School of Population Health Should Addiction researchers accept industry money from tobacco Alcohol or Gambling Wandering Hobbit ADDICTIVE CONSUMPTIONS CONSUMPTIONS DANGEROUS CONSUMPTIONS LEGAL ID: 468651
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Slide1
Peter J. AdamsSchool of Population Health
Should Addiction researchers accept industry money from tobacco, Alcohol or Gambling?Slide2
Wandering
HobbitSlide3
ADDICTIVE
CONSUMPTIONS
CONSUMPTIONS
DANGEROUS
CONSUMPTIONS
LEGAL
ADDICTIVE
CONSUMPTIONS
movies
Tobacco
pharma
f
ast
foods
clothes
houses
alcohol
cocaine
opioids
books
p
lastic
surgery
gambling
cannabis
a
ccepting industry moneySlide4
Addictive consumptions are specialSlide5
PROFIT
NOT MUCH
HEAPS
NUMBER OF CONSUMERS
LOW
HIGH
ADDICTIVE
NON-ADDICTIVESlide6
When the money’s there…. Hard to resist
Money exchange establishes expectations & obligationsReinforced by multiple
exchangesSlide7Slide8Slide9
Ostrich Response
“I didn’t really see that!”
“We’ve done so much work already”
“Let’s just pretend”Slide10
Bargaining Response
“Maybe it’s not that bad”“Gambling has its positive sides”“Only a small number have problems”Slide11
Missionary Response
“Money is sitting there”
“This funding will save lives”
“If we don’t get it, somebody else less deserving will”Slide12
Macho Response
“Be realistic”“To get things done you need to make some unpopular choices”“You have to be in to win”Slide13
Desire vs ValuesMessages favoured my ambitions
Ethical perspective minimisedNeed an outside reference point to gauge my viewsSlide14
SIMPLE
TRANSACTION
FUNCTIONS IN A WIDER
ARENASlide15
Plugging in….Slide16
Tobacco
Alcohol
Gambling
Industries
Political Chain of Engagement
Public
communication
strategies
Lobbying
& PR
companies
Producer
& retail
associations
Relationship
b
uilding
activities
Politicians
POLICY
MAKERS
Purposes:
Industry legitimate business
Key player in vitality of the economy
Long-term relationships with political actors
LOW VISSlide17
UK All-Party MP “Beer Group”U-Turn on minimum unit pricingBMJ study of infiltration of UK parliament
400 MPs from both houses of Parliament
Source
: http://www.morningadvertiser.co.uk/General-News/Chancellor-George-Osborne-named-Beer-Drinker-of-the-Year
UK Chancellor, George Osborne awarded “Beer Drinker of the Year” (2013) Slide18
NZ Tobacco (Alcohol) LobbyistCarrick GrahamPR lobbyist
Nicky Hager alleged he was paid by alcohol to engage Cameron Slater in attack on Doug Sellman
Source: http
://sciblogs.co.nz/griffins-gadgets/2014/08/18/cash-for-comment-and-new-zealands-mod-squad/Slide19
Public Good Chain of Engagement
Corporate social responsibility
Health & community programs
Social aspects & public relations organisations
Media coverage
Public consultation
Tobacco
Alcohol
Gambling
Industries
POLICY
MAKERS
Purposes:
Industry is a good corporate citizen
Industry is handling the harms
Individuals, not systems are responsible
HIGH VISSlide20
SAPROs“Social Aspects & Public Relations Organisations”DrinkWise
AustraliaIndustry fundedDo something visible about harm from alcoholBinge drinking, public awareness, alcohol & pregnancy, drink driving, underage drinking
How to Drink Properly
Source: https://www.drinkwise.org.au/Slide21
Knowledge Chain of Engagement
Priority setting processes
Researchers & research organizations
Funding & commissioning processes
Communication & dissemination
Government officials
Tobacco
Alcohol
Gambling
Industries
POLICY
MAKERS
Purposes:
Industry knows its own business
Industry shapes the research agenda
Credible pro-consumption knowledge base
MOD VISSlide22
Six steps to glory:The handshake
The pilot projectThe offerOngoing funding
Group membership
Policy communicationSlide23
US Tobacco ResearcherErnst Wynder (1923 – 1999)
Epidemiologist, in 1950 linked smoking to lung cancerResearch funded by Philip Morris 1961 – 1990
Opposed evidence for passive smokingSlide24
US Tobacco ResearcherHandshake:
1955 Philip Morris contacted himPilot: 1961 small fund for 3 years
Offer:
1969 $50 mill in resources
Ongoing $:
1970s regular amounts
Membership
: 1973 key in Philip Morris stablePolicy Communicator: 1980s spoke out about passive smokingSlide25
Brazilian Alcohol ResearcherArthur Guerra de AndradeIndustry funded at State University of São Paulo
Heads SAPRO “Center for Information on Health & Alcohol” (CISA)
Source:
Biblioteca
VirtualsSlide26
Brazilian Alcohol Researcher
Source:
Biblioteca
Virtuals
Handshake:
2002
AmBev invited him into discussionsPilot:
Mid 2000s form CISA & few public education projectsOffer: Accepted $ for researchOngoing $: 90% from industryMembership:
Late 2000s on international boards ICAP, ICAAPolicy Communicator: Advises state & federal governmentsSlide27
Harvard Gambling ResearchHoward ShafferDirector, Division of Addictions, Cambridge Health AllianceTeaching affiliate of Harvard Medical School
Source
: https
://www.youtube.com/watch?v=KhbmdyIlI7w Slide28
Harvard Gambling Research
Source
: https
://www.youtube.com/watch?v=KhbmdyIlI7w
Handshake:
1996 discussions with American Gaming Association
Pilot:
Accepted $140K Offer: 2000 director of industry- funded Institute (IRPGRD)
Ongoing $: By 2008 $9 millMembership: Prominent researcher internationallyPolicy Communicator: Advises US and other governmentsSlide29
Division on Addictions(Cambridge Health Alliance, teaching affiliate of Harvard Medical School)
Gamblers & Problem Gamblers
Gambling Operators
Division of Addiction
(US$7)
Institute for Research on Gambling Disorders
National Centre for Responsible
Gambling
Other Gambling Researchers
T1
T5
T4
T3
T2Slide30
Politicians
Public
Consultation
Government
Officials
Tobacco
Alcohol
Gambling
Companies
INDUSTRY
SECTOR
GOVERNMENT
SECTOR
Public Good Chain
Knowledge Chain
Political ChainSlide31
Profit Consumers
Addictive consumption industries
Industry services (lawyers, PR,
lobbyists, media, events ……)
Governments (& their agencies
)
Politicians & their parties
Health services
Community groups, charities,
NGOs, sports,
Researchers, universities…..Slide32
Supply control:
Limit community benefit funding
Demand reduction:
Improved information sources
Product labelling
Problem limitation
Assist in ethical decision-making
Accepting Industry Money as a Dangerous ConsumptionSlide33
MORAL JEOPARDY
Accepting industry money generates conflicts of interest
Consuming profits contributes to increased demand
Once consumed once, more likely to consume again
On-going profit consumption could lead to dependencySlide34
A DANGEROUS CONSUMPTION
5
Relationship
Risks
1
Ethical
Risks
4
Governance
Risks
3
Reputational Risks
2
Contributory
RisksSlide35
1
Ethical
Risks
Trying to do Good from sources that do Harm
Benefiting from
Deprived & Addicted
Exploiting Vulnerable
Groups
Money Derived
From HarmSlide36
2
Contributory
Risk
How
Industry Benefits from
the Relationship
Contributing to
S
ales
Improving
Public Profile
Positive view of
Policy MakersSlide37
3
Reputational Risks
How Others will Judge the Relationship
Judgement of
Colleagues
Judgement of
Funders
Judgement of
StakeholdersSlide38
4
Governance
Risks
Threats to Independence & Sovereignty
Creeping Funding
Reliance
Perceived
Dependence
Increasing Silence
& ComplianceSlide39
5
Relationship
Risks
Conflict from Differences in Viewpoint
Conflict between
Colleagues
Conflict between
Sections
Silencing &
LeavingSlide40
How to work out when a relationship is too risky?
Problem LimitationSlide41Slide42
Intensity of Relationship
Continuum of
Moral JeopardySlide43
OIL
LOTTERIES
ALCOHOL
TOBACCO
ARMAMENTS
POKIES
PORN
PHARMACEUTICALSSlide44
Low Risk
Moderate Risk
High Risk
Extremely
High Risk
Primary ConcernSlide45
Intensity Indicators
P
urpose
E
xtent
R
elevant-harm
IdentifiersLinkSlide46
Purpose E R I L
Degree to which purposes between funder and recipient diverge
How do purposes match?
E.g
.
general practice accepts funding support from tobacco companySlide47
P Extent R I L
Degree to which the recipient is reliant on this source What percentage of funding
?
E.g
.
Community service unwilling to criticise when alcohol income increases from 5% to 10%Slide48
P E Relevant-harm I L
Degree of harm associated with this form of consumption
Some products are less harmful than others
E.g.
researcher accepts money from lotteries but not pokiesSlide49
P E R Identifiers L
Degree to which the recipient is visibly identified with the funder
Branding using names, logos, advertising & other promotional linkages
E.g.
new laboratory with sign acknowledging brewery fundingSlide50
P E R I Link
Nature and directness of the link between recipient & funder Use of mediating
bodies or contracts?
E.g
.
Earmarked alcohol revenue channelled through government departmentSlide51
LOW
RISK
MOD
RISK
HIGH
RISK
EXTR. H.
RISK
Group 1:
A public health researcher receiving funds directly from
a tobacco company in
a publicly visible way.
Group 2: A genetics project receiving half its income
directly from a brewery
Group 3:
Research equipment funded partially from donations from a pokie trust
Group 4:
An addiction symposium funded by a small grant from lotteriesSlide52
Why are there nosapros in New Zealand?Slide53
PUBLIC GOOD
Hypothecated (earmarked) Taxation
90-95
%
spend
dependent
smoker
s
50-70
% spend
risky/addictive
drinkers
30-50%
spend
problem
gamblers
CONSOLIDATED FUNDSSlide54
SAPRO Attractiveness Criteria:Emphasis on personal consumptionEmphasis on individual explanations (e.g. biology)
Not linked to public healthNo track record of reducing consumptionConvey impression of being serious about harmsInvolve compliant partners (unlikely to criticize)Slide55
Traffic Light of Risk
Class
C (Monitor)
Pornography, Plastic Surgery, Oil
Class
B (Manage)
Psychotropics
,
Lotteries,
Fast
Food
Class
A (Curtail)
Tobacco,
Armaments, Pokies, AlcoholSlide56
Final Thoughts
Learnt much from tobacco
Easy to plug-in without realizing wider consequences
Promoting open dialogue about sources is key
Need ethical benchmarks & codes of practice