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Alcohol industry-funded bodies may increase health risk to pregnant women by disseminating misinformation on their websites, according to a new study published in the .

Led by researchers at the London School of Hygiene & Tropical Medicine, the study compared information on alcohol consumption and fertility, pregnancy, and breastfeeding on the websites of 23 alcohol industry-funded bodies and 19 public health organisations.

It found industry-funded organisations were significantly less likely than independent public health websites to provide information on foetal alcohol spectrum disorder and less likely to advise that no amount of alcohol is safe during pregnancy. Industry-funded websites were also significantly more likely to emphasize uncertainties and less likely to use direct language such as ‘don’t drink’.

The findings suggest that alcohol industry corporate social responsibility bodies use strategic ambiguity and other informational tactics to ‘nudge’ women toward continued drinking in pregnancy to protect the female alcohol market.

When alcohol is consumed during pregnancy it can cross the placenta and damage the brain and other organs of the developing embryo and fetus. The risks include foetal alcohol spectrum disorder (FASD), which refers to a range of mental and physical problems in the baby. One in every 13 pregnant women who consume alcohol during pregnancy is estimated to have a child with FASD.

Evidence of the harmful effects of drinking less than 32g of alcohol per week in pregnancy is limited, but even light prenatal alcohol consumption is associated with being small for gestational age and with preterm delivery. UK on alcohol consumption in pregnancy advise: ‘If you are pregnant or planning a pregnancy, the safest approach is not to drink alcohol at all, to keep risks to your baby to a minimum’. A recent systematic review concluded that female alcohol consumption was associated with a 13% reduction in the likelihood of pregnancy.

Professor Mark Petticrew, study author from the London School of Hygiene & Tropical Medicine, said: “It is essential that the public have access to health information that is easy to digest and complete. Alongside government-sponsored health websites, the alcohol industry also disseminates information on the risk of alcohol consumption on conceiving and pregnancy via corporate social responsibility organisations. We analysed this information to see how it was framed and if it gave the full picture. It frequently didn’t, and misrepresented the evidence on the risks.”

The study analysed 23 websites including Drinkaware (UK), Drinkwise (Australia), Educ’alcool (Quebec), and those of alcohol companies. These were compared against the health websites of government bodies from the UK, United States, Canada, Australia, Ireland, and New Zealand.

There was no significant difference between alcohol industry-funded bodies and public health bodies in the likelihood of including general information on alcohol and pregnancy; however, there are many significant differences in terms of the specific information that is presented, and how it is presented.

In particular, the health sections of the websites of alcohol industry-funded organisations were significantly less likely than those of public health organisations to include information on most topics relevant to fertility, pregnancy, breastfeeding, and (FAS) or FASD.

In the case of FAS, fewer than half of alcohol industry-funded organisations included this information, compared with approximately 90% of public health organisations. The websites of alcohol industry-related bodies were also significantly less likely to include information on most pregnancy-related harms.

The research identified how the alcohol industry-funded bodies highlight uncertainties in the evidence on health harms and frame those harms in such a way as to deflect responsibility from the industry itself. The research identified four such approaches:

• Emphasising uncertainty and implying safety
• Framing information to emphasize individual responsibility, drinking patterns, and individual variation and choice
• Framing light drinking, drinking within guidelines, and abstention as equivalent options
• Confounding: Focusing discussion away from alcohol to other risk factors

In the quantitative analysis comparing alcohol industry-funded and non-alcohol industry information, alcohol industry-related bodies were statistically significantly less likely to state that no amount of alcohol is safe during pregnancy – for example they were half as likely to describe the risk of foetal alcohol syndrome, compared to independent organisations. Industry-funded organisations were also significantly less likely to include information about risk in the early stages of pregnancy.

Professor Petticrew said: “Across alcohol industry-funded organisations there appears to be a consistent strategy to the delivery of information on alcohol consumption and pregnancy. One possible reason is that women are a crucial part of the alcohol market. Pregnancy, therefore, may represent a significant commercial threat to the alcohol industry.

“This study provides further evidence that these organisations pose a potential risk to public health, specifically to the health of pregnant women and the baby, and should have no role in disseminating health information.”

The authors acknowledge limitations of their study including that only websites in English were included and also that alcohol industry-related bodies disseminate information in other media, and these should be analysed. Also, the authors do not have direct evidence, such as written or oral statements, of industry intent in relation to the above strategies.

Publication

Audrey W. Y. Lim, May C. I. Van Schalkwyk, Nason Maani Hessari, Mark P. Petticrew. . Journal of Studies on Alcohol and Drugs. DOI:10.15288/jsad.2019.80.54