You’re About to Hear More About the Evils of Big Alcohol. Here's Why

It’s not just the drink itself being demonised, but the companies who make it

Academics and lobbyists who spend their days thinking about alcohol policy have a big problem: they have a completely different way of looking at alcohol harms than the general public.

This means there’s no popular support for the alcohol control measures they’re pushing.

So the public health lobby has put a lot of thought and research money into how they can get the public to come around to their point of view — and they may have found the answer.

Photo by Martin Martz on Unsplash

The perception mismatch

The public’s view is that you shouldn’t drink when pregnant, you shouldn’t drink and get behind the wheel of a car, and you shouldn’t get drunk and cause trouble. If you do, your sorry arse is going to end up in court, and that’s on you.

The public also knows that if you drink a lot over a long enough period, you’re at risk of doing fatal harm to your liver and other organs. They firmly believe that children shouldn’t drink or be marketed to.

And people think that when alcohol becomes a problem, individuals need treatment.

The OECD agrees. Having crunched the numbers, it argues that the best and most cost-effective ways to tackle alcohol harms include making treatment options easy to get, making sure alcohol isn’t too cheap, and getting the police to crack down on drunk driving and alcohol-fuelled disorder. If you know you’re going to get breathalyzed, you’re almost guaranteed to stay within the limits.

The public health lobby, on the other hand, sees alcohol as a population level or “whole of society” problem, where people who drink moderately and stay out of trouble are actually enabling heavy drinkers; this is known as the Total Consumption Model. So their goal is to get everybody to drink less — or, better still, stop drinking altogether — regardless of who has an alcohol problem and who is just fine.

(This is why they’re often called the neo-Prohibitionist or neo-temperance lobby. These are terms the public health lobby considers insults that are intended to delegitimise and undermine their work. On the other hand, the head of one of Europe’s anti-alcohol lobbies frequently refers to people in alcohol as “the baddies” and “the enemy”, so pots, kettles.)

Public health academics are also increasingly embracing an idea called the Commercial Determinants of Health, which see alcohol harms as something that are primarily a consequence of the alcohol industry pursuing profit, as opposed to any other social drivers.

To reduce the level of drinking in the population, the public health lobby want governments to raise taxes on alcohol, restrict its availability, ban marketing and advertising, and change fundamental social norms around drinking — basically, they want to take all the tactics they used against smoking and apply them to alcohol. It’s a strategy called ‘denormalisation’.

And I mean it when I say “they used” — many of the people now involved in alcohol control came out of tobacco control, so they have a template ready to go.

Anyway, here’s the problem: the public health lobby struggles to convince governments to impose these measures, because they’re pretty unpopular, and not just with the alcohol industry. Most people see these kinds of interventions as something between a cash grab and an assault on civil liberties.

So a fair amount of research money and brain power has gone into working out how to change the public’s hearts and minds. The results have just been published in the journal Addiction.

A new framing for alcohol

In 2021, the alcohol campaign group Alcohol Change UK — Dry January is one of their signature achievements — entered into a three-year partnership with the University of Stirling, with a handful of other universities bringing up at the rear. They worked with FrameWorks, a communications research company, and did the following:

1. Looked at existing academic research;

2. Conducted four focus groups, to try and understand what the public thought about alcohol (and discovered that the public associates alcohol with pleasure);

3. Developed different ways of framing alcohol harms;

4. Held online focus groups to test three of these communication strategies;

5. Launched an online experiment involving 2,997 people. Individuals were randomly assigned to one of 12 messages, and then asked about their agreement; and

6. Packaged the most successful messages in a communications toolkit.

Here are some messages that failed:

• The truth is that alcohol is not essential to anything.

• We can reduce harm from alcohol and enjoy life.

• When we drink alcohol, it’s hard to stay safe in the shallows.

• Anyone who drinks alcohol can experience alcohol harms or problems.

Here’s what worked:

“Based on the online experiment, the most effective framing approach at changing public attitudes in the desired direction was a value-based approach focusing on the public not being told the truth about the harms of alcohol (no. 2: There are more harms from alcohol, of many different kinds, than we are told).”

My paraphrase:

Big Alcohol is Lying to You

This really worked. After they’d heard the messaging, people said things like “I think it all sounds totally credible and it makes me feel like I’m probably being duped” and “I think the government needs to, you know, interfere a bit with alcohol companies”.

What comes next

A toolkit has been developed for alcohol charities, lobby groups, and basically anybody involved in talking about alcohol to the public.

In it, they advise using words like ‘truth’, ‘honesty’ and ‘secrecy’, to “show how we’re not told the full story about the alcohol we consume”. The toolkit gives examples of this dishonesty, like the way that alcohol producers don’t tell consumers that drinking any amount of alcohol carries health risks. Probably because it’s not true, as per December’s report from the National Academies of Sciences, Engineering and Medicine (NASEM). Other dishonest tactics employed by the alcohol industry include not having side effects listed on the bottle, not having tobacco-style warnings plastered everywhere, and not being explicit that alcohol can wreck your sleep.

Another message they want to roll out is that the only reason alcohol is part of social occasions like weddings is because “big alcohol companies” put it there. This would have come as an enormous surprise to those raising a toast to the happy couple back in Graeco-Roman times, but of course, they weren’t very sophisticated back then. That’s why they didn’t realise that when Jesus turned water into wine at the wedding in Cana, he wasn’t revealing that he had divine powers, but launching history’s most memorable alcohol marketing campaign.

Back to the toolkit. It advises communicators to stay away from mentioning the cost of alcohol to the health system, or mentioning addiction, because it might reawaken those old beliefs about alcohol problems being something that happens to other people.

And, finally:

Always pair this story with concrete policy solutions which will reveal the truth

(such as labelling regulations and marketing restrictions) to avoid fatalism

and show that change is possible.

And

Talk explicitly about the fact that we can change this.

And that’s how you get the public to agree to tobacco-style regulations.

International implications

This is a UK initiative right now, and it’s the basis for discussions with the public, rather than a widespread media campaign. But it’s slick and professional research which academics are watching closely, to see how it plays out.

The alcohol control community is small and close knit, much like any group of professionals. They all know each other, with the same names popping up at international conferences and seminars. So they watch what’s happening elsewhere and then recommend it in their own country. When the Canadian Center on Substance Abuse and Addiction (CCSA) created their latest drinking guidelines, for example, they drew heavily on work done in Australia.

Tl;dr If this messaging is successful in the UK, it will be rolled out elsewhere.

I imagine it will be highly effective. There’s public health research on young people and drinking that’s being published in the next few months; one of the lead researchers has said that one of the things that came out very clearly, across a number of countries, is how suspicious young people are of neoliberal capitalism — they assume the commercial sector is lying to them.

Of course, they’re not the only ones. We’ve all suffered from the various enraging practices of powerful corporations, making this kind of message feel intuitively correct.

So get ready to hear more about the nefarious schemes of Big Alcohol, particularly in light of the recent Surgeon General’s announcement.

And the next time you’re thinking about serving wine with dinner, stop and remind yourself — you only want to because Big Alcohol told you so.