Paula L O'Brien | University of Melbourne (original) (raw)

Papers by Paula L O'Brien

Population medicine, Apr 27, 2023

Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.

Alternative Law Journal, Sep 1, 2006

International Journal of Alcohol and Drug Research

From comparisons of World Health Organization statistics, it is clear that people in lower-income... more From comparisons of World Health Organization statistics, it is clear that people in lower-income countries experience more harms per litre of alcohol and different types of harms compared to those from higher-income countries. Yet studies in higher-income countries dominate research on policies to prevent alcohol problems. The paper reports on results of collaborative work to map priority areas for research relevant to low- and middle-income countries. Research focus areas were identified and discussed among potential coauthors from diverse fields with relevant knowledge, with agreement reached on an initial list of seven research priority areas. Areas identified include: (1) the effects of choices (e.g., national vs. local, monopoly vs. licensing system) in organising the alcohol market; (2) involvement/separation of alcohol industry interests in decisions on public health regulation; (3) options and effectiveness of global agreements on alcohol governance; (4) choices and exper...

Medical Law Review, Apr 29, 2023

For doctors with mental health or substance use disorders, publication of their name and sensitiv... more For doctors with mental health or substance use disorders, publication of their name and sensitive medical history in disciplinary decisions may adversely impact their health and may reinforce barriers to accessing early support and treatment. This article challenges the view that naming impaired doctors or disclosing the intimate details of their medical condition in disciplinary decisions always serves the public interest in open justice. We analysed and compared the approach of Australian and New Zealand health tribunals to granting orders that suppress the name and/or medical history of impaired doctors. This revealed that Australian tribunals are less likely to grant non-publication orders compared to New Zealand, despite shared common law history and similar medical regulatory frameworks. We argue that Australian tribunals could be more circumspect when dealing with sensitive information in published decisions, especially where such information does not directly form a basis for the decision reached. This could occur without compromising public protection or the underlying goals of open justice. Finally, we argue that a greater distinction should be made between those aspects of decisions that deal with conduct allegations, where full details should be published, and those that deal with impairment allegations, where only limited information should be disclosed.

PubMed, Sep 1, 2013

Most health systems have historically used a mix of public and private actors for financing and d... more Most health systems have historically used a mix of public and private actors for financing and delivering care. But the last 30 years have seen many rich and middle-income countries moving to privatise parts of their health care systems. This phenomenon has generated concerns, especially about equitable access to health care. This article examines what the international right to the highest attainable standard of health in Art 12 of the International Covenant on Economic, Social and Cultural Rights says about the obligations of states which use private actors in health care. The article involves a close study of the primary documents of the key institutions responsible for interpreting and promoting Art 12. From this study, the article concludes that in mixed public-private health care systems, states not only retain primary responsibility for fulfilling the right to health but are subject to a range of additional specific responsibilities.

Victoria is the first state in Australia to legalise voluntary assisted dying. The Premier, Danie... more Victoria is the first state in Australia to legalise voluntary assisted dying. The Premier, Daniel Andrews, has described the law that comes into effect on 19 June next year as “giving Victorians with a terminal illness the compassion and dignity they deserve at the end of their lives”.

© 2019 Dr. Paula Louise O'BrienAlcohol is the favoured drug of Western nations. It brings ple... more © 2019 Dr. Paula Louise O'BrienAlcohol is the favoured drug of Western nations. It brings pleasure, but it is also the source of untold harm to the drinker, third parties and the wider society. This thesis starts from the position that regulation has the capacity to contribute to minimising the harms associated with alcohol consumption. The traditional public health view is that it is regulation by the state in the form of legislation that should be used to address problems such as alcohol-related harm. For many researchers and advocates in this field, industry self-regulation is not compatible with the pursuit of public health goals. The reason is simple: the alcohol industry and other related industries cannot be trusted because of their overriding concern with their commercial success. The alcohol industry proclaims the effectiveness of its self-regulatory efforts, and the public health arguments have little traction with governments. The thesis interrogates the competing claims about the appropriateness of industry self-regulation for alcohol control. It asks the specific question: from a public health perspective, is industry self-regulation an appropriate regulatory choice for the control of alcohol marketing and alcohol health information labelling in Australia? The areas of alcohol marketing and health information are selected as the testing ground because these two aspects of alcohol control are characterised by extensive industry self-regulation in Australia. The thesis determines the appropriateness of industry self-regulation in these areas by examining the ‘functional legitimacy’ of the regulatory arrangements. It constructs a novel analytical framework for this inquiry by distilling, organising and expanding on the ideas about self-regulation which are fragmented and under-developed across the regulatory theory literature. The analytical framework offers public health researchers, advocates, as well as government, an objective and cogent basis for determining the appropriateness of industry self-regulation in public health and other problem contexts. To apply the framework, the thesis constructs a set of objectives for alcohol marketing and health information labelling from the public health perspective, which is one of the conceptual underpinnings of the thesis. It then maps the field of regulation of alcohol marketing and health information labelling as it relates to the formulated objectives. From this mapping, two case studies of industry self-regulation are selected for detailed examination against the criteria in the analytical framework. The first relates to alcohol marketing and the ‘Commercial Television Industry Code of Practice 2018’. The second relates to health information labelling about the risks of alcohol consumption during pregnancy and the DrinkWise Labelling Scheme. The thesis concludes that industry self-regulation is not appropriate for any health information labelling. The thesis also concludes that industry self-regulation of alcohol marketing on commercial television is an inappropriate regulatory choice for protecting minors from alcohol marketing in this medium. The thesis does not reach a conclusion about alcohol marketing generally. It recommends the study of additional self-regulatory schemes for alcohol marketing and an alertness to the likelihood that self-regulation is not appropriate for any alcohol marketing. Self-regulation for alcohol control generally should also be approached with extreme caution

Drug and Alcohol Review, Mar 18, 2013

A recent decision from theVictorian Court of Appeal in Australia gives new force to the concept o... more A recent decision from theVictorian Court of Appeal in Australia gives new force to the concept of harm minimisation in liquor licensing legislation. As a result of the decision in Kordister Pty v Director of Liquor Licensing [1], harm minimisation for liquor licensing purposes is now less about dealing with harms arising from misconduct by the individual licensee and more about developing a ‘risk profile’ for a venue in light of: (i) the physical, social and cultural environment in which the venue operates; and (ii) research about the relationship between alcohol and harm.

Drugs-education Prevention and Policy, Dec 12, 2022

Aims: This narrative review considers traditional strategies for regulating alcohol marketing and... more Aims: This narrative review considers traditional strategies for regulating alcohol marketing and their applicability to digital media. Method: Drawing on international research, case studies, and reports, we examine the applicability of (1) comprehensive or partial bans; (2) placement restrictions; (3) content restrictions; and (4) counter-advertising. Results: Comprehensive bans on advertising are generally the most effective option. A partial ban applying to digital media would make some lesser contribution to reducing exposure, but will usually simply result in the promotional budget being shifted to whichever media remain less strictly regulated. Limits on the placement of marketing have more salience for traditional media than for most digital media, which can be individualized and targeted. Content restrictions play a limited role in reducing exposure as they are not concerned with marketing volume, but with the way in which alcohol is represented. Conclusions: Although these traditional strategies have a role in regulating digital media and are applied in certain international jurisdictions, new regulatory approaches are needed. These may include the use of artificial intelligence for monitoring, transparency requirements, and privacy law rights and duties. Opportunities to regulate alcohol marketing online will need to be addressed and seized as they arise in the current volatile policy environment concerning the governance of social media.

Addiction, Mar 10, 2021

I declare travel expenses, research funds and a fee from Alko, the Finnish government alcohol mon... more I declare travel expenses, research funds and a fee from Alko, the Finnish government alcohol monopoly (which is located in the Ministry for Health and Social Affairs) for a research project modelling the impact on public health of disbanding the monopoly. We had an arms-length arrangement with the funder and the right to independent publication.

International Journal of Drug Policy, Nov 1, 2013

A burgeoning body of empirical evidence demonstrates that increases in the price of alcohol can r... more A burgeoning body of empirical evidence demonstrates that increases in the price of alcohol can reduce per capita alcohol consumption and harmful drinking. Taxes on alcohol can be raised to increase prices, but this strategy can be undermined if the industry absorbs the tax increase and cross-subsidises the price of one alcoholic beverage with other products. Such loss-leading strategies are not possible with minimum pricing. We argue that a minimum (or floor) price for alcohol should be used as a complement to alcohol taxation. Several jurisdictions have already introduced minimum pricing (e.g., Canada, Ukraine) and others are currently investigating pathways to introduce a floor price (e.g., Scotland). Tasked by the Australian government to examine the public interest case for a minimum price, Australia's peak preventative health agency recommended against setting one at the present time. The agency was concerned that there was insufficient Australian specific modelling evidence to make robust estimates of the net benefits. Nonetheless, its initial judgement was that it would be difficult for a minimum price to produce benefits for Australia at the national level. Whilst modelling evidence is certainly warranted to support the introduction of the policy, the development and uptake of policy is influenced by more than just empirical evidence. This article considers three potential impediments to minimum pricing: public opinion and misunderstandings or misgivings about the operation of a minimum price; the strength of alcohol industry objections and measures to undercut the minimum price through discounts and promotions; and legal obstacles including competition and trade law. The analysis of these factors is situated in an Australian context, but has salience internationally.

The Journal of World Investment & Trade, 2020

This article considers the issues that would arise in a dispute under an international investment... more This article considers the issues that would arise in a dispute under an international investment agreement about two innovative, public health alcohol labelling policies pursued by Thailand. One measure proposes graphic health warnings on alcoholic beverages. The other measure places extensive restrictions on the words and images that producers can use on alcoholic beverage labels. We focus on the consistency of these measures with the obligations of fair and equitable treatment and indirect expropriation. We place particular emphasis on the evidence that would likely be needed to defend these measures, including the areas where the science is somewhat tentative and might therefore pose problems for ‘first-mover’ States like Thailand. We conclude that there is a good chance that the warnings measure would be found compatible with investment law obligations. However, some aspects of the marketing measure are more vulnerable to findings of inconsistency.

European Journal of Risk Regulation, 2021

In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, com... more In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, coming of age and success.1 Alcohol industry marketing creates and reinforces these cultural understandings, downplaying facts about the harms associated with alcohol consumption.2 Alcohol is also a drug, and its harm profile distinguishes it from regular foodstuffs or other consumer items. Alcohol use is causally connected to more than 200 diseases, conditions and injuries,3 with at least 25 other diseases and conditions entirely attributable to alcohol.4 These harms include non-communicable diseases (such as cancer), mental health problems (including alcohol dependence), injuries from violence and accidents, and disabilities arising from foetal alcohol spectrum disorders.5 The burden of disease associated with alcohol use is “unacceptably high”, amounting to 3 million deaths (5.3% of all deaths) and 132.6 million disability-adjusted life years (DALYs) (5.1% of all DALYs) worldwide in 2016...

European journal of risk regulation, Jun 1, 2021

In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, com... more In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, coming of age and success. 1 Alcohol industry marketing creates and reinforces these cultural understandings, downplaying facts about the harms associated with alcohol consumption. 2 Alcohol is also a drug, and its harm profile distinguishes it from regular foodstuffs or other consumer items. Alcohol use is causally connected to more than 200 diseases, conditions and injuries, 3 with at least 25 other diseases and conditions entirely attributable to alcohol. 4 These harms include non-communicable diseases (such as cancer), mental health problems (including alcohol dependence), injuries from violence and accidents, and disabilities arising from foetal alcohol spectrum disorders. 5 The burden of disease associated with alcohol use is "unacceptably high", amounting to 3 million deaths (5.3% of all deaths) and 132.6 million disability-adjusted life years (DALYs) (5.1% of all DALYs) worldwide in 2016. 6 The impacts of alcohol use also extend beyond health, and include social and economic detriments. Preventing harms from alcohol requires intervention at multiple levelsin communities and organisations, and by governments acting at the national, regional and global level. The articles in this symposium issue of the European Journal of

Drugs: Education, Prevention and Policy

Aims: This narrative review considers traditional strategies for regulating alcohol marketing and... more Aims: This narrative review considers traditional strategies for regulating alcohol marketing and their applicability to digital media. Method: Drawing on international research, case studies, and reports, we examine the applicability of (1) comprehensive or partial bans; (2) placement restrictions; (3) content restrictions; and (4) counter-advertising. Results: Comprehensive bans on advertising are generally the most effective option. A partial ban applying to digital media would make some lesser contribution to reducing exposure, but will usually simply result in the promotional budget being shifted to whichever media remain less strictly regulated. Limits on the placement of marketing have more salience for traditional media than for most digital media, which can be individualized and targeted. Content restrictions play a limited role in reducing exposure as they are not concerned with marketing volume, but with the way in which alcohol is represented. Conclusions: Although these traditional strategies have a role in regulating digital media and are applied in certain international jurisdictions, new regulatory approaches are needed. These may include the use of artificial intelligence for monitoring, transparency requirements, and privacy law rights and duties. Opportunities to regulate alcohol marketing online will need to be addressed and seized as they arise in the current volatile policy environment concerning the governance of social media.

Journal of Law, Medicine & Ethics

In most countries, the alcohol industry enjoys considerable freedom to market its products. Where... more In most countries, the alcohol industry enjoys considerable freedom to market its products. Where government regulation is proposed or enacted, the alcohol industry has often deployed legal arguments and used legal forums to challenge regulation. Governments considering marketing regulation must be cognizant of relevant legal constraints and be prepared to defend their policies against industry legal challenges.

International Journal of Health Policy and Management, Feb 17, 2021

The power of the alcohol industry pervades the global governance of alcohol. The influence of the... more The power of the alcohol industry pervades the global governance of alcohol. The influence of the industry is seen in trade and investment treaty negotiations, operating through direct and indirect means. Curbing the influence of the industry is vital to improving the treatment of health issues generally and in trade and investment policy particularly. The World Health Organization (WHO) has an opportunity to start to rein in the power of the industry with its current work on drafting an 'action plan' for 2022-2030 to implement the Global Strategy to Reduce the Harmful Use of Alcohol. The WHO working paper, however, proposes inadequate controls on alcohol industry influence. The WHO proposes 'dialogue' with the industry and allows the industry to take a role with government in public health labelling of alcohol. The public's health will suffer if the WHO does not take a firmer stand against the industry in the 'action plan.'

The Lancet Global Health, 2022

Background Accelerating progress to implement effective alcohol policies is necessary to achieve ... more Background Accelerating progress to implement effective alcohol policies is necessary to achieve multiple targets within the WHO global strategy to reduce the harmful use of alcohol and the Sustainable Development Goals. However, the alcohol industry's role in shaping alcohol policy through international avenues, such as trade fora, is poorly understood. We investigate whether the World Trade Organization (WTO) is a forum for alcohol industry influence over alcohol policy. Methods In this qualitative analysis, we studied discussions on alcohol health warning labelling policies that occurred at the WTO's Technical Barriers to Trade (TBT) Committee meetings. Using the WTO Documents Online archive, we searched the written minutes of all TBT Committee meetings available from Jan 1, 1995, to Dec 31, 2019, to identify minutes and referenced documents pertaining to discussions on health warning labelling policies. We specifically sought WTO member statements on health warning labelling policies. We identified instances in which WTO member representatives indicated that their statements represented industry. We further developed and applied a taxonomy of industry rhetoric to identify whether WTO member statements advanced arguments made by industry in domestic forums. Findings Among 83 documents, comprising TBT Committee minutes, notifications to the WTO of the policy proposal, and written comments by WTO members, WTO members made 212 statements (between March 24, 2010, and Nov 15, 2019) on ten alcohol labelling policies proposed by

University of New South Wales law journal, 2014

There is intense conflict between public health advocates and the alcohol industry about the cont... more There is intense conflict between public health advocates and the alcohol industry about the content of alcohol beverage labels. Public health advocates are calling for health warnings and other product information. The industry is resisting, seeking to protect its ‘valuable label real estate’. This article reviews the current Australian laws on alcohol beverage labeling and analyses the public health proposals for reform of these laws, the industry’s arguments in opposition, and the federal, state and territory governments’ resistance to multiple attempts to bring these proposals into law from 1996 to 2013. The article finds that there are certain evidentiary issues which have dominated the debate about alcohol labelling in Australia since 1996. This article also identifies two significant shifts in the labelling debate: one arising from the recent widespread acceptance of the evidence of harm from drinking during pregnancy; the other related to the industry and governments’ recent...

Population medicine, Apr 27, 2023

Population Medicine considers the following types of articles: • Research Papers-reports of data ... more Population Medicine considers the following types of articles: • Research Papers-reports of data from original research or secondary dataset analyses. • Review Papers-comprehensive, authoritative, reviews within the journal's scope. These include both systematic reviews and narrative reviews. • Short Reports-brief reports of data from original research. • Policy Case Studies-brief articles on policy development at a regional or national level. • Study Protocols-articles describing a research protocol of a study. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Methodology Papers-papers that present different methodological approaches that can be used to investigate problems in a relevant scientific field and to encourage innovation. • Letters to the Editor-a response to authors of an original publication, or a very small article that may be relevant to readers. • Editorials-articles written by the Editorial Board or by invited experts on a specific topic. Research Papers Articles reporting research may be full length or brief reports. These should report original research findings within the journal's scope. Papers should generally be a maximum of 4000 words in length, excluding tables, references, and abstract and key points of the article, whilst it is recommended that the number of references should not exceed 36.

Alternative Law Journal, Sep 1, 2006

International Journal of Alcohol and Drug Research

From comparisons of World Health Organization statistics, it is clear that people in lower-income... more From comparisons of World Health Organization statistics, it is clear that people in lower-income countries experience more harms per litre of alcohol and different types of harms compared to those from higher-income countries. Yet studies in higher-income countries dominate research on policies to prevent alcohol problems. The paper reports on results of collaborative work to map priority areas for research relevant to low- and middle-income countries. Research focus areas were identified and discussed among potential coauthors from diverse fields with relevant knowledge, with agreement reached on an initial list of seven research priority areas. Areas identified include: (1) the effects of choices (e.g., national vs. local, monopoly vs. licensing system) in organising the alcohol market; (2) involvement/separation of alcohol industry interests in decisions on public health regulation; (3) options and effectiveness of global agreements on alcohol governance; (4) choices and exper...

Medical Law Review, Apr 29, 2023

For doctors with mental health or substance use disorders, publication of their name and sensitiv... more For doctors with mental health or substance use disorders, publication of their name and sensitive medical history in disciplinary decisions may adversely impact their health and may reinforce barriers to accessing early support and treatment. This article challenges the view that naming impaired doctors or disclosing the intimate details of their medical condition in disciplinary decisions always serves the public interest in open justice. We analysed and compared the approach of Australian and New Zealand health tribunals to granting orders that suppress the name and/or medical history of impaired doctors. This revealed that Australian tribunals are less likely to grant non-publication orders compared to New Zealand, despite shared common law history and similar medical regulatory frameworks. We argue that Australian tribunals could be more circumspect when dealing with sensitive information in published decisions, especially where such information does not directly form a basis for the decision reached. This could occur without compromising public protection or the underlying goals of open justice. Finally, we argue that a greater distinction should be made between those aspects of decisions that deal with conduct allegations, where full details should be published, and those that deal with impairment allegations, where only limited information should be disclosed.

PubMed, Sep 1, 2013

Most health systems have historically used a mix of public and private actors for financing and d... more Most health systems have historically used a mix of public and private actors for financing and delivering care. But the last 30 years have seen many rich and middle-income countries moving to privatise parts of their health care systems. This phenomenon has generated concerns, especially about equitable access to health care. This article examines what the international right to the highest attainable standard of health in Art 12 of the International Covenant on Economic, Social and Cultural Rights says about the obligations of states which use private actors in health care. The article involves a close study of the primary documents of the key institutions responsible for interpreting and promoting Art 12. From this study, the article concludes that in mixed public-private health care systems, states not only retain primary responsibility for fulfilling the right to health but are subject to a range of additional specific responsibilities.

Victoria is the first state in Australia to legalise voluntary assisted dying. The Premier, Danie... more Victoria is the first state in Australia to legalise voluntary assisted dying. The Premier, Daniel Andrews, has described the law that comes into effect on 19 June next year as “giving Victorians with a terminal illness the compassion and dignity they deserve at the end of their lives”.

© 2019 Dr. Paula Louise O'BrienAlcohol is the favoured drug of Western nations. It brings ple... more © 2019 Dr. Paula Louise O'BrienAlcohol is the favoured drug of Western nations. It brings pleasure, but it is also the source of untold harm to the drinker, third parties and the wider society. This thesis starts from the position that regulation has the capacity to contribute to minimising the harms associated with alcohol consumption. The traditional public health view is that it is regulation by the state in the form of legislation that should be used to address problems such as alcohol-related harm. For many researchers and advocates in this field, industry self-regulation is not compatible with the pursuit of public health goals. The reason is simple: the alcohol industry and other related industries cannot be trusted because of their overriding concern with their commercial success. The alcohol industry proclaims the effectiveness of its self-regulatory efforts, and the public health arguments have little traction with governments. The thesis interrogates the competing claims about the appropriateness of industry self-regulation for alcohol control. It asks the specific question: from a public health perspective, is industry self-regulation an appropriate regulatory choice for the control of alcohol marketing and alcohol health information labelling in Australia? The areas of alcohol marketing and health information are selected as the testing ground because these two aspects of alcohol control are characterised by extensive industry self-regulation in Australia. The thesis determines the appropriateness of industry self-regulation in these areas by examining the ‘functional legitimacy’ of the regulatory arrangements. It constructs a novel analytical framework for this inquiry by distilling, organising and expanding on the ideas about self-regulation which are fragmented and under-developed across the regulatory theory literature. The analytical framework offers public health researchers, advocates, as well as government, an objective and cogent basis for determining the appropriateness of industry self-regulation in public health and other problem contexts. To apply the framework, the thesis constructs a set of objectives for alcohol marketing and health information labelling from the public health perspective, which is one of the conceptual underpinnings of the thesis. It then maps the field of regulation of alcohol marketing and health information labelling as it relates to the formulated objectives. From this mapping, two case studies of industry self-regulation are selected for detailed examination against the criteria in the analytical framework. The first relates to alcohol marketing and the ‘Commercial Television Industry Code of Practice 2018’. The second relates to health information labelling about the risks of alcohol consumption during pregnancy and the DrinkWise Labelling Scheme. The thesis concludes that industry self-regulation is not appropriate for any health information labelling. The thesis also concludes that industry self-regulation of alcohol marketing on commercial television is an inappropriate regulatory choice for protecting minors from alcohol marketing in this medium. The thesis does not reach a conclusion about alcohol marketing generally. It recommends the study of additional self-regulatory schemes for alcohol marketing and an alertness to the likelihood that self-regulation is not appropriate for any alcohol marketing. Self-regulation for alcohol control generally should also be approached with extreme caution

Drug and Alcohol Review, Mar 18, 2013

A recent decision from theVictorian Court of Appeal in Australia gives new force to the concept o... more A recent decision from theVictorian Court of Appeal in Australia gives new force to the concept of harm minimisation in liquor licensing legislation. As a result of the decision in Kordister Pty v Director of Liquor Licensing [1], harm minimisation for liquor licensing purposes is now less about dealing with harms arising from misconduct by the individual licensee and more about developing a ‘risk profile’ for a venue in light of: (i) the physical, social and cultural environment in which the venue operates; and (ii) research about the relationship between alcohol and harm.

Drugs-education Prevention and Policy, Dec 12, 2022

Aims: This narrative review considers traditional strategies for regulating alcohol marketing and... more Aims: This narrative review considers traditional strategies for regulating alcohol marketing and their applicability to digital media. Method: Drawing on international research, case studies, and reports, we examine the applicability of (1) comprehensive or partial bans; (2) placement restrictions; (3) content restrictions; and (4) counter-advertising. Results: Comprehensive bans on advertising are generally the most effective option. A partial ban applying to digital media would make some lesser contribution to reducing exposure, but will usually simply result in the promotional budget being shifted to whichever media remain less strictly regulated. Limits on the placement of marketing have more salience for traditional media than for most digital media, which can be individualized and targeted. Content restrictions play a limited role in reducing exposure as they are not concerned with marketing volume, but with the way in which alcohol is represented. Conclusions: Although these traditional strategies have a role in regulating digital media and are applied in certain international jurisdictions, new regulatory approaches are needed. These may include the use of artificial intelligence for monitoring, transparency requirements, and privacy law rights and duties. Opportunities to regulate alcohol marketing online will need to be addressed and seized as they arise in the current volatile policy environment concerning the governance of social media.

Addiction, Mar 10, 2021

I declare travel expenses, research funds and a fee from Alko, the Finnish government alcohol mon... more I declare travel expenses, research funds and a fee from Alko, the Finnish government alcohol monopoly (which is located in the Ministry for Health and Social Affairs) for a research project modelling the impact on public health of disbanding the monopoly. We had an arms-length arrangement with the funder and the right to independent publication.

International Journal of Drug Policy, Nov 1, 2013

A burgeoning body of empirical evidence demonstrates that increases in the price of alcohol can r... more A burgeoning body of empirical evidence demonstrates that increases in the price of alcohol can reduce per capita alcohol consumption and harmful drinking. Taxes on alcohol can be raised to increase prices, but this strategy can be undermined if the industry absorbs the tax increase and cross-subsidises the price of one alcoholic beverage with other products. Such loss-leading strategies are not possible with minimum pricing. We argue that a minimum (or floor) price for alcohol should be used as a complement to alcohol taxation. Several jurisdictions have already introduced minimum pricing (e.g., Canada, Ukraine) and others are currently investigating pathways to introduce a floor price (e.g., Scotland). Tasked by the Australian government to examine the public interest case for a minimum price, Australia's peak preventative health agency recommended against setting one at the present time. The agency was concerned that there was insufficient Australian specific modelling evidence to make robust estimates of the net benefits. Nonetheless, its initial judgement was that it would be difficult for a minimum price to produce benefits for Australia at the national level. Whilst modelling evidence is certainly warranted to support the introduction of the policy, the development and uptake of policy is influenced by more than just empirical evidence. This article considers three potential impediments to minimum pricing: public opinion and misunderstandings or misgivings about the operation of a minimum price; the strength of alcohol industry objections and measures to undercut the minimum price through discounts and promotions; and legal obstacles including competition and trade law. The analysis of these factors is situated in an Australian context, but has salience internationally.

The Journal of World Investment & Trade, 2020

This article considers the issues that would arise in a dispute under an international investment... more This article considers the issues that would arise in a dispute under an international investment agreement about two innovative, public health alcohol labelling policies pursued by Thailand. One measure proposes graphic health warnings on alcoholic beverages. The other measure places extensive restrictions on the words and images that producers can use on alcoholic beverage labels. We focus on the consistency of these measures with the obligations of fair and equitable treatment and indirect expropriation. We place particular emphasis on the evidence that would likely be needed to defend these measures, including the areas where the science is somewhat tentative and might therefore pose problems for ‘first-mover’ States like Thailand. We conclude that there is a good chance that the warnings measure would be found compatible with investment law obligations. However, some aspects of the marketing measure are more vulnerable to findings of inconsistency.

European Journal of Risk Regulation, 2021

In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, com... more In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, coming of age and success.1 Alcohol industry marketing creates and reinforces these cultural understandings, downplaying facts about the harms associated with alcohol consumption.2 Alcohol is also a drug, and its harm profile distinguishes it from regular foodstuffs or other consumer items. Alcohol use is causally connected to more than 200 diseases, conditions and injuries,3 with at least 25 other diseases and conditions entirely attributable to alcohol.4 These harms include non-communicable diseases (such as cancer), mental health problems (including alcohol dependence), injuries from violence and accidents, and disabilities arising from foetal alcohol spectrum disorders.5 The burden of disease associated with alcohol use is “unacceptably high”, amounting to 3 million deaths (5.3% of all deaths) and 132.6 million disability-adjusted life years (DALYs) (5.1% of all DALYs) worldwide in 2016...

European journal of risk regulation, Jun 1, 2021

In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, com... more In many cultures, alcohol is regarded as a food that is associated with festivities, leisure, coming of age and success. 1 Alcohol industry marketing creates and reinforces these cultural understandings, downplaying facts about the harms associated with alcohol consumption. 2 Alcohol is also a drug, and its harm profile distinguishes it from regular foodstuffs or other consumer items. Alcohol use is causally connected to more than 200 diseases, conditions and injuries, 3 with at least 25 other diseases and conditions entirely attributable to alcohol. 4 These harms include non-communicable diseases (such as cancer), mental health problems (including alcohol dependence), injuries from violence and accidents, and disabilities arising from foetal alcohol spectrum disorders. 5 The burden of disease associated with alcohol use is "unacceptably high", amounting to 3 million deaths (5.3% of all deaths) and 132.6 million disability-adjusted life years (DALYs) (5.1% of all DALYs) worldwide in 2016. 6 The impacts of alcohol use also extend beyond health, and include social and economic detriments. Preventing harms from alcohol requires intervention at multiple levelsin communities and organisations, and by governments acting at the national, regional and global level. The articles in this symposium issue of the European Journal of

Drugs: Education, Prevention and Policy

Aims: This narrative review considers traditional strategies for regulating alcohol marketing and... more Aims: This narrative review considers traditional strategies for regulating alcohol marketing and their applicability to digital media. Method: Drawing on international research, case studies, and reports, we examine the applicability of (1) comprehensive or partial bans; (2) placement restrictions; (3) content restrictions; and (4) counter-advertising. Results: Comprehensive bans on advertising are generally the most effective option. A partial ban applying to digital media would make some lesser contribution to reducing exposure, but will usually simply result in the promotional budget being shifted to whichever media remain less strictly regulated. Limits on the placement of marketing have more salience for traditional media than for most digital media, which can be individualized and targeted. Content restrictions play a limited role in reducing exposure as they are not concerned with marketing volume, but with the way in which alcohol is represented. Conclusions: Although these traditional strategies have a role in regulating digital media and are applied in certain international jurisdictions, new regulatory approaches are needed. These may include the use of artificial intelligence for monitoring, transparency requirements, and privacy law rights and duties. Opportunities to regulate alcohol marketing online will need to be addressed and seized as they arise in the current volatile policy environment concerning the governance of social media.

Journal of Law, Medicine & Ethics

In most countries, the alcohol industry enjoys considerable freedom to market its products. Where... more In most countries, the alcohol industry enjoys considerable freedom to market its products. Where government regulation is proposed or enacted, the alcohol industry has often deployed legal arguments and used legal forums to challenge regulation. Governments considering marketing regulation must be cognizant of relevant legal constraints and be prepared to defend their policies against industry legal challenges.

International Journal of Health Policy and Management, Feb 17, 2021

The power of the alcohol industry pervades the global governance of alcohol. The influence of the... more The power of the alcohol industry pervades the global governance of alcohol. The influence of the industry is seen in trade and investment treaty negotiations, operating through direct and indirect means. Curbing the influence of the industry is vital to improving the treatment of health issues generally and in trade and investment policy particularly. The World Health Organization (WHO) has an opportunity to start to rein in the power of the industry with its current work on drafting an 'action plan' for 2022-2030 to implement the Global Strategy to Reduce the Harmful Use of Alcohol. The WHO working paper, however, proposes inadequate controls on alcohol industry influence. The WHO proposes 'dialogue' with the industry and allows the industry to take a role with government in public health labelling of alcohol. The public's health will suffer if the WHO does not take a firmer stand against the industry in the 'action plan.'

The Lancet Global Health, 2022

Background Accelerating progress to implement effective alcohol policies is necessary to achieve ... more Background Accelerating progress to implement effective alcohol policies is necessary to achieve multiple targets within the WHO global strategy to reduce the harmful use of alcohol and the Sustainable Development Goals. However, the alcohol industry's role in shaping alcohol policy through international avenues, such as trade fora, is poorly understood. We investigate whether the World Trade Organization (WTO) is a forum for alcohol industry influence over alcohol policy. Methods In this qualitative analysis, we studied discussions on alcohol health warning labelling policies that occurred at the WTO's Technical Barriers to Trade (TBT) Committee meetings. Using the WTO Documents Online archive, we searched the written minutes of all TBT Committee meetings available from Jan 1, 1995, to Dec 31, 2019, to identify minutes and referenced documents pertaining to discussions on health warning labelling policies. We specifically sought WTO member statements on health warning labelling policies. We identified instances in which WTO member representatives indicated that their statements represented industry. We further developed and applied a taxonomy of industry rhetoric to identify whether WTO member statements advanced arguments made by industry in domestic forums. Findings Among 83 documents, comprising TBT Committee minutes, notifications to the WTO of the policy proposal, and written comments by WTO members, WTO members made 212 statements (between March 24, 2010, and Nov 15, 2019) on ten alcohol labelling policies proposed by

University of New South Wales law journal, 2014

There is intense conflict between public health advocates and the alcohol industry about the cont... more There is intense conflict between public health advocates and the alcohol industry about the content of alcohol beverage labels. Public health advocates are calling for health warnings and other product information. The industry is resisting, seeking to protect its ‘valuable label real estate’. This article reviews the current Australian laws on alcohol beverage labeling and analyses the public health proposals for reform of these laws, the industry’s arguments in opposition, and the federal, state and territory governments’ resistance to multiple attempts to bring these proposals into law from 1996 to 2013. The article finds that there are certain evidentiary issues which have dominated the debate about alcohol labelling in Australia since 1996. This article also identifies two significant shifts in the labelling debate: one arising from the recent widespread acceptance of the evidence of harm from drinking during pregnancy; the other related to the industry and governments’ recent...