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Mentor UK, Diageo and Me – A Personal Ethical Perspective

Jim McCambridge and his colleagues at the London School of Hygiene and Tropical Medicine have usefully explored in various publications the operations of the alcohol industry in trying to influence alcohol policy. For example, (http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1001431) they have drawn attention to the behaviours of a number of economic operators to misrepresent evidence on Minimum Unit Pricing as the policy was being considered by the Scottish Government in 2008. In a recent article in the European Journal of Public Health, Lyness and McCambridge continued their investigations,(http://eurpub.oxfordjournals.org/content/early/2014/06/09/eurpub.cku076.short ). However, in doing so, I feel that they may have inadvertently damaged by insinuation and misrepresentation the reputation of Mentor UK, the charity of which I was Chief Executive from 2000 – 2009. I think it’s therefore important to provide some clarification. This is a personal perspective, and I am not writing in my capacity as Director of SHAAP (Scottish Health Action on Alcohol Problems).

I was Chief Executive of Mentor UK from 2000 – 2009. Mentor UK, as a drug (including alcohol) misuse prevention charity, always found it difficult to get funding. Year on year, there was always a worry about whether we would even have sufficient unrestricted income to make it into the next year. Not unusual, of course, for a small charity. We had to fundraise from trusts, foundations, individuals and government, just as other charities do. However, it was always difficult to bring in unrestricted income and most funding was restricted for project work. Our focus throughout all of our work was on expanding the evidence base for prevention and we always therefore included evaluation, ideally by external experts, in all of our projects.

In 2006, with other colleagues at Mentor, I designed the CHAMP Awards project which gave three cash awards each year to local projects working in the field of prevention and with three categories – young people-led, school and community. In addition, we provided external support, with equivalent funding to the awards, to help agencies evaluate and review their activities and disseminate their findings. The funding was provided by Diageo, the global drinks producer. We were totally up-front about Diageo’s involvement. This was at my insistence, so that there could be no accusations of inappropriate behaviour or relationships. As stated by Mentor UK on its website,
( http://www.mentoruk.org.uk/2014/06/where-does-mentors-funding-come-from/ , accessed 28th June 2014):

“The company’s sponsorship of the competition was wholly transparent: it was published in our annual accounts, as well as mentioned in press releases, annual reports and at the Awards ceremony itself, which was attended by Diageo representatives.”

Mentor UK trustees debated the ethical issues associated with accepting funding from Diageo before going forward with the arrangement and the project was consistently reviewed in line with the charity’s written ethical policy.

The winners of the CHAMP awards were selected by a jury with substantial prevention expertise. At no stage was Diageo involved in shaping the project, influencing the criteria for decision making or selecting the winners. To the best of my knowledge, ie even now, four years after my own involvement, they never tried to influence what we were doing.

My understanding is that the CHAMP Awards project had a significant impact on improving the operations of some of the agencies with which we worked. For example, the Greater Easterhouse Alcohol Project expanded its delivery from 38 to 100 primary schools.

From looking now at Mentor UK’s website (http://www.slideshare.net/Mentor_UK/champ-awards-achievements , accessed 28th June 2014), it seems that the project supported the development of the evidence base for effective prevention:

“The evaluation would not have gone ahead without this money”

and in some cases, even kept small local charities afloat:

“ I don’t know how we would have paid for what we did. It kept us going – it meant we could pay our bills.”

In fact, the funding also helped Mentor UK stay afloat, given the funding pressures to which I have alluded above.

The only other involvement I had with Diageo when I was at Mentor UK was when they came to events, in making a brief video about the awards scheme and when I facilitated a workshop for their staff about evidence-based prevention. Bearing in mind Mentor UK’s mission, this focussed on evidence for effective individual interventions and education. This was not to ignore the importance of actions on Price, Availability and Marketing and in my current role as Director of SHAAP (Scottish Health Action on Alcohol Problems – http://www.shaap.org.uk ), I have consistently challenged industry opponents, including Diageo on these issues. It is however erroneous, as claimed or implied by many who argue for population level measures that there is no evidence of effectiveness of individual and educational interventions. Rather, it is the case that too few projects are evaluated and there is consequently a lot of poor practice. Mentor in the UK and internationally plays an important role in trying to improve the quality of prevention work.

I left Mentor UK in 2009. I understand that Diageo ceased its funding of the CHAMP Awards a short time after that. Lyness and McCambridge’s article states that:

“In 2008/9 Mentor UK received 25% of its income from Diageo and continues to receive funding for CHAMPS”.

In the interests of clarity and fairness, it would have been appropriate to stress that the 2008/9 funding was restricted for the CHAMP project. The statement that they continue to receive funding for the project is simply untrue.

It is important to recognise that relationships with funders often present challenges for charities. However, at Mentor UK, I felt more directly under pressure from Home Office politicians not to criticise the UK Government’s drug policy while they funded the Drug Education Forum, which we hosted and I chaired, than I ever did from Diageo.

The only other contact I had with Diageo before joining SHAAP was when I was commissioned by Comic Relief to undertake a confidential review of their relationships with the alcohol industry. This indicated their recognition of the need to think carefully about these matters.

The first publication produced at SHAAP after I joined (http://www.shaap.org.uk/UserFiles/File/SHAAP%20Irresponsibility%20Deal%20AmendedMay13.pdf ) was titled “The (Ir)responsibility Deal?: Public Health and Big Business”. The title deliberately alluded to the ethical tightrope that has to be walked in managing relationships with economic operators. Our paper drew attention to similarities between large parts of the Alcohol, Tobacco and Food industries and challenged specifically,

“some tactics employed by the alcohol industry to subvert or circumvent legitimate public health policy interventions …in spite of the precedence given in domestic and EU law to the protection of human health over economic interests.”

I was not involved with Mentor UK when the UK’s Responsibility Deal was set up. I am not able to comment on whether it was appropriate for Mentor UK to join it or to remain in it. However, I disagree with Mentor UK’s assertion (http://www.mentoruk.org.uk/2014/06/where-does-mentors-funding-come-from/, accessed 28th June 2014) that:

“It is…disingenuous to assume that the alcohol industry is deliberately using corporate philanthropy to gain influence inside government and sow division in the public health community.”

Although this may not be the only reason for alcohol industry corporate giving, my experience as a player in the battles on Minimum Unit Pricing in Scotland and at EU level lead me to conclude that it is often, perhaps always, a motivating factor. With colleagues, I have headed our assault on what we believe to be outrageous behaviours by some alcohol industry operators, including Diageo, in challenging evidence-based public health measures to reduce alcohol-related harms. (For example, http://www.youtube.com/watch?v=TR6c2ZXrlVw&feature=youtu.be , http://www.gcph.co.uk/latest/blogs/504_alcohol-related_harm_in_glasgow_a_national_city_and_neighbourhood_perspective ).

Notwithstanding this, in my view, it does not benefit the Public Health cause to misrepresent the ethical positions and actions of charities like Mentor UK, which have left the charity feeling accused of (http://www.mentoruk.org.uk/2014/06/where-does-mentors-funding-come-from/, accessed 28th June 2014),

“a dishonesty that could damage our reputation as a leading voice against alcohol misuse among young people.”

I am certain it was not the intention of the researchers to do this. However, and also as a researcher myself, I am always conscious that I operate in a complex and political environment. I therefore have a responsibility in relation to checking out what I assert in publications and thinking about the resultant impact. That’s my personal ethical position.

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Brewing up a storm – Carlsberg admit influencing EU Alcohol Policy

McCambridge et al (“Industry Use of Evidence to Influence Alcohol Policy: A Case Study of Submissions to the 2008 Scottish Government Consultation”, PLOS Medicine, 2013) have asserted that whereas the tobacco industry has been excluded from direct influence in policy making in many countries, alcohol industry actors continue to exercise a strong influence on alcohol policies across the world. Protecting their profits, they consistently oppose whole-population approaches, promoting instead targeted interventions that focus on a supposedly problematic minority of drinkers and emphasising the role of individual responsibility. In Scotland, hiding behind the ‘gloss’ of Scotch Whisky, as a front to purvey their cheap vodkas, Big Alcohol has blocked the implementation of Minimum Unit Pricing, despite the legislation being enacted to introduce this life-saving policy with no Parliamentary opposition (apart from the one unfortunate MSP who pressed the wrong button when voting).

McCambridge et al state that the alcohol industry is actively involved in drafting policy documents in low-income countries. However, we ought not to be complacent about what happens closer to home, and in Europe specifically. Alcohol is the world’s number one risk factor for ill-health and premature death among 25-59 year-olds, a core of the working age population. Europe is the heaviest drinking region of the world and alcohol is a major threat to the public health, safety and economic prosperity of EU citizens. Consumption levels in some EU countries are around 2.5 times higher than the global average. There is clear and comprehensive evidence that reducing alcohol-related harm across the EU requires regulation to reduce alcohol consumption, through the whole population. This includes actions on availability, marketing and price, all of which are consistently opposed by global alcohol producers.

The World Health Organisation has provided clear guidance that the alcohol industry’s activities should be restricted to their core roles as developers, producers, distributors, marketers and sellers of alcoholic beverages and that they should have no role in the formulation of alcohol policies, which must be protected from distortion by commercial or vested interests.

My current experience in Europe indicates that the governance arrangements to ensure that this happens may be insufficient to protect this position.

I represent Public Health interests as a member of the EU Alcohol and Health Forum, which also includes industry representatives. The governing document of the Forum and all guidance related to it makes clear that EU policy on Alcohol should be determined by member states, with no interference from industry. Current events, however, demonstrate that industry knowingly influences policy. Member states are currently working on an EU Action Plan, which conveniently ignores measures to reduce alcohol consumption across the whole population. In line with industry’s priorities, the focus is on binge or problem drinking, young people and reducing foetal alcohol harm. No danger to Big Alcohol’s profits if the rest of us keep on drinking as usual, encouraged by their advertising and promotions.

The main business of the Forum is to deliver and report on commitments in relation to existing EU policy. However, this week its members have been asked to supply commitments in relation to the draft objectives in the latest draft of the new Action Plan, although the latter has not yet been signed off by member states. By asking for commitments before objectives are finalised, the Commission is opening the door for Forum members – including the alcohol industry – to influence which objectives end up in the final version of the plan. (For example, if SAB Miller look at draft Objective 1 and make 20 commitments to it, you would expect that draft Objective 1 would be likely to stay and be prioritised.)

EU Commission officials continue to hold the line that the Forum does not influence policy. However, the industry are confident of their ability to do this. In an email sent to me in error yesterday by Carlsberg’s representative, (in Danish), discussing my objections to what is going on, he stated:

“It is an absurd discussion around policy in general. Of course we all influence policy.”

Eric Carlin: Young people, alcohol and (the troubling concept of) ‘resilience’

BSA Alcohol Study Group Blog

I’m delighted to have the opportunity to present in Cardiff some thoughts about young people and alcohol drawn from my PhD research which is exploring the usefulness of theories of ‘social exclusion’ and ‘resilience’ to describe contemporary youth transition experiences in Pilton, a disadvantaged neighbourhood of Edinburgh.

My fieldwork was conducted between July 2012 and March 2013 and I am currently analysing findings and writing up.  I recruited young people (aged between 16 and 23) and people who work with them from youth centres and colleges and advertising in the local community newsletter. I also held two focus groups with local mothers.

The theoretical context has been strongly influenced by the sociology of Norbert Elias, who believed that human beings are engaged in a ‘civilising process’. He argued that we should study the constantly changing figurations that  individuals, families and others in society engage in with each other. I therefore…

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Glasgow Pride? Yes, but for some LGBT people, get a grip on your drinking behaviours!

I went to my first ever  Glasgow LGBT Pride event on Saturday, rather proud and excited that this city,  for so long riven by sectarianism and daily violence, had changed so much while I was away that it could – safely – host such an event.  I’ve written before about my ambivalence towards this city. Many LGBT people, like myself, had been driven away from the city in our youth, in large part to escape the prejudice and fear that growing up there, or in my case, in one of its feeder towns, Coatbridge, caused us. Nonetheless, I have always remained proud of my West Coast, working-class heritage, which in many ways has helped to define me as much as my sexuality has.

I took my partner along and was explaining to him on the way to Glasgow Green what an enormous shift had taken place in a very short period of time. So far, so good.

When I got to Glasgow Green I was surprised that there was a tent selling alcohol which was cordoned off from the rest of the festival. This meant that, rather than as I had experienced at festivals elsewhere, there weren’t families and groups having picnics, including wine, watching the free concert.  The few people who were drinking outside the cordon were being stopped and warned by the police, a result of a local bye-law to try to prevent alcohol-related disorder. This meant that those who were drinking alcohol legally were fenced uncomfortably, like pigs in a pen. “How ridiculous”, I said to my partner. Surely at an event like this, people could be allowed to celebrate, to let their hair down for one day in the year, to celebrate the huge achievements our community has made. Isn’t it insulting to them to assume that they need to be policed to ensure they behave? How wrong I now realise I was.

In my professional capacity, now working on alcohol policy, I have myself been accused on TV very recently of being a public health kill-joy who wants to restrict the rights of the sensible majority because of the behaviours of a small minority, policing people’s health behaviours with regulations that interfere with their individual choices in an unwarranted fashion. Of course, that’s not the case. However, alcohol is a regulated commodity and a drug and people will differ on what is appropriate. We must all be open to changing our positions based on the evidence that is available to us.

The connection between alcohol and violence has been well-documented by many researchers. They often differ on the causality of the relationship but there is consensus that where violent behaviours occur, alcohol is often somewhere around. In my current PhD research, many young people have described to me how, rather than places of festivity, alcohol often turns their parties into violent occasions. One young man expressed it thus:

“Ye get people that just go out, get full ae drink and just, somebody’ll look at them, somebody’ll just look at ye and that’ll be it. “What are ye looking at?””

Easy for me as a middle-aged man to think that that only happens at young people’s parties. However, at various times in Glasgow on Saturday (and not late at night – I’d made my exit long before that), I saw drunken women fighting with each other, men and women throwing up in the streets, women falling down. Finally, to top it all off, I was personally whacked in the face by a six foot six man’s shoulder as he flew towards me, having been punched in the face and knocked off his feet in an argument he was having with another man in a city centre gay pub. I didn’t know them. Just wrong place, wrong time.

Loic Wacquant’s research in French banlieues and US ‘ghettos’ unearthed experiences of what he calls an “extraordinary prevalence of physical danger and…acute sense of insecurity” (Wacquant 2008,p.54). He contextualises the daily experience of young people in these areas within what he calls “violence ‘from above’” (2008, p. 24). His thesis is that poor urban young people are constantly abused by the impacts of macro—level socio-economic change including, mass unemployment, relegation to decaying neighbourhoods and a heightened stigmatisation in their daily lives. Violent responses to this, though often self-destructive for individuals and communities, are easily comprehensible. 

I am disappointed by what I experienced this week in Glasgow. Is it possible that the Glasgow experiences of social disadvantage, combined with continuing prejudice against LGBT people from establishment figures, including a not-long-departed-in-disgrace Cardinal, influences some of them, instead of celebrating their diversity in a festival of celebration, to ape the worst behaviours of macho, boorish, prejudiced, drunken (mainly) men?

I wasn’t feeling very proud of the LGBT community in Glasgow on Saturday evening. I was proud though of the very considerate and kind bar staff who gave me ice to put on my cheek. Proud also that working-class people in places like Glasgow are standing up for equality. Proud that many people had dressed up and had fun.

I’m very grateful to so many LGBT activists who give so much  time and effort to celebrate our community and to champion equal rights in marriage, employment, immigration and a host of other areas.

To the others, in local parlance, I’d say, “Get a grip!” We can discuss appropriate health behaviours but violence? Really?

 I missed Heather Small who closed the Pride festival on the Green. The words of her song “Proud” may be a little trite but still pertinent:

“What have you done today to make you feel proud?
It’s never too late to try
What have you done today to make you feel proud?
You could be so many people
If you make that break for freedom
What have you done today to make you feel proud?”

Wacquant, L. (2008) Urban Outcasts. Cambridge: Polity Press.

 

Risk and Responsibility

In “World at Risk” (2009), Ulrich Beck asserts that we now live in a Risk Society where the old institutions of industrial society – family, community, social class – have been undermined by the process of global modernisation and where individuals have to learn to navigate society for themselves. Beck does not suggest that we face a world of “unprecedented dangers”; rather that we live in conditions of “manufactured, self-inflicted insecurity.”

Beck’s thesis can provide a backdrop for many current ethical and moral debates. These include discussions about what should be the role of the state in public health interventions and where individuals should be left alone to make their own decisions, based on their individual assessment of risk and with a moral sense of responsibility. This ‘individualism’ conflicts markedly with Elias’ assertion in “What is Sociology?” (1970) that we are interdependent: the term individual can only be understood as referring to interdependent people in the singular, society referring to interdependent people in the plural.

How we organise our social and economic systems relies on the dynamic interweavings in which we engage. The limitations of our linguistic and conceptual abilities lead us into and trap us in dualistic debates about rights versus responsibilities that neglect human complexities and dynamism and how more powerful groups exert power over weaker groups. Thus, for example, poor people rather than globalisation are blamed for their ‘cultures of worklessness’ and the duty of individuals to “drink responsibly” is emphasised over corporations’ responsibility to promote their goods in an ethical fashion.

In 1970, Elias discussed what he saw as the fetishisation of the hydrogen bomb and argued that people projected their fears and blame onto it and the scientists who created it rather than taking responsibility for their own complicity in the reciprocal hostilities which led to its creation. Contemporary discussions about issues such as child abuse follow the same tangent; rather than considering how we have encouraged the development of a culture where sexualised imagery, whether or not involving children themselves, is displayed to them, we lament the discovery that ‘much-loved’ entertainers have been monstrous sexual predators. The individualistic culture responsibilises those monstrous individuals and the ‘victims’, i.e. those who suffer the most demonstrable harm at an individual level are deemed to be unfortunate. We convince ourselves that society has changed, that such abuse is terrible but exceptional.

As individuals and as a society, we carry on as before in our “manufactured, self-inflicted insecurity”.

Aged 16-20 in West Pilton and want to talk to a researcher?

Interviewees wanted

Are you aged 16- 20?

Do you live in West Pilton?

Can you spend 45 minutes to tell me what it’s like growing up and living here?

£10 will be paid for your time.

I want to interview young people, aged 16-20, to find out about their experiences of becoming adult in Pilton. The interviews will take around 30-45 minutes.

The interviews will be totally confidential and no personal details, including your names, will be shared with anyone outside the interviews.

All interviews will be held on the premises of Edinburgh’s Telford College, Granton Campus or Pilton Youth and Children’s Project. A fee of £10 will be paid to each volunteer once the interview has been conducted.

If you are willing to take part, please email me on ecarli01@mail.bbk.ac.uk or call me on 0750 5081784.

Thank you!

Eric Carlin

This study is part of my PhD degree in the Department of Geography, Education and Development Studies, Birkbeck, University of London. The study has received ethical approval and is supervised by Dr. Paul Watt who may be contacted at: Department of Geography, Education and Development Studies, BIRKBECK, University of London, Malet Street, London WC1E 7HX, Tel: 020 7631 6000.