no ordinary commodity but its presence and marketing seem ubiquitous. In this workshop, we will explore how policymakers, public health experts and researchers are responding to industry efforts to expand the presence and normality of alcohol in our lives. With inputs from leading international researchers and advocates we will explore alcohol marketing and availability in a digital age; industry manoeuvres, and potential countermeasures.

This years workshop will feature sessions from a variety of speakers including a session on Alcohol Marketing and the loi Évin, which is a French alcohol and tobacco policy that was passed in 1991. In this session Nathan Critchlow from the University of Stirling and Prof Karine Gallopel-Morvan from the EHESP School of Public Health, France will look at consumer marketing of alcohol brands in a digital age, controlling alcohol advertising and lessons learnt from the loi Évin.

We also have inputs from a variety of speakers from a number of organisations that focus on alcohol harm, including Jon Foster from the Institute of Alcohol Studies and Alison Douglas & Laura Mahon from Alcohol Focus Scotland.

We are also pleased to announce that Prof. Mike Daube from Curtin University, Australia will be joining us to discuss advocacy on alcohol advertising and the influence of the alcohol industry. To discuss the alcohol industry in more detail we also welcome Prof. Jeff Collin from the University of Edinburgh. Jeff is a regular speaker at the Alcohol Policy in Practice CPD and provides a deep insight into the alcohol industry actions.

The Ubiquity of Alcohol

Location: University of Stirling

Date: Wednesday 20th September

Cost: Standalone workshop cost: £150.00

More informationwww.ukctas.net/ubiquity

This workshop is included in our 4 day Alcohol Policy in Practice CPD course we run every September, to find out more information about this course and it’s content please click here.

 

Alcohol and breast cancer – How big is the risk? ~ Report from the World Cancer Research Fund

Half a glass of wine a day increases breast cancer‘ was just one of the headlines this WCRF_main-150x150week, which discussed a report that reinforced the evidence that alcohol can increase a woman’s risk of developing breast cancer.

The report from the World Cancer Research Fund outlined the latest evidence on how we can reduce that risk – focusing on weight, physical activity and drinking.

The WCRF studies all the evidence on a potential risk and decides whether it’s strong enough to be a basis for making recommendations to the public.

Breast cancer is the most common cancer in the UK, and 1 in 8 women will be diagnosed with breast cancer at some point in their lives. And since we know that almost a third of breast cancer cases in the UK could be prevented, largely by changes to lifestyle, this is important stuff.

While the cause of an individual’s cancer can never be certain, there are still things you can do to reduce your risk. And evidence like this is the first step to helping women to do just that.

So what exactly does the report say?

Alcohol

The report backs up previous research showing that drinking alcohol can cause 7 types of cancer  including breast cancer. Even though it’s in the headlines, this is nothing new.

While the reports may sound alarming, we also know that the more you cut down, the more you’re reducing your risk.

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Although most women don’t regularly drink very large amounts of alcohol, thousands of cases of cancer – including breast – are linked to alcohol each year.

There are 3 good theories on the link between alcohol and cancer which we’ve written about before.

  • When we drink alcohol, it’s broken down into a toxic chemical called acetaldehyde. Acetaldehyde can damage the DNA inside our cells, and then prevent damage from being repaired. This is important because it allows cancer to develop.
  • Alcohol can increase the levels of certain hormones in the body, including oestrogen. We know that high levels of oestrogen can fuel the development of breast cancer, so this might be particularly important here.
  • Alcohol also makes it easier for cells in the mouth and throat to absorb other cancer-causing chemicals. This is probably more important for other cancer types linked to alcohol rather than breast cancer.

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Physical activity

The evidence on the link between breast cancer risk and both weight and physical activity is a bit more complicated. This is because there is evidence that the causes of breast cancer that occur in women before the menopause, compared to after the menopause, are different.

But overall there is strong evidence that keeping a healthy weight and being physically active, can help prevent breast cancer.

Unlike its previous report, this time WCRF says that some forms of physical activity probably reduce the risk for pre-menopausal breast cancer But the finding is only true for ‘vigorous’ activity – exercise which gets you breathing hard and your heart beating fast, so that you won’t be able to say more than a few words without pausing for breath.

The report also adds to the existing evidence that physical activity at any age is related to a lower risk of breast cancer in women after the menopause. This can be anything that gets you a bit hot and out of breath – from fast walking, to cycling, or even heavy housework. And the more you do the better.

Body weight

The evidence on weight and breast cancer is also complicated: as your risk changes depending on the ages at which you were overweight.

But overall the report agrees with previous work showing that being overweight or obese throughout adulthood causes postmenopausal breast cancer, something that is already well established.

Bringing it all together

Other things that affect a woman’s breast cancer risk are less easy to control. As with most cancers, the risk of developing the disease increases with age. Having a family history of the disease can increase a woman’s risk, and breastfeeding can reduce it.

All the different things that can increase the risk of breast cancer are held together by a common thread: they all affect the hormones circulating around in the body in some way.

Hormones help control what happens inside our bodies by sending messages from one place to another – including instructing cells when to stop and start multiplying.

If this system goes wrong, cells can get too many messages telling them to make more cells. And that can lead to cancer.

Overall the best advice is the same as at the start of the week: to keep active, keep a healthy weight throughout life, and limit alcohol.

Originally posted on CRUK, taken from Cancer Research UK Cambridge Institute

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Study finds poorest of us at greater risk of harm from heavy drinking.

Drinking heavily is more harmful to the poorest people in society, who are at greater risk of illness or death because of alcohol consumption, according to a recent medical study. Published in medical journal The Lancet Public Health on Wednesday, it found there is a marked link between socio-economic status and the harm caused by drinking alcohol excessively.

Researchers taking part in the study found increased alcohol consumption was “disproportionately harmful” to the poorest in society. Compared with light drinkers in advantaged areas, excessive drinkers were seven times at risk of an increase in alcohol harm.

This contrasted with excessive drinkers in deprived areas, who were 11 times at risk of an increase. Harmful impacts of alcohol are higher in socio-economically disadvantaged communities. However, until now it was unclear whether those were as a result of
differences in drinking or as a result of other factors.

Lead author Dr Vittal Katikireddi, of the University of Glasgow, said:

“Our study finds that the poorest in society are at greater risk of alcohol’s harmful impacts on health, but this is not because they are drinking more or more often binge drinking.

“Experiencing poverty may impact on health, not only through leading an unhealthy lifestyle but also as a direct consequence of poor material circumstances and psychosocial stresses. Poverty may, therefore, reduce resilience to disease, predisposing people to greater health harms of alcohol.

The authors linked different sets of data to bring together information from Scottish Health Surveys with electronic health records, studying more than 50,000 people.
It suggested that even when other factors are accounted for, including smoking and obesity, living in deprived areas was consistently associated with higher alcohol-related harms. Researchers defined harm from alcohol consumption based on deaths, hospital visits and prescriptions that were attributable to alcohol.

Study co-author Dr Elise Whitley said:

“Heavier drinking is associated with greater alcohol-related harm in all individuals. However, our study suggests that the harm is greater in those living in poorer areas or who have a lower income, fewer qualifications or a manual occupation.

Responding to the study published on Wednesday in The Lancet Public Health which found that drinking heavily is more harmful to the poorest people in society. Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“The findings in this study are worrying if not altogether surprising. It is clear that the way alcohol is being sold and promoted in Scotland and elsewhere in the UK is harming some of the most vulnerable people in society. On the other hand, we know what needs to be done, in particular to tackle the scourge of cheap alcohol. In real terms, alcohol is 60% cheaper than it was in 1980 and measures like strength based pricing would disproportionately benefit the poorest groups, in terms of reduced deaths, illness and hospital admissions.

Studies have shown that 82% of the lives saved through minimum unit pricing would come from the lowest income groups. Overall, in the first year alone minimum unit pricing in Scotland is expected to save 60 lives and lead to 1,600 fewer hospital admissions and 3,500 fewer crimes, yet its introduction has been held up for years by alcohol industry legal challenges.

Importantly, minimum unit pricing would leave pub prices untouched, and moderate drinkers would spend only about £2.25 extra per year with a 50p minimum price.”

This is even more evidence of the Alcohol Harm Paradox, which refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. A study published in 2016 hoped to deconstruct this idea and assessed socioeconomic patterns of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. You can read the research article here: Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England



Citation of original research article:

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data. 

Dr Srinivasa Vittal Katikireddi, Elise Whitley, Jim Lewsey, Linsay Gray, Prof Alastair H Leyland. Published: 10 May 2017 – Open Access DOI: http://dx.doi.org/10.1016/S2468-2667(17)30078-6


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Alcohol-related Hospital Admissions are at a Record High!

New figures released this week shows that hospital admissions due to alcohol are at their highest ever levels.

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The data, summarised in a release from NHS Digital, shows that alcohol-related hospital admissions in England have increased by 64% over the last decade, with an extra 430,000 people being admitted due to alcohol-related causes in 2015/16 compared with 2005/06.

This takes the total number of alcohol-related hospital admissions to over 1.1 million in 2015/16.

alcohol

Alcohol is linked to over 60 illnesses and diseases, including heart disease, liver disease and cancer. Figures from the local alcohol profiles for England show that admissions due to liver disease have gone up 57% over the last decade, and that the number of people diagnosed with alcohol-related cancer has increased 8%.

In contrast, separate data released today by the Office of National Statistics shows that the proportion of adults drinking is at its lowest level since 2005, with younger people more likely to be abstaining from alcohol. However, 7.8 million people admit to binge drinking on their heaviest drinking day.

In response to the figures, alcohol health experts called for more to be done in the UK to tackle the health harm done by alcohol.

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Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“These figures show that the UK continues to have a dysfunctional relationship with alcohol. We know that over the long term, rates of binge drinking are falling, and more people are choosing to abstain from alcohol. Worryingly, however, these trends do not appear big enough to stop alcohol harm from continuing to rise, and the sharp increase in alcohol-related hospital admissions over the last few years means hundreds of thousands more people each year are experiencing the misery associated with harmful alcohol consumption.

“The data released today should be sobering reading for whoever wins the upcoming general election, and we would urge the next government to make tackling alcohol harm an immediate priority to save lives, reduce harm, and reduce the pressure on the NHS.”

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 The data is available via the following links.