Neither the alcohol industry nor the advocacy community is a monolithic entity. Dominant industry players include beer, wine, and distilled spirits manufacturers, who compete for consumers. The public health advocacy community often competes for state and federal budget allocations against other health issues as well as among themselves. This paper describes the relationships within and between the alcohol industry and the advocacy worlds and explores underlying reasons for the divisiveness and cohesion that exist among the players. Findings are based on 64 in-depth qualitative interviews with key informants in these communities. The differing positions that players take on a variety of alcohol control policies stem from assumptions and historical events as well as from shifting priorities of the public and politicians. The industry is divided on global environmental policies like taxation and television advertising, while the public health community demonstrates fragmentation in its valuation of key targeted policies, such as responsible beverage service and underage drinking programs.
KEY WORDS: Alcohol, policy, public health, United States.
Given the limited societal resources for the prevention and treatment of problems associated with alcohol consumption, the identification of strategies to maximize available political and financial capital is an important area for policy research. As part of the Robert Wood Johnson Foundation-funded study of the process of alcohol policy formation at the U.S. federal level, we asked industry representatives, public health advocates, and government officials to identify policy areas on which the different interest groups could potentially work together. This paper reports on what these respondents said.
When speaking about potential alcohol policies with the alcohol industry and public health advocates, we did not limit respondents to a single definition or type of policy. Discussions included global environmental control policies, which have as their goal an overall reduction in the level of consumption in the general population (policies such as reducing the hours of operation of liquor outlets, increasing alcohol taxes, and placing limits on advertising), as well as targeted policies intended to address specific groups or problem areas (like underage purchasing, drinking and driving, campus policies, and prevention of fetal alcohol syndrome). Part of our goal was to determine whether certain types of policies are off limits for consideration by one group or another.
Results address two questions that emerged from the data: First, is there consensus for particular policies within the respective communities (industry and public health)? second, what are the areas of common ground between these communities that might represent fruitful avenues for pursuing potential public policies to reduce alcohol-related problems while allowing industry profits?
Sample, data collection, and analytic approach are described elsewhere in this special issue (see Greenfield et al., 2004). Briefly, data presented here are based on 64 semistructured, mainly in-person interviews. Interviewers were doctoral (three) or master's level (two) researchers from the fields of sociology, psychology, and public health; the multidisciplinary research team included a political scientist as a consultant. Interview participants were chosen using a two-phase sampling strategy. The research team identified a core of prominent policy-community members who, when interviewed, were asked to suggest names of further contacts. This snowball sample grew in size and then leveled off in later interviews as people nominated tended to have been sampled already. A quota system was implemented to ensure a balanced representation from the industry and public health communities.
Interviews were transcribed and coded by a subset of the study team, using a code book that had been derived from the interview transcripts. …