NADRA 2014: Q&A with Professor Jeff Collin

Folkesundhed

25 aug 2014

Jeff Collin is a professor of global health policy and head of social policy at the University of Edinburgh. A political scientist, his research focuses on globalisation, health governance and corporate strategies to influence public policy.

Professor Jeff Collin, what is the theme of your presentation at the Nordic Alcohol and Drug Researchers’ Assembly?

As a political scientist working in public health, my research interests focus on the role of the commercial sector in health policy. My work has focused mostly on the tobacco industry, including the central importance that health advocates and policymakers have placed upon recognition of a fundamental conflict of interest between public health objectives and the industry’s economic interests.

This strikes me as critical to the rapid development of tobacco control policies at national and international levels over the last decade. As a professor of global health policy with an interest in NCDs, I’ve become increasingly intrigued by the question of why tobacco companies are perceived as being so different from the alcohol industry, and by the implications of such perceived differences have for public health policy.

In my talk I’m looking to consider these issues with reference to evidence based policy, exploring the very similar ways in which diverse industries make appeals to evidence in seeking to oppose the development of effective policies.

Why are the alcohol industry actors in many contexts regarded as legitimate while the tobacco industry actors are not?

This is something that puzzles me. I don’t have a very convincing explanation for the extent of the difference, and I’m not sure anybody else does either! Analytically, from a public health perspective, it seems very clear that the rising global burden of NCDs should be understood with reference to industrial epidemics, and that this analysis is as applicable to alcohol as it is to tobacco.

Yet while the tobacco industry is clearly identified as the vector of the tobacco epidemic, in many contexts the alcohol industry is seen more as a key partner in health policy. The presentation will draw on my colleague Katherine Smith’s ongoing research exploring perceptions of these differences among policymakers and health advocates.

Personally, I don’t think they can be fully explained with reference to differences in the varying attributes of the products or in the structure or behaviour of the respective industries or their consumers. We need to develop a clearer analysis of the politics and economics of alcohol across national, European and international levels to better understand the comparative legitimacy of alcohol industry actors, and of ways in which this status may be questioned and challenged.

Which are the challenges to these contrasting framings?

The increasing prominence of NCDs on the global health and development agenda raises some interesting opportunities here. While the UN High Level Summit and its political declaration embodies the very different treatment of alcohol and food manufacturers on the one hand, and the tobacco industry on the other, partners vs pariahs, this just doesn’t seem sustainable.

In a context in which multiple pressures are pushing towards the integration of tobacco, alcohol and obesity strategies, the peculiarity of treating tobacco as exceptional is becoming increasingly evident. The successes of tobacco control, based on taking conflict of interest seriously, bring their own pressures to extend such approaches and discard as inadequate strategies that rely on corporate social responsibility by alcohol companies.

In which ways are key alcohol industry interests using appeals to “evidence based policy” in seeking to maintain its status?

‘Evidence based policy’ has a powerful intuitive appeal, reflected in its invocation by policymakers, health advocates and economic interests alike. I’m interested in the potential tension between evidence based policy and policy innovation. If an unambiguous evidence base becomes a pre-requisite for policy change, does this constitute a barrier to introducing radical measures like plain packaging for tobacco products or minimum unit pricing for alcohol?

My talk explores how companies are looking to exploit this conservative potential in seeking to restrict policy options. Alongside this, particular constructions of evidence based policy are also used in attempting to discredit public health researchers as biased, and as requiring the full participation of economic stakeholders both within the policy process and in the conduct of research.

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