What is the problem?
The concept of framing is “what we emphasise, how we explain an issue, and what we leave unsaid”. The framing of public health issues influences how they are understood and addressed by researchers, professionals and the wider public. For example, if we mainly understand alcohol or gambling harm to be a result of individual actions and choices rather than considering the wider environment and influences, then we might focus on solutions that target individuals, such as education about product harms, rather than thinking about wider regulation of the availability and promotion of these products and the actions of these industries.
Studies of industries whose products are harmful to health show that they use strategies to ensure more favourable framings to inform how we come to understand the harm and solutions in relation to their products. Educational materials put out by unhealthy commodity industries (including alcohol and gambling) focus on individual responsibility and other framings favourable to business practices. This is part of growing evidence of a longer-term history of industry influencing understanding about alcohol harms, including efforts to influence science and policymaking. Most of the existing research has focused on analysing industry materials related to government consultation and policymaking.
One way in which unhealthy commodity industry organisations can potentially influence the framing of harms and solutions is by providing sponsorship to specific conferences or being involved in deciding what is on the agenda at these conferences. There is an inherent conflict of interest when these industries, which need to profit from selling health-harming products, may have the opportunity to influence conferences aimed at health professionals and researchers.
What did we do?
Our recent study published in the Journal of Studies on Alcohol and Drugs aimed to identify industry-funded gambling and alcohol conferences and then to analyse materials to explore similarities or differences in the framings they employed.
We identified conferences held between 2016-21 that had received ‘industry funding’. We defined this term in two ways:
- They had visible sponsorship from an alcohol or gambling producer.
- They had visible funding or links to a third-party organisation demonstrating links to the alcohol or gambling industry on their website or in the existing literature.
For our identified conferences we collected publicly available materials from the internet, ensuring that we had a full agenda for each conference and information about the intended conference audience. We only included conferences aimed at professionals in public health research or healthcare (not those just aimed at industry attendees).
We then undertook a framing analysis which involved coding the conference materials and then grouping together to form sub-themes and then wider themes. This approach was informed by similar analyses of industry materials.
What did we find?
All the conferences included in our sample had target audiences outside of the product industry specifically mentioning healthcare professionals, policymakers or researchers. In addition, some of these conferences offered professional development points for attending them.
We found four main frames in the materials for both the gambling and alcohol conferences. These were:
- Emphasising the complex link between product consumption and harm.
While it is widely understood in the public health community that drivers of harm and disease can be complex, we found examples of a complexity framing which emphasised the benefits of consumption and mediators or confounders of the relationship between product consumption and harm. Research has found that this complexity framing is a characteristic of harmful industry arguments and may be intended to cloud the independent relationship between these products and their harms.
- Focus on the individual.
This framing was widespread throughout the materials, including the use of ‘problematic’ and ‘responsible’ consumption and promoting educational initiatives as a preferred solution.
- Deflection from population-level approaches.
This frame highlighted certain demographic groups as being more vulnerable to product harm without mentioning the universal impact of these products and their broader harms.
- Medicalisation/specialisation of solutions.
This frame included promoting pharmacological treatments and artificial intelligence as ways to reduce harm, suggesting that a medical or specialised approach to harm reduction is needed while neglecting population-based approaches.
These are similar to frames found in other industry materials in previous studies (Cowlishaw & Thomas, 2018; Savona et al, 2020; Knai et al., 2021; van Schalkwyk et al., 2021).
Why does this matter?
Our study is the first paper to our knowledge to undertake a framing analysis of materials from industry-funded alcohol and gambling conferences.
These four similar framings all focus on the individual as the locus of the problem and the target of harm reduction. Previous research has suggested that this is favourable to industries as it allows them to avoid restrictions on business practices and to avoid responsibility for harms. Demonstrating the common framings across multiple products and in numerous settings helps build a comprehensive picture and toolkit for understanding and challenging these framings.
Although we could not examine the amount of funding and if and how the funding influences the individual conference content, the funding of some conferences can shape the research landscape over time and allow particular framings to dominate over others. This mainly relates to frames with an individual focus on harms and solutions, whilst deflecting attention from broader policy measures and more population-level solutions (such as restricting access to alcohol or gambling).
Conclusion
Our study found industry-favourable framings of harms and solutions at industry-funded alcohol and gambling conferences, with a particular focus on individual responsibility for harms and solutions related to alcohol and gambling.
When attending or presenting at conferences, it is essential to consider the conference funding and other forms of sponsorship, and whether these are reflected in the overall framing, messages and themes of the conference, and who might benefit from these.
Written by Dr Kate Dun-Campbell, Dr May CI van Schalkwyk, Professor Mark Petticrew & Dr Elizabeth McGill, London School of Hygiene and Tropical Medicine and Dr Nason Maani, University of Edinburgh.
All IAS Blogposts are published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Institute of Alcohol Studies.