Dr Gemma Mitchell, Institute for Social Marketing and Health, Faculty of Health Sciences and Sport
In 2018, a $100 million clinical trial on how ‘moderate’ drinking affects health was cancelled in the US. This was because it was found to be biased towards producing findings that small amounts of alcohol have health benefits. The trial was paid for by both the alcohol industry and the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the self-described largest funder of alcohol research globally. Researchers, industry, and NIAAA officials were found to have worked together to produce this biased trial. If successful, it could have influenced millions of people across the globe to think (wrongly) that good quality science was telling them to drink alcohol for the sake of their health.
This scandal led me and Professor Jim McCambridge to ask: what other contacts do NIAAA officials have with the alcohol industry, what topics do they discuss, and does the alcohol industry try to influence NIAAA decision making?
What we did
We sent two Freedom of Information Act requests in 2020 and 2021 to the National Institutes of Health, the parent organisation of the NIAAA. We scientifically analysed the 4784 pages of email correspondence (including attachments) we received as a result.
What we found
We found 43 NIAAA officials interacting with 15 alcohol industry groups between 2013-2020. NIAAA leaders gave the alcohol industry lots of information about science and policy developments. Discussions took place by email, telephone, and in-person. They discussed a lot of different topics, including the US and UK dietary guidelines, which include advice on alcohol. I summarise what we know about the dietary guidelines conversations below.
Industry interest in the US and UK dietary guidelines
All requests by an alcohol industry trade organisation to discuss the US dietary guidelines with NIAAA leaders were granted, with that trade organisation then involving other industry groups in the discussions. A key concern from this trade association was the standard drink model used in the US guidelines, and they tried to build ‘consensus’ with NIAAA leaders on the issue.
A NIAAA senior leader also attended a trade association Annual Meeting and took part in a panel titled ‘Commercial Impact of Health Policy: Dietary Guidelines, Labeling Facts and What Makes Beer Distinct’.
Between 2013 and 2017, a separate alcohol company representative expressed concern with a NIAAA senior leader about both the US and UK Dietary Guidelines. The company was against the removal of content in the US dietary guidelines on alcohol being part of a healthy diet. They also expressed negative views about the UK drinking guidelines being changed so that the guide for men and women was the same, and suggested taking action in some way:
“Attached is a notice of the new UK guideline on alcohol. It is truly crazy!! They have lowered the guideline for men to be the same as women under the conclusion that there are only potential benefits for women 55 and older and otherwise there is a risk of cancer at any level for any one! [C]an we discuss some people to send comments. This is rockers!!.”
Alcohol company senior executive to NIAAA senior leader, 7th January 2016
The NIAAA leader responded by setting up a telephone call the same day. There were lots of other interactions between the NIAAA and the alcohol industry on this topic, including attempts to set up a meeting at an international scientific conference to discuss global drinking guidelines, although it appears the plans were cancelled by industry.
Why is this important?
As the largest funder of alcohol research globally, what this organisation says about dietary guidelines matters. It also funds the research that influences the content of those guidelines, impacting the health of millions. NIAAA leaders’ willingness to meet with the alcohol industry and discuss this and other topics is therefore hugely concerning.
We have a right to expect that publicly-funded institutions – including the NIAAA – put public health first. Our findings lead us to ask questions about whether commercial interests are influencing decision making at the NIAAA, in ways that may have a negative effect on public health.
What needs to happen next?
We need an independent investigation into how much the alcohol industry may be influencing NIAAA activity. We need to do this urgently, to protect public health not only in the US, but also globally.
This article was first published by the Institute of Alcohol Studies on 20 February 2023.