CHAPTER 9: RESEARCH |
245. As we said in Chapter 3, the Fifth Priority
of the Strategy was to "Develop, support and maintain a common
evidence base". This was underpinned by Aim 10: "To
obtain comparable information on alcohol consumption, especially
on young people; definitions on harmful and hazardous consumption".
In our request for written evidence we specifically asked whether
the EU's alcohol policies were in fact underpinned by a sound
246. Witnesses who answered this question thought,
without exception, that any strategy and indeed any action on
alcohol policy should have a sound scientific base. We agree.
Indeed, this is true of any policy, and President Juncker, in
a recent letter to the Chairman of this Committee, has confirmed
that he is "a strong believer in the necessity to ground
policies in solid evidence, with the help of independent scientific
Research Commissioned by the
247. Sarah Godman from the NHS European Office
described to us the relevant research over the last 10 years:
"The EU's Health Programme has supported
37 projects since 2004 on alcohol-related harm in support of the
alcohol Strategy. The existence of the strategy has helped to
focus the funding that is channelled through that programme. There
have been projects that supported all areas of the Strategy. It
is probably also worth noting that the research programme, which
has larger funds apportioned to it, has also funded a number of
research programmes that underpin the research that is necessary
for a lot of the public health work that is funded through the
EU's public health programme. The 37 projects funded through the
EU Health Programme came to about 15 million of EU support.
There are four strong significantly relevant projects funded through
the research programme, which amounted to another 15 million
of support. Those four projects had strong involvement from the
UK, particularly from higher education institutions."
248. Looking at rather different dates, the 2012
evaluation of the Strategy stated: "Since 2007, the EU Health
Programme has supported alcohol related projects with approximately
9 million, and the EU Research Framework Programmes provided
approximately 49 million for studies on alcohol and health.
These amounts represent, respectively, less than 3% of the total
budget of the Health Programme for 2008-2013, and less than 1%
of the budget for health under Seventh Research Programme."
249. One of the projects we heard most about
was AMPHORA. This
was a four year project funded by the 7th Framework Programme
of the European Commission, which aimed to contribute new evidence
on scarcely explored or unexplored areas of alcohol consumption
and alcohol-related harm in Europe. It involved research institutions
from 12 European states in collaboration with organisations from
all the Member States. Among the research areas covered by AMPHORA
were an update on European epidemiological data; the definition
of standard common indicators of alcohol consumption and harm;
the measurement of the strength of alcohol policies; the study
of contextual determinants of alcohol consumption, the analysis
of the impact of marketing on youth; the availability of treatments
at a European level; and two areas of harm reduction (contamination
of illegal or surrogate alcohols and the reduction of harm in
250. Ms Godman told us that one of the biggest
projects funded by the research funds in the 7th Framework Programme
was ALICE RAP,
"which did research into addictionbroadly, not just
alcoholand lifestyles in contemporary Europe. Around 8
million was given to that project alone. It had 42 participants,
twelve of whom were from the UK."
251. For the future, DG Research currently has
a programme, Horizon 2020, running from 2014 to 2020, which has
a budget of 7.5 billion allocated to health, democratic
change and well-being. Within this programme, Ms Godman told
us that "the Council has recommended an ongoing area focusing
on effective health promotion, disease prevention, preparedness,
screening and research that tries better to understand health,
ageing and disease. There is definitely scope for projects on
alcohol harm-related projects or on understanding the impact of
alcohol on health, ageing and disease."
In addition to the funding of Horizon 2020, the EU's health programme
provides approximately 450 million for health research from
2014 to 2020.
252. DG Research provides funding in response
to bids from researchers. In Ms Godman's words, it "basically
waits for excellent proposals. It is a competitive funding line.
It is driven by the kind of proposals that it receives. If there
are excellent research projects on alcohol, they have every chance
of success. This programme is demand driven. It is supposed to
be grass-roots research on expert opinion."
253. Dr Ruxandra Draghia-Akli and her colleagues
confirmed this in the evidence we took from them. They explained
that they were sponsoring programmes "around the biology
of ageing, addiction and the mechanism of ageingit is not
alcohol only, it is the link between alcohol and nicotine and
the link between alcohol and transport, driving and behaviour
and all these areas that are interlinked."
In other words, the policy of DG Research is not to take the initiative,
but to respond to proposals from researchers, and requests for
funding. This is essential to provide a scientific basis for developments
in health and wellbeing, and it is right that researchers should
take the initiative in proposing the topics for such research.
THE PERCEIVED QUALITY OF RESEARCH
254. Where the formulation of policy requires
additional research into specific issues, this has to be commissioned
by DG SANCO, which is responsible for the formulation of the Commission's
alcohol policy. The fact that those formulating the policy are
also commissioning the research does not in our view mean that
the quality of that research is necessarily compromised, but it
can give rise to such a perception, in particular where the alcohol
industry might be adversely affected by policies which the research
might support. SpiritsEUROPE told us they had "concerns about
the way research on alcohol-related harm is funded, conducted
and presented by DG SANCO, believing much of the 'evidence' generated
provides misleading signals to policy-makers."
255. Speaking for the WHO, Dr M¾ller
told us that they had been "extremely happy" with the
quality of the EU-supported research: "we published a book
where we went through all the 10 action areas [of the Strategy]
and the evidence for all these policies. A lot of that was based
on the EU-supported research, so we had a very good evidence base
when we drafted our action plan."
256. However, the quality of much of the research
was the subject of sustained criticism from the industry, retailers
and advertisers. The WSTA told us that "The quality of the
research in a number of projects funded by the European Commission
has been poor and this has been challenged by the European body
representing national trade associations and the alcohol industry."
Mr Baker too thought that the quality of research was "patchy
257. The Scotch Whisky Association wrote:
"It is important that research used by policy-makers
is relevant, neutral and objective, fair and transparent, robust
and based on appropriate engagement with all stakeholders, and
subject to the highest levels of scrutiny and accountability.
It should be conducted to the highest methodological standards,
with data sources that are transparent and accessible. These principles
have not always been respected in the past. We have seen projects
funded by the EU which have been presented to the EAHF. In our
opinion, a number of those reports have had pre-judged conclusions
and been conducted with the aim of justifying a particular policy
recommendation. These reports are now being widely quoted by health
stakeholders as irrefutable evidence."
INDEPENDENCE OF RESEARCHERS
258. The problems are compounded when the researchers
and the policy-makers who are also in charge of the funding are
seen to be getting too close. Mr Skehan told us:
"What we see time and again is that we have
a whole group of people who are not quite making a living from
this but certainly it is a part of their life and they are drawing
down funds to produce material that we do not have trust in. We
are not against research. I come back to this. We firmly believe
it is the way it should be, but we would love to see it be more
neutral, less biased, with oversight by some neutral body."
259. SpiritsEUROPE made a similar point, saying
they had "concerns about the way research on alcohol-related
harm is funded, conducted and presented by DG SANCO, believing
much of the 'evidence' generated provides misleading signals to
We have noted that the funds available have
been repeatedly allocated to the same entities, even though the
quality of the reports produced was consistently questioned. Of
nearly 15 million awarded in research contracts between
2009 and 2012 across 10 projects, RAND Europe were awarded three
Dutch Institute for Alcohol Policy (STAP (NL)) gained three, and
the same researchersand research topicscrop up time
260. The same point was made by Mr Beale:
"Eleven projects have been conducted, to the tune of 15 million,
and some organisationsand I shall not name themappear
four or five times, so that is almost 50%."
Mr Duffy said: "My view of the AMPHORA and ALICE RAP
projects is that while they may well be extremely worthy, they
always involve the usual suspects. The scientific quality is variable."
261. The criticism of a lack of independence
is not all one way. ScHARR told us that "Senior researchers
have encountered inappropriate involvement of the alcohol industry
in the research process, particularly around the lack of promotion
and utilisation of research findings which are contrary to industry
On the other hand, as Mr Ashworth said, "If the drinks
industry were to do research, the public health community would
not accept that research."
262. The Minister thought it unrealistic to expect
all concerned to agree on evidence: "I do not think that
we see it as [a] primary aim to obtain universal consensus on
evidence, because I think we fear that we would never act if that
was the bar that was set. It is almost inevitable that there will
be disagreements about evidence, and even if we have really good
evidence, such as on the relationship between high levels of alcohol
consumption and increased health risks or the relationship between
price and consumption, it might not be accepted by some, so I
think it is always the case that even when one group says, 'We
are absolutely convinced that this is solid evidence', there will
be others who will dispute it."
263. We accept that there will be disagreements
about the value of evidence and the strength of any conclusions
based on it. But we do not think progress will be made unless
there is a degree of mutual trust in the researchers and their
work. Policies cannot sensibly be discussed, whether at EU or
national level, unless there is a basis of evidence derived from
research which is trusted by all, including the public health
lobby and the industry.
264. It is clear from our witnesses that there
is scarcely a single matter on which the evidence is currently
trusted by all concerned. Whether what is at issue is an attempt
to measure the harm caused by excessive and irresponsible drinking
or the effect which pricing, advertising or labelling policies
have in reducing alcohol-related harm, or any other relevant issue,
research is currently trusted only if its results happen to coincide
with the interests of those considering it.
265. We are not ourselves qualified to evaluate
any of the research which has been criticised, and we do not take
a position on the criticisms of its quality. Nor are we suggesting
that there is or has been any bias in the selection of researchers,
or defects in the conduct of research, or lack of integrity in
266. Where those responsible for formulating
policy, in this case DG SANCO, identify a need for further information,
they are best placed to commission such research.
267. The quality of research will be questioned
if it is carried out by researchers who are perceived to have
vested interests in the outcome. The best way to diminish any
such perception is to commission research from as wide and varied
a network of researchers as possible. This should be done through
268. It should be no part of the researchers'
task to suggest what policies should be based on their findings.
Any attempt to do so will give rise to the perception of a lack
Where research is needed
269. We received a considerable quantity of evidence
on the matters which witnesses felt needed further research. Mr Acton
commented: "We need to distinguish between areas of policy
that are under-researched and those where there is lots of evidence
there is a lot of evidence on alcohol, taxation and price.
There are a lot of areas of alcohol policy that are under-researched,
including harms to young people. Although having a lot of evidence
does not guarantee consensus, if you have very little evidence
there is still less chance of consensus." The Minister agreed:
"We would be keen to see the EU focus on areas that have
been under-researched and where the research would be the most
Four such areas identified to us by witnesses were behavioural
change; the impact of advertising on consumption by children and
young people; harm to others; and alcohol-related crime.
270. Dr M¾ller advocated further research
into behavioural change:
"We know very little about how to change
behaviour, but we know that policies do change behaviour. We can
see that with the smoke-free environment
A little more
about behaviour, binge drinking and so on would be interesting
We have these differences: some countries binge drink,
while other countries do not, and we see much more harm when you
We do not have very good evidence about whether
education, training and awareness has any impact. So far the evidence
is that it is not very useful."
THE IMPACT OF ADVERTISING ON CONSUMPTION
BY CHILDREN AND YOUNG PEOPLE
271. We have already quoted
the view of Mr Acton that, although there is "quite
solid" evidence for the effect of advertising on adults'
alcohol consumption, there are evidence gaps on the effect of
advertising on consumption by children and young people. There
was also, in his view, very little evidence on effective interventions
to restrict advertising.
Given that such research as there has been on these topics, and
the evidence and findings derived from it, are so strongly contested,
we agree that this must be a priority area for future research.
HARM TO OTHERS, AND ALCOHOL-RELATED
272. Data on alcohol-related harm to others are
at best patchy, both at UK and EU levels. Ms Brown told us:
"there are definitely gaps with regard to monitoring levels
of harm, particularly harms to third parties: rates of alcohol-related
domestic abuse, child abuse, rates of foetal alcohol spectrum
rates of exposure of alcohol marketing and
advertising to children
. If we can quantify that burden
and that harm, that will produce more evidence and more incentive
to governments to take action and implement effective policies,
and that is where better data collection will be able to help.
Dr Gillan agreed: "Where we have the gap is harm to
people other than the drinker. We did a national survey in Scotland
that showed that one in two people reported being harmed in some
way as a result of someone else's drinking, and one in three people
had a heavy drinker in their life."
273. Mr Ashworth made the same point in
relation to alcohol-related crime: "There is no comparable
alcohol-related crime data, such as government statistics comparing
one country to another in terms of alcohol-related crime. We know
in the UK that violent crimes related to alcohol have decreased
32% since 2004 and 47% since 1995. Are we doing better or worse
than other countries, and why would that be?"
274. Behavioural change, the impact of advertising
on consumption by children and young people, harm to others and
alcohol-related crime are some of the many areas where there are
gaps in knowledge and where further research would significantly
assist policy formulation.
STANDARDISED TERMINOLOGY AND MEASUREMENT
275. Member States have different ages of majority
and different minimum ages for buying alcohol, so that the use
in research of words like 'child', 'young person' and 'adult'
may not compare like with like, and should therefore be avoided.
The WHO refers to 'adult (aged 15+)'. It seems to us that the
only sensible classification is to refer to ages, and that the
EU could influence researchers and the authorities of Member States
to use common age ranges.
276. Mr Beale thought that "Better
comparability of data across the EU can really only be done at
EU level, for the Commission, for Eurostat, for others. One area
where this is a problem, for example, is that WHO, Eurostat and
Member States all have slightly different definitions of alcoholrelated
harm, and that gives you obvious comparability problems in looking
at the figures across the union."
277. Eurocare suggested that: "Common measurement
standards could be agreed across the EU in order to monitor and
evaluate alcohol harm and interventions to reduce harm and help
to prevent cross-border discrepancies. For example, a common unit
of alcohol or standard drink would harmonise consumption trend
data across the region and also allow for common EU consumer information
such as low risk drinking guidelines and health information on
AROLE OF THE SCIENCE GROUP
278. Prof Sheron said: "There is a
role here for the Science Committee, perhaps reporting to CNAPA
or to the Commission itself, not only giving a verdict on establishing
the evidence base and stamping its imprimatur on it, but outlining
where the research gaps are."
279. The Science Group could play a useful
part in identifying gaps in the knowledge surrounding alcohol-related
harm, and suggesting the parameters for research. It could also
promote standardised terminology and common measurement standards
to improve the comparability of research across the EU.
233 Letter of 16 January 2015 from the President of
the Commission to Lord Boswell of Aynho, Chairman of the
House of Lords European Union Committee, and the Earl of
Selborne, Chairman of the House of Lords Science and Technology
of the added value of the EU strategy to support Member States
in reducing alcohol-related harm, Final Report (December 2012),
paragraph 2.5: http://ec.europa.eu/health/alcohol/
[accessed 24 February 2015]. These figures were cited by a large
number of our witnesses in written evidence, including Eurocare
(EAS0006), Alcohol Health Alliance UK (EAS0012) , Balance (EAS0017),
Institute for Alcohol Studies (EAS0002), and SHAAP (EAS0001),
and Katherine Brown Q45 Back
Alcohol Measures for Public
Health Research Alliance Back
Addictions and Lifestyles
in Contemporary Europe Reframing Addictions Project Back
Q21 (Sarah Godman) Back
European Commission, The
Third Health Programme 2014-2020: Funding Health Initiatives Factsheet
[accessed 24 February 2015] Back
Q141 (Maria Vidal, Head of Unit for Medical Research) Back
Written evidence from spiritsEUROPE (EAS0025) Back
Written evidence from WSTA (EAS0016) Back
Written evidence from SWA (EAS0020) Back
One of these was the report by RAND Europe on the assessment of
young people's exposure to alcohol marketing in audiovisual and
online media, which we have referred to in Chapter 5. Back
Written evidence from spiritsEUROPE (EAS0025) Back
Q198. The bodies Mr Beale declined to name are those
listed by spiritsEUROPE in their written evidence, quoted in the
previous paragraph. Back
Written evidence from the University of Sheffield Alcohol Research
Group (ScHARR) (EAS0014) Back
Paragraph 172 Back
Written evidence from Eurocare (EAS0006) Back
Q44. See also the evidence from Lundbeck Ltd (EAS0011) quoted
in paragraph 227. Back