Observations Alcohol and Public Health

Costs of minimum alcohol pricing would outweigh benefits

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1572 (Published 19 February 2014) Cite this as: BMJ 2014;348:g1572

Re: Costs of minimum alcohol pricing would outweigh benefits

Christopher Snowdon who leads the new 'Lifestyle economics' at the Institute of Economic Affairs (IEA) writes to admonish the BMJ for publishing an article critical of the alcohol industry’s role in undermining the adoption of Minimum Unit Pricing of alcohol by the UK government.(1) The BMJ requires authors to declare competing interests (‘when a person has a personal or organisational interest that may influence or appear to influence the work they are doing. Usually this is a financial interest, but it may also be non-financial.'(2)) Snowdon disclosed only a personal conflict of interest, yet a close reading of his article and other data on IEA funding suggest that additional potential conflicts of interest exist.

The Institute of Economic Affairs is the oldest market liberal think tank in the UK. Snowdon’s role there is to examine 'the issues surrounding alcohol, tobacco, gambling, sugar, fat and soft drinks'.(3) Although the IEA 'has a policy of donor confidentiality',(1) even Snowdon’s article indirectly acknowledges alcohol industry funding of IEA stating that no evidence 'can be found' that 'the drinks industry’s funding to the Institute of Economic Affairs is at all significant as a proportion of our income or that drinks industry funding is greater than… funding by the retail industry. He also notes that that 'such donations to the institute are small.' Small or not, the fact that the IEA receives funding from the alcohol and retail industries when elements of both opposed MUP and therefore have an interest in what he writes, clearly constitutes a conflict of interest under the BMJ terms and should have been declared.

Additional evidence suggests other potential conflicts of interest may exist and raises serious concerns about the role IEA plays for major corporations whose products are potentially damaging to health. For example, tobacco industry documents released in legal settlements and recent documentation reveal that the major tobacco companies historically and currently fund the IEA.(4, 5, 6) This is relevant since Altria, the parent of tobacco firm Philip Morris USA and which spun off Philip Morris International in 2008, owns almost 30% of the global alcohol producer, SABMiller. Perhaps more importantly, however, it is clear that the IEA has played a role in the tobacco industry’s well documented attempts to create doubt about the health impacts of second-hand smoke and to influence the general way that risk is dealt with(7); the latter an issue that would also work to the alcohol industry’s advantage and on which alcohol and tobacco companies have previously collaborated (8). It is the apparent attempt by segments of the tobacco industry to undermine science that underpinned the BMJ’s recent decision to no longer publish research funded by the tobacco industry.(9)

A key issue is that the secrecy surrounding IEA funding makes it difficult to accurately assess the extent of any conflict of interest, an issue that has become a major concern of addiction specialty journals.(10) This secrecy appears to be something IEA’s funders deliberately seek – Philip Morris International has deliberately used the IEA to represent its interests in media debates (11) and other funders go to considerable lengths to disguise their funding of the IEA, channeling it for example through secretive US-based foundations.(12).

In the case of Christopher Snowdon the conflict of interest statement falls below the standards of transparency expected of academic authors writing in medical journals. We believe the BMJ should go back to Snowdon and require a full disclosure of both personal and organisational conflicts of interest. This should including the amounts and identity of the donor(s) of personal funding given for travel and accommodation and organisational funding to the IEA. The latter should include all funding (for membership, projects and events) from the alcohol and retail industries and indeed any other industry or industry-linked funds given for work on alcohol related topics.

In the wider case of the relationship between the IEA and its funders, the BMJ have said to us (in discussion of this Rapid Response) that their policy is to ask for disclosure of any relevant competing interests to the topic under discussion. We argue that all competing interests are relevant and should be declared; if they are not relevant then they are not competing interests.

The BMJ has two choices in relation to any articles from the IEA and related organisations: to require full disclosure of all funding or to refuse to publish the work. Without this, it is impossible to rule out or even assess potential financial conflicts of interest. As a result the BMJ may inadvertently be allowing the hidden vested interests its conflict of interest policy seeks to expose to promote their agenda via third parties such as the IEA.

References

1. Christopher Snowdon Costs of minimum alcohol pricing would outweigh benefits OBSERVATIONS Alcohol and Public Health BMJ 2014; 348 doi: http://dx.doi.org/10.1136/bmj.g1572 (Published 19 February 2014)
http://www.bmj.com/content/348/bmj.f7531/rr/685644 (last accessed 24 February 2014).

2. BMJ. BMJ Group policy on declaration of interests http://www.bmj.com/sites/default/files/BMJ_Group_policy_on_declaration_o... (last accessed 24 February 2014).

3. Institute of Economic Affairs. 'Lifestyle Economics' http://www.iea.org.uk/lifestyle-economics (last accessed 24 February 2014).

4. Tobacco Tactics. Institute of Economic Affairs. http://tobaccotactics.org/index.php/Institute_of_Economic_Affairs (last accessed 25 Feb 2014).

5. Tobacco Tactics. IEA: History of Close Ties with the Tobacco Industry. http://www.tobaccotactics.org/index.php/IEA:_History_of_Close_Ties_with_... (last accessed 25 Feb 2014).

6. Doward J. Health groups dismayed by news 'big tobacco' funded rightwing thinktanks. The Adam Smith Institute and the Institute of Economic Affairs received money from cigarette firms, it has been revealed. The Observer, 1 June 2013. http://www.theguardian.com/society/2013/jun/01/thinktanks-big-tobacco-fu.... (last accessed 25 Feb 2014)

7. Tobacco Tactics. IEA: Working with RJ Reynolds, BAT and Philip Morris on Environmental Risk http://www.tobaccotactics.org/index.php/IEA:_Working_with_RJ_Reynolds,_B... (last accessed 25 Feb 2014).

8. Smith KE, Fooks G, Collin J, Weishaar H,Mandal, S, Gilmore A. “Working the System” – British American Tobacco’s influence on the European Union Treaty and its implications for policy: an analysis of internal tobacco industry documents. PLOS Medicine 2010. DOI: 10.1371/journal/pmed.10000202 http.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000202

9. Godlee F et al. Journal policy on research funded by the tobacco industry. BMJ 2013; 347:8.

10. Babor D, Miller P. McCarthyism, conflict of interest and Addiction’s new transparency declaration procedures. Addiction 2014, 109, 341–344
DOI: 10.1111/add.12384

11. Tobacco Tactics. PMI’s anti plain packaging media campaign. http://www.tobaccotactics.org/index.php/PMI%E2%80%99s_Anti-PP_Media_Camp... (last accessed 21 Dec 2013).

12. John Mashey Fakery 2: More Funny Finances, Free Of Tax Desmogblog Thu, 2012-10-25 05:00. http://desmogblog.com/2012/10/23/fakery-2-more-funny-finances-free-tax

Competing interests: DM receives funding from the European Commission for an FP7 project (ALICE RAP) that focuses on rethinking addictions in Europe – the same project which funded the article criticised by Christopher Snowdon. He is also a director of Public Interest Investigations, a non-profit company which is behind two websites: spinwatch.org and powerbase.info. ABG has been subject to persistent defamation from Christopher Snowdon –he has published over 100 blog entries attempting to defame her and critique her research (http://velvetgloveironfist.blogspot.co.uk/search?q=gilmore%2Banna). Her research on the tobacco industry is currently funded by the US National Cancer Institute, National Institutes of Health (grant R01CA160695), Cancer Research UK (grants C38058/A15664, C27260/A12294) and ESRC (grant ES/L00206X/1); the funding from CRUK and ESRC supports the online wiki www.TobaccoTactics.org. JB is a board member of ASH. DM, ABG, JB are members of the UK Centre for Tobacco and Alcohol Studies, a UK Centre for Public Health Excellence (MR/K023195/1) funded by the BHF, CR-UK, ESRC, MRC, and NIHR, under the auspices of the UK Clinical Research Collaboration. NS has undertaken paid consultancy work and received travelling expenses from pharmaceutical companies developing drugs for the treatment of inflammatory bowel disease and liver disease &been paid for medico-legal work in the area of Hepatitis C and alcohol related liver disease. The following memberships and advisory work are unpaid apart from travelling expenses: EU Alcohol Forum, EU Alcohol Marketing Taskforce, Royal College of Physicians Alcohol Committee, Alcohol Health Alliance UK. Advisory work for the UK Department of Health, Home Office, Department of Transport, Cross Cabinet Strategy Committee, NICE, Southampton City Council, UK Police, British Liver Trust, various other bodies, NGO’s and local government, media activity of various forms. I was a trustee of the Drinkaware Trust until May 2013, and co-chair of the Responsibility Deal Alcohol Network until my resignation in August 2013 as a result of the u-turn over minimum unit price. TB: None declared.

04 June 2014
David Miller
Professor of Sociology
Anna B. Gilmore, Nick Sheron, John Britton, Thomas F. Babor
University of Bath
Claverton Down, Bath, BA2 7AY
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