Peter J. AdamsSchool of Population Health

FUNDING OF SOCIETY ACTIVITIES BY ORGANIZATIONS WITH COMPETING INTERESTS:

RISKS & OPTIONS

ICARA MEETING, BUDAPEST 31 AUGUST 2015

ADDICTIVECONSUMPTIONS

CONSUMPTIONS

DANGEROUSCONSUMPTIONS

LEGALADDICTIVE

CONSUMPTIONS

movies

tobacco

pharma

fast foods

clothes

houses

alcoholcocaine

opioids

books

plasticsurgery

gambling

cannabis

accepting industry money

ADDICTIVE CONSUMPTIONS

ARE SPECIAL

Rational consumer?

Struggles with control

Consume more than intended

Over-consume despite knowledge

Addiction Add-on

ProductionCosts

Normal Profit

AddictionAdd-on

PROFIT

NOT MUCH

HEAPS

NUMBER OF CONSUMERS

LOW HIGH

ADDICTIVE

NON-ADDICTIVE

When the money’s there….

Hard to resist Money exchange

establishes expectations & obligations

Reinforced by multiple exchanges

Ostrich Response

“I didn’t really see that!”

“We’ve done so much work already”

“Let’s just pretend it’s not there”

Bargaining Response

“Maybe it’s not that bad”

“Gambling has its positive sides”

“Only a small number have problems”

“Can’t spoil it for the rest of us”

Missionary Response

“Money is sitting there”

“This funding will save lives”

“If we don’t get it, somebody else less deserving will”

Macho Response

“Be realistic” “To get things

done you need to make some unpopular choices”

“Say no to one, then the rest will follow”

Desire vs Values Messages

favoured my ambitions

Ethical perspective minimised

Need an outside reference point to gauge my views

SIMPLETRANSACTIO

N

FUNCTIONS IN A WIDER

ARENA

Three Connecting Chains

TobaccoAlcoholGamblin

gIndustrie

s

Political Chain

Publiccommunicatio

nstrategies

Lobbying& PR

companiesProducer

& retailassociation

s

Relationship

buildingactivities

Politicians

POLICYMAKERS

Purposes:• Industry is a legitimate business• Is a key player in vitality of our economy• Build long-term relations with political

actors

LOW VIS

British Medical Journal studies on infiltration of UK Parliament

All-party MP “Beer Group”

400 MPs from both houses of Parliament

David Cameron reversal on minimum unit pricingSource:

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)

Public Good Chain

Corporate social

responsibility

Health & communit

y programsSocial aspects

& public relations

organisations

Media coverage

Public consultatio

n

TobaccoAlcoholGamblin

gIndustrie

s

POLICYMAKERS

Purposes: • Industry is a good corporate citizen• Industry is handling the harms• Individuals, not systems are

responsible

HIGH VIS

SAPROs“Social Aspects & Public Relations

Organisations”

DrinkWise Australia Industry funded Do something visible

about harm from alcohol

Binge drinking, public awareness, alcohol & pregnancy, drink driving, underage drinking

How to Drink Properly

Source: https://www.drinkwise.org.au/

Knowledge Chain

Priority setting processes

Researchers & research

organizationsFunding &

commissioning processes

Communication &

dissemination

Government officials

TobaccoAlcoholGamblin

gIndustrie

s

POLICYMAKERS

Purposes: • Industry knows its own business best• Industry shapes the research agenda• Credible pro-consumption knowledge

base

MOD VIS

Six steps along the chain:

1. The handshake2. The pilot project3. The offer4. Ongoing funding5. Group membership6. Policy

communication

US Tobacco Researcher

Ernst Wynder (1923 – 1999)

Epidemiologist, in 1950 linked smoking to lung cancer

Research funded by Philip Morris 1961 – 1990

US Tobacco ResearcherHandshake: 1955 Philip Morris contacted himPilot: 1961 small fund for 3 yearsOffer: 1969 $50 mill in resourcesOngoing $: 1970s regular amountsMembership: 1973 key in Philip Morris stablePolicy Communicator: 1980s spoke out about passive smoking

Brazilian Alcohol Researcher

Arthur Guerra de Andrade

Industry funded at State University of São Paulo

Heads SAPRO “Center for Information on Health & Alcohol” (CISA)

Source: Biblioteca Virtuals

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 governments

Harvard Gambling Research

Howard Shaffer Director, Division of

Addictions, Cambridge Health Alliance

Source: https://www.youtube.com/watch?v=KhbmdyIlI7w

Harvard Gambling Research

Source: https://www.youtube.com/watch?v=KhbmdyIlI7w

Handshake: 1996 discussions with American Gaming AssociationPilot: Accepted $140K Offer: 2000 director of industry- funded Institute (IRPGRD)Ongoing $: By 2008 $9 millMembership: Prominent researcher internationallyPolicy Communicator: Advises US and other governments

Politicians

Public Consultation

GovernmentOfficials

TobaccoAlcoholGamblin

gCompani

es

INDUSTRY SECTOR

GOVERNMENT

SECTOR

Public Good Chain

Knowledge Chain

Political Chain

Ethical decision making strategy PERIL analysis

Establishing benchmarks Policy & process for managing

engagement

Accepting Industry Money is a Dangerous Consumption:

Two Interventions

Intensity of Relationship

Continuum of Risk

OIL

LOTTERIES

ALCOHOL

TOBACCO

ARMAMENTS

SLOTS

PORN

PHARMACEUTICALS

Low RiskModerate Risk

High RiskExtremelyHigh Risk

Primary Concern

Intensity Indicators

Purpose

How purposes match?

Extent

Percent of funding?

Relevant-harm

How harmful the product?

Identifiers

How visible the relationship?

Link

Directness of relationship?

Purpose Extent Relevant-harm Identifiers Links

LOWRISK

MODRISK

HIGHRISK

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 lotteries

Traffic Light of Risk

Class C (Monitor)Pornography, Plastic Surgery, Milk

Class C (Monitor)Pornography, Plastic Surgery, Milk

Class B (Manage)Fossil fuels, Lotteries, Fast Food

Class B (Manage)Fossil fuels, Lotteries, Fast Food

Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol

Class A (Curtail)Tobacco, Armaments, Pokies, Alcohol

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

MORAL JEOPARD

YThe Risks of Accepting Money from Tobacco, Alcohol & Gambling

Industries

Cambridge University Press

Peter J. Adams

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