The first part of just-drinks February management briefing, which considers the alcohol debate, turns the spotlight on the US. Ben Cooper looks at an arena where the debating is at its fiercest.

The strength of the religious right in the US, coupled with the fact that the country enacted Prohibition as an alcohol policy within living memory, may go some way to explaining why neo-prohibitionist groups have tended to find support in the country (though the American experiment with alcohol Prohibition between 1919 and 1933 arguably provides more evidence against banning alcohol than for it).

While there are temperance-linked groups involved in the alcohol debate all over the world, the US boasts more than its fair share. Some are labelled neo-prohibitionist, though this is not a term the organisations would themselves use.

Interestingly, while the arrival of President Obama in the White House has led to tighter regulation being mooted in areas such as junk food advertising, the alcohol industry has not yet been targeted by the new administration. Nevertheless, it remains firmly in the cross-hairs of many campaigners.

Alcohol policy activism in the US

Unlike temperance campaigners of the 19th century, who saw alcohol itself as the problem, ‘anti-alcohol’ groups of today are far more focused on the alcohol industry, and nowhere is this more the case than in the US. There is a spectrum of opinion across these groups with the neo-prohibitionist tag fitting some better than others.

They campaign against what they see as pernicious tactics by alcohol marketers and for changes in the law which would restrict commercial freedoms enjoyed by alcohol companies. They also perceive a need to counter-balance the lobbying muscle and political influence of the industry. 

Among the most prominent of these is the California-based Marin Institute which “envisions communities free of the alcohol industry’s negative influence and an alcohol industry that does not harm the public’s health”. The organisation says it “fights to protect the public from the impact of the alcohol industry’s negative practices” by monitoring and exposing the industry’s “harmful actions related to products, promotions and social influence” and helping communities to reject “these damaging activities”.

Marin obtains its core funding from the Buck Trust but has also obtained grants from the Center for Substance Abuse Prevention (CSAP), a unit of the Department of Health and Human Services, which has angered critics who view the granting of federal funds to such groups as inappropriate.

The focus on monitoring what the industry is doing is epitomised in the mission statement of the Center on Alcohol Marketing and Youth (CAMY).

CAMY says it seeks to “monitor the marketing practices of the alcohol industry to focus attention and action on industry practices that jeopardise the health and safety of America's youth” and “reduce high rates of underage alcohol consumption and the suffering caused by alcohol-related injuries and deaths among young people”. This requires the use of public health strategies to limit the access to and the appeal of alcohol to underage persons.

CAMY has received funding from the Pew Charitable Trusts and the Robert Wood Johnson Foundation (RWJF), a charity created by the will of Johnson & Johnson magnate Robert Wood Johnson II which has itself been labelled as neo-prohibitionist by some, owing to its funding of organisations pushing for tighter regulation.

Mothers Against Drunk Driving (MADD) was formed in 1980 as an organisation to help victims of drink-driving and to increase public awareness of the issue. The organisation’s aims have changed over the intervening 31 years, as shown by successive redrafting of its mission statement. MADD now states: “The mission of Mothers Against Drunk Driving is to stop drunk driving, support the victims of this violent crime and prevent underage drinking.”

MADD cites evidence on its website suggesting children who begin drinking young are seven times more likely to be involved in an accident. This may help to explain the broadening of its agenda but critics have suggested the group has become over-politicised and has adopted an increasingly neo-prohibitionist stance. 

In 2002, MADD founder Candy Lightner left the organisation stating that it had “become far more neo-prohibitionist than I had ever wanted or envisioned”. In an interview with the Washington Times, Lightner said: “I didn't start MADD to deal with alcohol. I started MADD to deal with the issue of drunk driving.”

Consumer advocacy group Center for Science in the Public Interest (CSPI) had been a prominent participant in the alcohol policy debate but ceased campaigning on alcohol issues in 2009 due to funding issues. However, its former alcohol specialist, George Hacker, remains active in the international alcohol policy arena as a board member of the Global Alcohol Policy Alliance (GAPA).

Medical organisations

The American Medical Association (AMA) is another organisation that has been accused of becoming over-politicised in its views on alcohol consumption. Libertarian sociologist Professor David J. Hanson of the State University of New York at Potsdam, who has researched and written on neo-prohibitionism and has received funding from the drinks industry, asserts that AMA promotes a “temperance-oriented agenda”.

AMA certainly holds trenchant views on alcohol availability and marketing. Among numerous positions on alcohol, it campaigns for the total statutory prohibition of alcohol advertising except for inside retail or wholesale outlets. 

In contrast, the Institute of Medicine (IOM) advises: “Drink alcohol in moderation, if you drink, and avoid addictive drugs. Used in excess, alcohol is a poison. But low amounts - one or two drinks per day - have some beneficial effects on blood lipids.” The IOM has also supported the idea of a multi-stakeholder approach to tackling underage drinking, involving the alcohol industry.

Government public health agencies

Government agencies with responsibility for alcohol policies include the Food and Drug Administration (FDA), the Federal Trade Commission (FTC), the Bureau of Alcohol, Tobacco, Firearms and Explosives and the Department of Health and Human Services.

As regulators, they may come into conflict with alcohol companies, such as recent FDA interventions over alcoholic beverages with added caffeine. But, in general, the exchanges between industry and government agencies tend not to be as charged as those with non-governmental groups. This may reflect the industry’s expertise in government relations but also says something about how the agencies themselves approach their relationship with industry. 

The agencies help to shape policy but, as heads of agencies such as FDA and FTC are appointed by the administration, their tone will reflect the elected government’s thinking on alcohol. In recent times no administration, Republican or Democrat, has supported the more draconian alcohol policy measures advocated by certain extreme activists. When the Stop Act, which introduced a raft of measures aimed at tackling underage drinking, was passed into law in 2006, it was welcomed by a wide range of industry bodies and by campaigners.

By and large, the current positions of the major government agencies regarding the control of alcohol appear to be ones that the industry can work with.

The Surgeon General’s Call to Action to Prevent and Reduce Underage Drinking, issued in 2007, was an extensive raft of measures to tackle underage consumption involving government agencies and other organisations. Notably, it did not include the industry as one of those stakeholders. But, it fell some way short of advocating the measures proposed by some campaigners. FTC, meanwhile, has continued to endorse industry self-regulation of alcohol advertising following a review completed in 2008.

To read the introduction to this management briefing, click here.

Part II can be seen here.