INTEREST MIGHT IN THE EUROPEAN UNION: HOW ADVOCACY SHAPED EU S STANCE ON ALCOHOL AND TOBACCO

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1 INTEREST MIGHT IN THE EUROPEAN UNION: HOW ADOCACY SHAPED EU S STANCE ON ALCOHOL AND TOBACCO Ananalysisanddiscussionofpolicyandlobbyismwithin tobaccoandalcoholintheeuropeanunion!!!!! Master!of!Science!(M.Sc.)!thesis!in!International!Business!&!Politics! Copenhagen!Business!School,!2015! Written!by!Simon!Redder!Berthelsen!&!Morten!Elkjær!Kraul! Supervised!by!Magali!Gravier,!Department!of!Intercultural!Communication!and!Management! STUPcount:!270,730! Pages:!115!(excluding!bibliography!and!appendices)! a

2 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Abstract((Danish)( DettespecialefokusererpålovgivningenaftobakogalkoholiEU,deresforskelle,samtomfanget hvorvedprivateinteresseroglobbykoalitionerkanbeskrivedenneproces.påtrodsafvissetydelige kulturelleforskelledetoprodukterimellem,såblivertobakogalkoholihøjeregradadresseretisamme kategoriiforholdtilsundhedsproblemstillinger.tobakogalkoholerderudoverbeggenydtafmangei EU,trodsderessundhedsskadeligekapaciteter.Detosubstanserbliverdogregulatoriskbehandlet megetforskelligtieu.detvilidettehenseendebliveundersøgt,hvorvidtprivateinteresserog lobbyvirksomhedspillerenrolleiatinfluereoglegitimerelovgivningindenfordissetoområder. EmpiriskbaseresanalysenogdiskussionenprimærtpåEU stobaksproduktsdirektivfortobak,mens alkohol,grundetbegrænsetreguleringpåeuniveau,vilblivevurderetpåbaggrundafbestemtblød lovgivningindenfordetsidsteårti.teoretiskbenytterdettespecialesigafpaulsabatiers lobbykoalitionsteori( advocacycoalitionframework ),samtheikeklüverslobbyismeudvekslingsmodel ( exchangemodeloflobbying )tilatbeskrivelobbyprocessenoglobbyindflydelsenindenforalkoholog tobakieu.neofunktionalismeogliberalintergovernmentalismevilogsåblivebrugtsom integrationsteoriertilatundersøgeeu slovgivningsmæssigekompetencerindenfordissetoområder. Baseretpåanalysenogdiskussionen,konkludererdettespeciale,atreguleringenafalkohologtobaker megetforskelligpåeuniveau,selvomdeinstitutionellekompetencerforlovgivningafdisseto substanserieuisundhedsogdetindremarkedsregikansidestilles.grundentildenneasymmetrii lovgivningskalfindesibådedenoffentligeopfattelseafdetoprodukter,samtdegraverendeforskellei lobbykoalitioner.udoverstoreforskelleioplevelsenafdetoprodukter,harprivateinteresserog lobbykoalitionerstorindvirkningpåeureguleringgennemderesaktiviteterogbudskaber.den lovgivningsmæssigedistinktionmellemalkohologtobakkanderfortilvisgradtilskrives lobbykoalitioner,dadissevariererbetydeligtpåvigtigeparametredetosubstanserimellem.slutteligt foreslårdettespeciale,atalkohologtobakmedstorsandsynlighedvilopleveøgetreguleringpåeu niveauidekommendeårtier,grundetenkombinationafnuværendepolitisketendenserogøget europæiskintegration. SpecialetspotentialeogbidragliggerisammenligningenaftobaksogalkoholpolitikiEU,samtdets analyseogdiskussionaflobbyismesomdenbeskrivendefaktor.tilforfatternesvidenhar lobbykoalitionsteorioglobbyismeudvekslingsmodellenikkeværetanvendtpåeutobaksog alkoholpolitiktidligere.ydermereerenkomparativundersøgelseafeu sreguleringafdetoområder, detsunderliggendekompetencestrukturogenrefleksionafprodukterneslighederogforskelleikke tidligereblevetforetagetividenskabeligepublikationer.derforerformåletmeddettespecialeatyde bidragtildeneksisterendevidenogvidenskabeligediskursindenfordetteområde. 2

3 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Abstract((English)( Thismaster sthesisfocusesonthelegislationoftobaccoandalcoholateulevel,thedifferencesinsuch andtheextenttowhichprivateinterestsandadvocacycoalitionscandescribethisprocess.despite certaindistinctculturaltraits,tobaccoandalcoholaretreatedincreasinglyinunisononhealthmatters. TobaccoandalcoholarealsosimilarlyenjoyedsubstancesacrosstheEU,despitetheirpotentialfor harm.yet,theyremaingovernedextensivelydissimilarateulevel.theroleofadvocacyininfluencing andlegitimisingpolicywithinthesetwoareaswillforthismatterbeassessed.empirically,theanalysis anddiscussionisbasedprimarilyonthetobaccoproductsdirectivefortobacco,whilealcohol,dueto limitedeulevelregulation,isassessedonthebasisofcertainsoftlawmeasureswithinthelastdecade. Theoretically,thethesisusesPaulSabatier sadvocacycoalitionframeworkandheikeklüver sexchange modeloflobbyingasameansofexplainingtheadvocacyprocessandinfluence.additionally,the integrationtheoriesofneofunctionalismandliberalintergovernmentalismareappliedtouncoverthe frameworkofcompetencywithintheseareasateulevel. Onthebasisoftheanalysis,thethesisconcludesthatalcoholandtobaccoasregulatedareashavefared differentlyatthehandsoftheeu,despitesimilarcompetencyframeworksgoverningthetwo substancesateulevelundertheauspicesofhealthandthesinglemarket.itsuggeststhatthereasons fordissimilarityinregulatorypathsderivefromperceptionandadvocacycoalitiondifferences.besides distinctpublicperceptionofthetwosubstances,theadvocacycoalitionswithintobaccoandalcoholare foundtoimpactsignificantlythelegislationateulevel,throughtheiractivitiesandmessages.the differenceinlegislationoftobaccoandalcoholcanthusbeattributedtoacertainextenttheadvocacy coalitions,astheyvaryacrossthetwosectorsonvitalparameters.finally,thethesisproposesthat alcoholandtobaccowilllikelybesubjecttoincreasedlegislationateulevelinthecomingdecades,due toacombinationofcurrentpoliticaltrendsandfurthereuropeanintegration. Thepotentialandcontributionofthisthesisliesinthecomparisonofalcoholandtobaccoregulationat EUlevelandtheanalysisanddiscussionofadvocacyasadescriptivefactor.Totheauthors knowledge, theadvocacycoalitionframeworkandperspectivesoninterestsgroupshavenotbeenappliedtoalcohol andtobaccoateulevelpreviously.inaddition,acomparativeassessmentofeualcoholandtobacco regulation,itsunderlyingcompetencystructureandabroadreflectionoftheirsimilaritiesand differenceshasnotbeenfoundinexistingscholarlypublications.thus,theaimofthisthesisisto providenovelcontributiontosaidknowledgeandscholarlydiscourse. ( 3

4 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Table(of(content( 1. INTRODUCTION!&!METHODOLOGY!...! STRUCTURE!...! CHOICE!OF!THEORY!...! EMPIRICAL!SOURCES!...! DELIMITATIONS!...! CRITICAL!REALIST!PHILOSOPHY!OF!SCIENCE!...! THEORETICAL!FOUNDATION!...! ADOCACYCOALITIONFRAMEWORK EXCHANGEMODELOFLOBBYING NEOFUNCTIONALISM LIBERALINTERGOERNMENTALISM MULTILEELGOERNANCE(MLG) LIMITATIONS!OF!ANALYSIS!...! READING!GUIDANCE!...!26 2. ALCOHOL!AND!TOBACCO!IN!THE!EUROPEAN!UNION!...! TOBACCO!IN!THE!EU!...! REGULATIONOFTOBACCOATEULEEL TOBACCODIRECTIESRELATEDTOTHESINGLEEUROPEANACT TOBACCOPRODUCTDIRECTIE FRAMEWORKCONENTIONONTOBACCOCONTROL REISIONOFTHETOBACCOPRODUCTDIRECTIE ALCOHOL!IN!THE!EU!...! HISTORYOFALCOHOLINTHEEU ALCOHOL SIMPACTONTHEEUTODAY LEGISLATINGALCOHOLINTHEEU COMPARING!PERCEPTIONS!OF!ALCOHOL!AND!TOBACCO!AS!SUBSTANCES!...! CONCLUSION!...!46 3. INTEREST!GROUP!INFLUENCE!AND!ADOCACY!COALITIONS!WITHIN!TOBACCO!AND!ALCOHOL!IN! THE!EU!...! INTEREST!GROUP!INFLUENCE!ON!EU!INSTITUTIONS!...! INPUT!NEEDS!FOR!EU!INSTITUTIONS!...! ADOCACY!COALITIONS!...! ALCOHOL!IN!THE!EU!P!INTERESTS,!ADOCACY!COALITIONS!AND!POLICY!PREFERENCES!...!55 4

5 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco PUBLICHEALTHCOMMUNITYANDNGOS ALCOHOLINDUSTRY TOBACCO!IN!THE!EU!P!INTERESTS,!ADOCACY!COALITIONS!AND!POLICY!PREFERENCES!...! THETOBACCOINDUSTRY PUBLICHEALTHCOMMUNITY OUTCOMES!OF!ADOCACY!COALITION!INFLUENCE!...! COMPARING!THE!ADOCACY!COALITIONS!WITHIN!TOBACCO!AND!ALCOHOL!...! INDUSTRYADOCACYWITHINALCOHOLANDTOBACCO AFINALTHOUGHT CRITIQUE!OF!THE!ADOCACY!COALITION!FRAMEWORK!AND!INTEREST!GROUP!INFLUENCE!...! CONCLUSION!...!84 4. PUBLIC!HEALTH!AND!ECONOMIC!INTERESTS!IN!THE!EUROPEAN!UNION!...! INTRODUCTION!TO!EUROPEAN!INTEGRATION!...! HEALTH!POLICY!IN!THE!EU!...! TOBACCO!AND!ALCOHOL!!AN!EU!OR!NATIONAL!COMPETENCE?!...! CONCLUSION!...!97 5. ALCOHOL!AND!TOBACCO!LEGISLATION!IN!THE!EU!!A!LOOK!TO!THE!FUTURE!...! ALCOHOL!TO!FOLLOW!IN!THE!FOOTSTEPS!OF!TOBACCO!...! FURTHER!REGULATION!OF!TOBACCO!IN!THE!FUTURE!...! CONCLUSION!...! PERSPECTIATION!...!113 BIBLIOGRAPHY!...!116 APPENDICES!...!138 TRANSCRIPTION!OF!INTERIEW!WITH!EMPLOYEE,!PUBLIC!AFFAIRS!AGENCY!...!138 TRANSCRIPTION!OF!INTERIEW!WITH!EMPLOYEE,!WORLD!HEALTH!ORGANIZATION!(WHO)!...!146 TRANSCRIPTION!OF!INTERIEW!WITH!EMPLOYEE,!EUROPEAN!ALCOHOL!POLICY!ALLIANCE!(EUROCARE)!...!153 TRANSCRIPTION!OF!INTERIEW!WITH!EMPLOYEE,!SPIRITSEUROPE!...!161 TRANSCRIPTION!OF!INTERIEW!WITH!EMPLOYEE,!EUROPEAN!CANCER!LEAGUES!(ECL)!...!173 TABLE!1!!TEXTUAL!CHANGES!TO!THE!2014!TOBACCO!PRODUCTS!DIRECTIE!(TPD)!...!178 FIGURE!1!!LEGISLATIE!PROCESS!UNDERTAKEN!TO!REIEW!THE!TOBACCO!PRODUCTS!DIRECTIE!(TPD)!...!180 ( 5

6 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!1! Introductionandmethodology??F? I E E C CE C? C C C EC? CE A C I??E C? CC? F I C? E? A C AE? A F CA F ( 6

7 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 1. Introduction(( If tobacco andalcoholwere invented today, it would be difficult to see the two substances legalised (Nutt,2012).Forthismatter,severalhealthandeconomicinterestsareatstakewithinthetwoareas, anditisthusnotasurprisethattheycontinuetoseeincessantadvocacyeffortsandregulationattempts fromthepublicandprivatesphereateulevel.tobacco,alongwithalcohol,comprisekeyexamplesof the continuous struggle to balance public health prioritisation with industry and hence economic interestsintheeuropeanunion.bothsubstancesareinrecentyearsfurthermoreincreasinglytreated uniformlyinhealthmatters,astwooftheprimaryriskfactorsforchronicdiseases,oneofthegreatest threatstohealthinmoderntimes(who,2013).however,whereastobaccohasseenstricterregulation inrecentyears,exemplifiedbythetobaccoproductsdirectiveandthewho sframeworkconvention on Tobacco Control (FCTC), alcohol has not experienced the same degree of EU regulation. Consequently,thesetwoproductsareaninterestingtopicofanalysis,comparisonanddiscussion.Due tothelackofobviousdivergingtechnicalcharacteristicstodistinguishthetwosubstances,thediffering regulationmustresultfromotherforcescentraltolegislationateulevel.forthismatter,thispaperwill emphasisetheroleofperception,advocacyandlobbyismincomparingandexplainingtheregulatory measuresimplementedforthetwosubstancesintheeu. GiventhefactthatalcoholandtobaccoaretwoofthemostcommondrugsintheEuropeanUnionand thattheyhavebeenregulatedverydifferently,theresearchquestionofthisthesisfocusesontheextent towhichpublicperceptionandtheefficiencyofadvocacyand lobbyismcanexplainthedifferencein legislationofalcoholandtobacco.theresearchquestionliesonthepremiseofbothanadvocacyand culturalunderstandingofthetwosubstances.thus,theresearchquestionwillbeansweredthrougha perception, advocacy and integrational perspective. The public perception analysis will follow an introductiontoalcoholandtobaccointheeu,tograspthecurrentculturalandnormativesimilarities anddifferencesbetweenthetwosubstances.subsequently,theadvocacyanalysisanddiscussionwillbe commenced,specificallythroughthetheoreticalargumentofadvocacycoalitions,asproposedbypaul Sabatier(1988;1998)andHeikeKlüver(2011;2013).Thisscholarlypositionwillbeleveragedtograsp keyadvocacycoalitionsasthedominantentitiesinvolvedinlobbyingwithintobaccoandalcoholinthe EU,andconsequentlytheirimpactonEUlegislation.Theadvocacyanalysisanddiscussionwillfocuson thetobaccoproductsdirective(tpd),whichserveasakeypillarineulegislationaroundtobacco,and ongoingmeasurestolegislatewithinalcohol,suchasthe2006eualcoholstrategy,itsprovisionsand theeffortsofdifferentadvocacycoalitionsinrecentyearstoensureitsrenewal. 7

8 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Based on the advocacy coalition analysis and discussion, the paper will embark on an analysis of European integration and social visions of the two substances in the context of EU s current competencies and legislative prowess. Specifically, the varying competencies within health and economic matters between the EU and its Member States will be assessed. As the levels of public perception,advocacyandintegrationaremutuallyinflicting,theseshouldcollaborativelyseetoassess the difference in legislation of the two drugs and the reasoning behind it, thereby answering the researchquestion. ThroughanalysisanddiscussionoftobaccoandalcohollegislationintheEU,thepaperwilluncoverthe advocacydriversforregulatorychangeofthesetwoheavilylobbiedpolicyareasintheeuropeanunion, and assess their relevance in explaining the differences in EU legislation around the two substances. Subsequently,afinalsectionwillbedevotedtoprovideaninformedreflectionoffuturelegislationof thesetwosubstancesinaeuropeanregionmarredbyoverconsumptionandresultingconsequenceson health,butequallyreliantoneconomicdexterityintheaftermathofoneofthemostsevereeconomic crisesinrecenthistory Structure( GiventhesignificantnumberofinterestgroupsthatlobbydecisionmakersinBrusselswiththeaimof impactingpolicyoutcomes,assessingtheirinfluenceisessentialforunderstandingtheeupolicymaking process (Dür, 2008a). However, as multiple interest groups seek to influence the decisionmaking processsimultaneously,itiscrucialtoconsiderthecoalitionsthatareformedaroundthesepolicyissues (Sabatier,1998;Klüver,2013). TheaimofthisthesisistouncoverlegislationoftobaccoandalcoholatEUlevelthroughananalysisand discussion of the perception and advocacy context of the substances to understand and explain the difference in legislation of the two. In order to achieve this, the paper will be structured in seven chapters,whichwillgraduallyuncovertheperceptionandadvocacysettingofthetwosubstancesateu leveltograsptheirinterdependencyandabilitytoexplainlegislationwithinthetwoareas. Thethesiswillfollowthestringentacademicwritingpreceptsofdescription,analysisanddiscussionin thecorrelatedchapters.aftertheintroductionandmethodologysection,thepaperwillproceedwitha section explaining the current legislative frameworks governing tobacco and alcohol at EUlevel. In 8

9 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco additiontolayingacommongroundforsubsequentanalysisanddiscussion,thesectionwillintroduce someofthevariationsinperceptionbetweenthetwoproducts,asameanstogaugethecomplexityof thepolicyfield. In turn, an analysis and discussion of the advocacy circumstances around the two substances will be embarkedupon,toassessitspotentialforexplainingthereasonbehindtheirdifferentlegislativepaths. Forthismatter,thefollowingchapterwillbroadenthescopetoincludeintegrationtheoriesanddiscuss regulationofhealthasacompetenceateulevel.thefinalsectionofthepaperwilllooktowardsthe future to assess a plausible direction for regulating tobacco and alcohol at EUlevel moving forward, encompassingprecedinganalysisanddiscussionoftheperceptionandadvocacyperspectivesofthetwo substances,aswellastheoverallpotentialforhealthregulationatthehandsoftheeu. Aconclusionandsubsequentperspectivationwillthenfollow,toassessthefindingsofthismultilayered andcomplexpolicyfield.throughoutthethesis,political,economicandbusinessperspectiveswillbe leveragedinaccordancewiththeguidelinesoftheinternationalbusiness&politicsprogramme Choice(of(theory( Thetheoriesthathavebeenchosentoassisttheanalysisofthispaperareusedtouncoverthelobbyism andadvocacystructures,aswellastheoverarchingdevelopmentrelatedtotheregulationoftobacco andalcoholateulevel. We have chosen to use Paul Sabatier s advocacy coalition framework (1988; 1998; 2007) and Heike Klüver s more recent exchange model of lobbying (2011; 2013), to uncover the different advocacy coalitionswithintobaccoandalcoholintheeu.thesetheoreticalframeworkshavetheadvantageof objectivelyandconcretelyassessingthedifferentstakeholdersandprivateactorinfluenceandactivities, whichisanecessityforsaidanalysis.additionally,theirpropositionthatadvocacygroupsandcoalitions shouldbethemainsubjectofanalysisisintriguingforthistopic,asthestrengthinnumbersapproach seemstobeverifiedbyactorsoperatinginthesefieldsatbrusselslevel(eurocareemployeeinterview, 09/04/2015;ECLemployeeinterview,11/06/2015).Thetheorieswillalsoassistinthediscussionofthe internalconfigurationofinterestgroups,aswellastheinstitutionalpressuresoftheeuthatinsome aspectshaveledtosimilarprofessionalizationofinterestgroups(klüver&saurugger,2013). 9

10 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Asameanstoencompassthewiderimplicationsoftheadvocacycoalitionswithintobaccoandalcohol onlegislationandeusocieties,theintegrationtheoriesofneofunctionalism,intergovernmentalismand multilevel governance (MLG) will also be included in the paper. This should be seen as a means to address the development of alcohol and tobacco legislation in the EU and its prioritisation of health versuseconomicinterests.themultilevel governance of the EU, and especially the areas of tobacco and alcohol, encompasses both intergovernmental and supranational issues of mutual relevance and implicationhistoricallyandcurrently.thus,itisanecessitytoincludeboththeories,aswellasthemlg, despitetheirrelativedifferenceinapproachtointegrationtoexplaintheconcessionsandcompromises frombothmemberstatesandtheeuasasupranationalentity. Due to the variety of theories, we use a horizontal setup, whereby the theories are determined as equallyimportantfortheanalysisofthistopic.theintegrationtheorieswillserveasthebackbonefor understandingtheinterstateandeulevelbargainsandeucompetencywithinthisfield,whereasthe advocacycoalition framework andexchangemodeloflobbying willdigdeeperintothemorespecific area of advocacy groups and their influence on EUlegislation. This circular relationship, in which advocacycoalitionsinfluencememberstatesandtheeulevelandvice%versa,shouldensureaconsistent and comprehensive approach to address the subject matter. By constructing the paper on this theoreticalfoundation,itshouldencompassthetotalityofinterestsrelatedtotobaccoandalcoholin theeutothegreatestextentpossible. FortheadvocacycoalitionframeworkoriginallyproposedbySabatier,itisimportanttonotethatitis bothrelativelyoldandoriginallyproposedforamericanadvocacycoalitionswithinahighlydelineated area. However, with the assistance of Klüver s more recent additions to the debate from an EU perspective,thereisastrongmandateforitscontinuedrelevancewithintheeu.especiallyfortobacco and alcohol, which has a clearly defined set of interests and coalitions, the advocacy coalition framework can provide novel insights, which will be tested and subsequently reflected upon in the paper Empirical(sources( Beingattentivetothelimitationsofmerelyusingonetypeofsource,thispaperwillincorporateboth primaryandsecondarysources,asthebasisforanalysisanddiscussion.thesourcematerialwillthus 10

11 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco compriseawidearrayofinputincluding,butnotlimitedto,interviewswithkeystakeholders,treaties, publications,articles,journalsandinternalindustrydocuments. Understanding the advantages and constrains of diverse types of sources is important for identifying theirrelevancetodifferentpartsofanalysis.primarysourcesconsistoforiginalmaterialcreatedatthe timeofstudy,suchasthetreatyonthefunctioningoftheeu(tfeu),interviewsandstakeholderinput. The use of primary sources in this paper further comprises explicitly stated views from the different advocacycoalitions 1,roadmaps,andinternaldocumentsaswellasofficialdocumentsfromthedifferent EU institutions (the European Commission, European Parliament, and European Council 2 ) and court material from previous cases involving particularly the tobacco industry. Having access to these documentsyieldanimportantparameterforanalysisoftobaccoindustrylobbyingandpractices,butto this extent it is essential to acknowledge that source material differs substantially when addressing alcohol industry lobbyism, reasons to which will be uncovered in more detail in the paper. It is also important to consider the impact of accessing all official documents from the EU in English, since translatedsourcescanpossiblycreateambiguitytowardstheoriginalityofsources.theaforementioned serve as primary sources, as they are all qualitative, accurate, and contain updated firsthand information,atleastfromthespecifiedtimeofwriting.inaddition,neitherhavethedisadvantageof distortingnorspinningoftheoriginalmaterialbysubsequentauthors,whichcanbedeemedspecifically importantwhenaddressingprivateactormaterial. Secondary sources on the other hand have the advantage and ability of presenting extensive and epistemicmaterialinanorderlyandunderstandableway,aswellasthepossibilityofincludingseveral scholars work on the matter, which can contribute to providing an overview of different stances or developments.secondarysourcesconsistofmaterialpresentedsecondhand,andincludeinthispaper the use of textbooks, EU articles and journal articles, which do not present original information but ratherreestablishestheoryandmaterialfromothersources.furthermore,becauseweareaddressing and discussing a dynamic policy area, we have used several acknowledged newspaper and journal articlescontainingcontemporary,relevantinformationontheadvocacycoalitions,tobaccoandalcohol industrylobbyismandlegislation.specifically,itmustbenotedthatalimitedsetofarticlespublishedin thebritishmedicaljournal s(bmj)tobaccocontroljournal(i.e.costaetal.,2014;peetersetal.,2015), 1 Theseareexemplifiedbyhearingsorofficialdocumentsfromtherelevantstakeholderoradvocacycoalition. 2 ThroughoutthispaperwewillrefertotheEuropeanCommission,EuropeanParliamentandtheEuropeanCouncil assimplythecommission,parliamentandcouncil. 11

12 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco willbeleveragedextensivelyfortheassessmentofthetobaccoindustry sactivitiesandstrategytowards thetobaccoproductsdirective(tpd)revision.duetothesearticles farreachingbackgroundanalysisof leakeddocumentsfromthetobaccoindustry,aswellasdocumentsobtainedviafreedomofinformation requests,theirinputwillcontributesignificantlytotheanalysis.alongwithinterviewsconductedwith the public health community within tobacco, these however are largely portraying negatively the tobacco industry, and unfortunately, it has not been possible to get an interview with the tobacco industryitselftograsptheircontrastingstancefirsthand.thiscanestablishthepotentialforcertainbias inthethesis analysisofadvocacywithintobacco. Byusingan approach encompassing bothprimaryandsecondarysources,the paper circumvents the fallaciesassociatedwithusingonlysecondarysourceswhichcanbebothoutdatedanddistorted,oronly using primary sources which can be too narrow in scope, not taking in all relevant information and therefore become biased. For this paper, the use of only primary sources in the form of interviews wouldhavebeendetrimentaltotheobjectivityofanalysis,duetotheonlypartiallysuccessfuloutreach toallrelevantstakeholdersandadvocacycoalitionrepresentatives.notincludingothertypesofprimary andsecondarysourceswouldhavemadetheanalysisbiasedfromthebeginning. Addressing our use of empirical sources in terms of our choice of philosophy of science, the critical realistapproach,wehavepreferredtouseseveralmethodsforgatheringinformation.thereasonfor doingthisshouldbeseenasresultofthecriticalrealistassumptionthatusingdifferentmethodologies yieldthebestpossiblepointofdepartureforcreatingknowledgeaswellasacknowledgingandtryingto understand the underlying, nonobservable structures of social reality. As it has been postulated, compared%to%positivism%(naturalism)%and%interpretivism%(constructivism),%critical%realism%endorses%or%is% compatible%with%a%relatively%wide%range%of%research%methods,%but%it%implies%that%the%particular%choices% should%depend%on%the%nature%of%the%object%of%study%and%what%one%wants%to%learn%about%it (Sayer,2000; citedinmoses&knutsen,2007).therefore,inthisprojectwehaveusednaturalistsourcesintheform of official documents, statistics, laws and treaties as official empirical data to supplement subjective sourcestherebyaccumulatingthehighestpossiblelevelofknowledge,despitetheoverarchingcritical realistassumptionthattrueknowledgewillalwaysbeimpossibletounderstandcompletely. 12

13 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 1.4. Delimitations( As proposed in prior sections, it is vital for delimitation purposes to acknowledge the novelty of this paper s approach for outlining the regulatory EU development of tobacco and alcohol through an advocacylens.evenmoreso,thisbecomesrelevanttounderstand,asthetheoreticalfoundationofthis assessmentreliesprimarilyontheexchangemodeloflobbyismandtheadvocacycoalitionframework, which was published thirty years ago and developed to explain the activities of American advocacy coalitions as a denominator of the development of certain water politics in a region in the U.S. Delimitingthepapertousingtheseperspectivestoaddressadvocacy,withproperassistancefromlater revisionsandadditions,hasbeendonedecisively,astheyremainrelevanttoaddresspresentadvocacy effortsandstrandswithintobaccoandalcoholintheeu. This paper will predominantly address the EUlevel of tobacco and alcohol policy. It is acknowledged thatthesubsidiarityprincipleintheeuropeanunionyieldsstrongsovereignpowerstolegislatewithin health, making a crosscountry comparison interesting. However, due to the extent and research timeline of this paper, tobacco and alcohol legislation is primarily targeted as a public health and economicfactorfortheeuwithonlyperipheralreferencetonationalmemberstateexamples.despite thedifficultyindefiningalcoholandtobaccolegislationmerelyateulevel,duetoglobalisationandthe interdependentvertical 3 andhorizontal 4 multilevelgovernanceconcerningtheseareas,thepaperwill focusprimarilyonsuch,withreferencetocertainnationalandinternationaldevelopments,suchasthe WHOFrameworkConventiononTobaccoControl (FCTC), as this has guided much of the subsequent official advocacy processes in the EU. Moreover, the analysis and discussion parts of thesis will be limitedprimarilytoeventsanddevelopmentswithinthelastdecade.thisisanecessitytogaugethis comprehensiveanddynamicpolicyareainwhichalterationscontinuetoappear,andthereforetomake thisresearchstudyapplicableithasbeenessentialtodefineamorespecificperiodofattention. Duetotheextensivesourcematerialandmedicalnatureofthesubjectsofanalysis,itisalsoimportant tonotethatwearegoingtoselectaspectsofalcoholandtobacco,whichwehavefoundparticularly interesting in answering our research question. Thus, the paper will take certain elements of the EU legislative capacity as given, and will further accept the commonly referred medicalcomponentsand contentoftobaccoandalcohol,asputforwardbytheworldhealthorganization(who).thispaperwill thus not devote attention nor introduce the more specific neurological or healthrelated issues 3 erticalgovernancereferstothelocal,national,regional,supranationalandinternationallevels. 4 HorizontalgovernancecoverstheEUlevelacrosstopics,includinghealth,trade,taxationandagriculture. 13

14 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco regardingtobaccoandalcohol,suchasitbeingagammahydroxyaminobutyricacidorgabaagonist, but instead accept the internationally agreed concepts of alcohol and tobacco as key risk factors for numerouschronicdiseases,anddependenceofsuchasbraindiseasesratherthanattitudinaldefects. Thiswillallowfordogmaticscholarlyunderstandingofthepoliticalratherthanthemedicalaspectof saidtopic. As is otherwise the case in many empirical papers on lobbyism, and especially within alcohol and tobacco,itisalsoimperativetonotethatthepurposeofthispaperisnottoidentifypotentialblames and take side on the health contrasting economic interest debate. Rather, the aim is to objectively assess the balancing act of the EU and its institutional framework between economic interests and public health organisations within an immensely topical, debated and in recent years, for one of the substancesatleast,increasinglyregulatedissue. Duetothescopeofthepaper,aswellasthelimitedresourcesandpagesattheauthors disposal,ithas been decided against including additional components, such as similar chronic disease risk factors as definedbywhoofmoredietarynature,i.e.sugar.additionally,duetotheseconstraints,aspecificset ofinterviewtargetshavebeendefined,ofwhichsomeunfortunatelyhavebeenunabletoparticipate.it has further been specifically decided to defer from contacting specific companies Brusselsbased offices,astodelimittheresearchscope.instead,outreachhasbeenconductedtoumbrellaassociations forboththeeconomicoperatorsandpublichealthcommunity 5 toencompassaholisticapproachfor referenceinthepaper. Finally,thepaperwillnotdescribetheoverallfunctioningoftheEUnortakeinadditionalpolicyareasor EUinstitutionsinparticularinthisprojectandtherewillbeinitiatedneitherathoroughdescriptionnor discussion of the surrounding causes for the different international agreements. Instead, these developments will be accepted as exogenous, and the focus will remain on the overall effect of the developmentoftobaccoandalcohollegislationintheeuthroughanadvocacylens,whichisthemain outsetofthisthesis. 5 Thisincludesreachingouttobothproindustryassociationswithinalcoholandtobacco(SpiritsEUROPEand EuropeanSmokingTobaccoAssociation)andpublichealthNGOs(Eurocare,SmokeFreePartnershipandEuropean CancerLeague). 14

15 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 1.5. Critical(realist(philosophy(of(science(( Thispaperwillrelyonacriticalrealistphilosophyofscience,asameanstogaugeandframetheanalysis ofthetopicalissueofalcoholandtobaccointheeu.criticalrealism,asfirstproposedbyroybhaskar, encompasses transcendental realism with critical naturalism to explain the process of generating knowledge,albeitneverbeingcertainnordefinite.asisargued,thenatureandhierarchicalstructureof theworldisorganisedintodifferentstrata,whichare emergent,meaningthatuncoveringonestrataof realityproposesnewproblemsandpropertiesatotherstrata. ThispaperwillseetoexplainalcoholandtobaccopolicyandadvocacyintheEUbeingattentive,but analyticallypassivetoemergentstructuresinotherstrataandpolicies,duetothescopeofthepaper.as such,retroductionwillbeleveragedasthemainmethodologicalreasoning.ingeneral,criticalrealism leverages retroduction, where inferences are made on the basis of identifying means capable of producingthem(sayer,1992).itwillbeusedespeciallyforprimarysources,suchasinterviews,toinfer moregeneralandnovelideasabouttheadvocacycoalitionsandtheirpoliticalinfluenceandmessages withinalcoholandtobacco,asameanstopotentiallyuncoveringnewstratawithinthispolicyfield.as Lawson (1997) has posited, retroduction implies moving from a conception of some phenomenon of interest to a conception of a different kind of matter (power, mechanism) that in turn could have generated the given phenomenon. Retroduction means moving backwards and that is what the processinvolves,byasking whatmustbetrueinordertomakethiseventpossible? (Easton,2010).For this thesis, retroduction will further be leveraged to assess lobbyism and advocacy coalitions as descriptor for the regulatory variance between alcohol and tobacco at EUlevel. By focusing on the advocacy level of these policy areas, it will potentially allow for understanding and explaining the processandreasoningforthedifferentstagesofsupranationalpoliticallegislationofthesematters. Retroductionandthechangingpaceofknowledgecreation,duetoemergentstrataandparadigmshifts (Gorski, 2013), yields both a transitive and intransitive dimension according to critical realism. The intransitive dimension encompasses the natural world as it objectively is, whereas the transitive dimensionreliesonourchangingconceptsofit.thus,causallaws,rejectingthepositivistperceptionof itasbeingconstantconjunctionsbetweenobservableevents,shouldinsteadbedefinedbythemultiple layers of agents that produce them, and thus, they should be the principal objects of science. The distinctivenessinpropertiesandpowerbetweenpeople,andforthispaper,advocacycoalitions,canfor criticalrealismthenbeexplainedbythedifferentstrataofreality,whichtheyoccupy. 15

16 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Knowledgeproductionwithincriticalrealismisthusasocialprocesswherebyknowledgecanneverbe certainordefinite(radford,2013),andwherefocusisonexplanationratherthanpredictivemeasures. Therefore,realityisopen,stratifiedanddifferentiatedandthereareonlyafewregularitiesinthereal world(moses&knutsen,2007).ithasbeenpostulatedthatcriticalrealismis realist %in%the%generic% sense%that%it%takes%a% mind>independent %nature%as%a%fundamental% condition%of%possibility %for%natural% science.% But% it% is% also% realist% in% the% critical % sense% that% it% sees% science% as% a% human% activity% that% is% inevitably%mediated%(if%not%determined)%by%human%language%and%social%power (Gorski,2013).Thus,the ontological difference in nature and society leads to an epistemological equivalent, making it solely possibletoobservesocialstructuresviatheactivitiesandideasofhumanbeingsorthematerialobjects theygenerate.examplesofsuchanalysiswillinvolvethestakeholderandadvocacycoalitionanalysis, whichfortobaccoandalcoholisalsomaterialisedintheobjectsoftheeuropeanalcoholandhealth ForumandTobaccoProductsDirectiverevisionsamongothers. Thecriticalrealistapproachfurtherfocusesontheagencystructureprinciple,inwhichitargueshow structuresshapeagents behaviourandviceversa.theagencystructureprincipleissubsequentlysplit intotwosubsetsofstudy,namelystructuralismandindividualism.throughstructuralism,criticalrealists seek to explain how structures dominate agents and act as the explanatory variable and thus how structuresshapeandconstrainanagent sactions.onthecontrary,criticalrealistsuseindividualismto explainhowagentsfunctionastheexplanatoryvariableforstructures,andemphasisethatstructures aretheintentionaloutcomeofagents actions. Inordertoassesscriticalrealismandtheperceptionsofstructureandagencymutuallyshapingeach other sbehaviour,thisthesiswillintroducethedifferentintegrationtheoriesofneofunctionalismand intergovernmentalism as well as the advocacy coalition framework and exchange model of lobbyism usingcriticalrealismaspointofdeparture.insuchcapacity,theintegrationtheorieswillalludetothe powersoftheeustructureinexplainingtheadvocacycoalitions activities,whiletheadvocacycoalition framework and related exchange model of lobbyism instead will assess the potential of an agent in shaping the structure in which it operates. For this matter, the critical realist philosophy of science acknowledges the uncertainty of actual knowledge through the transitive, epistemological and intransitive,ontologicaldimensionsandfocusesonexplainingthepowers,whichforthispaperarethe actorsandadvocacycoalitionsthatproducedastructureorchangeratherthanalawitself.asgorski (2013)hasproposed, to%explain%something%is%to%identify%the%structures%and%powers%that%produced%it.% Laws %are%statements%about%powers,%not%events. 16

17 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 1.6. Theoretical(foundation(( Advocacy(coalition(framework( Paul Sabatier, in collaboration with Hank JenkinsSmith, published the advocacy coalition framework (ACF)in1988asaframeworkofpolicyprocessestodealwithcomplexissuesinvolvingelementssuchas considerableconflictsofmainobjectives,imperativeproceduraldisagreementsandseveralactorsfrom differentlevelsofgovernment(sabatier,1988;sabatier&jenkinssmith,1988).itwasrevisedtosome extent in 1993 (Sabatier & JenkinsSmith, 1993), and was initially applied to the U.S. energy and environmental policy. The ACF was further revised in 1999 to apply to case studies of policymaking withintheeuropeanunion(sabatier&jenkinssmith,1999). Sabatier and JenkinsSmith developed the ACF to deal with complicated policymaking in which the environmentischaracterisedbyhavingmultipleactorsatseverallevelsofgovernment,inturnyielding high levels of uncertainty and ambiguity. The tedious policy procedures further create large gaps between decisionmaking and actual implementation and outcome. The ACF framework rests on the basisofthreepillars,namelyamacrolevelassumptionthatpolicymakinggenerallyisconductedbya groupofspecialistswithinaspecificpoliticalsubsystemwhosepreferences,behaviourandopinioncan beswayedandinfluencedbydynamicsintheoverallpoliticalandsocioeconomicsystem.secondly,the ACFsuggeststheexistenceofamicrolevel,whichappliessocialpsychologytomodelindividuals,and lastly,amesolevelpropositionsuggestingthatthemostefficientwaytodealwithseveralactorsofa political subsystem is to group them into what Sabatier and JenkinsSmith refer to as advocacy coalitions. Sabatier and JenkinsSmith further argue that these foundations influence the dependent variablesofbeliefandpolicychangethroughtwocriticalpathsknownaspolicyorientedlearningand externalperturbations. Thefirstmacrolevelpillariscomprisedofpoliticalsubsystemsandtheinfluence,whichexternalfactors haveovertheactorswithin,andassumesthatcomplexitywithinmodernpolicymaking,bothlegallyand substantivelyhasreachedadegreetowhereonlyspecialisedindividualscanbeinfluentialinpolitical system.specialistsseektoexertinfluencewithinapoliticalsubsystem,oftencomposedofindividuals whoregularlytrytoinfluencethepolicymakingwithinacertainpoliticalsubsystem.thesespecialistor policyparticipantscanbelegislators,agencyofficials,interestgroupleaders,researchersandjournalist interestedinthefield.theacfframeworksuggeststhatthespecialistsorpolicyparticipantswilltryto implementpolicies,whichcorrespondwith their own beliefs. As mentioned above, the ACF is mainly 17

18 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco concerned with policy change over a decade or more and in turn believes that individual beliefs are difficulttochangeandthusmakeslargerscopepolicychangesdifficulttoimplement. Thesecondpillarreferstotheindividualspecialistsorpolicyparticipantsinvolvedandtheirbeliefs.The ACFclaimsthatthesebeliefsarenearlyimpossibletochangebecauseindividualsseetheworldthrough whatisreferredtoasasetof perceptualfilters constructedonthebasisofpreexistingbeliefs,which are difficult to alter. Due to this, Sabatier and JenkinsSmith point to the fact that it can prove very difficult for actors from different coalitions to work together because they perceive the world fundamentallydifferent.moreover,theacfappliesaconceptofthe devil sshift,whichexplainshow individualsarelikelytoremembertheirownlossesmorethantheirvictoriesandthereforetendtoview theiropponentsaslesstrustworthy,moreevilandmorepowerfulthantheyreallyare.ultimately,this strengthens the ties between individuals within one coalition who share the same beliefs and concurrentlyincreasestheconflictbetweencompetingcoalitions.intheacf,sabatierandjenkinssmith establish three different subsegments of an individual s beliefs, namely core beliefs, which are fundamentaltotheindividualsuchasgeneralassumptionsabouthumannatureandthecorrectbalance between liberty and equality. Core beliefs are expected to remain the same, however these are too broad to steer policymaking. In turn, policy core beliefs are core beliefs, which capture an entire subsystemandarethereforegenerallymorespecificthanbasiccorebeliefsandrestonasubsystematic perception of the ideal society. For this matter, Sabatier and JenkinsSmith (1999) define eleven components, namely prioritisation of different policyrelated values, welfare, appropriate authority balance between governments and free markets, appropriate roles of the general public, elected officials, civil servants, experts, and the relative seriousness and causes of policy problems in the subsystemasawhole.operationalizingtwoorthreeoftheseelementsshouldbesufficienttoidentifyat leasttwoadvocacycoalitions.becausethesebeliefsarelinkedtoanentirepoliticalsubsystemandby nature are large in scope, they are also difficult to change. Instead, secondary beliefs relate to the implementation of policies and are by nature narrower in scope as they address concrete policy proposals.giventhenarrowerscopeandthemoreadhocapproach,secondarybeliefsaregenerallyless engravedinthefundamentalmindsetsofthepolicyparticipantsandthusshouldbeeasiertochange. ThethirdpillaroftheACFisconcernedwithadvocacycoalitions,inwhichtheauthorsarguethatpolicy participants will strive to exert their beliefs into concrete policies before their opponents. The ACF suggests that in order to be successful, policy participants will do this most efficiently by seeking to groupthemselveswithotherpolicyparticipantswhosharethesamebeliefs,whichinturnwillmake 18

19 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco them capable of pooling resources and cooperatively develop complementary strategies. In turn, the concept of the devil s shift becomes relevant, as the fear of losing to opponents incentivises policy participants to align and cooperate with their allies. Sabatier and JenkinsSmith (1999) argue that advocacy coalitions is amongst the most powerful tools for individual interest groups and policy participantstoexacerbateinfluencewithinonepoliticalsubsystemwithhundredsofdifferentactors, becausebyaggregatingeffortsandresourcestheywillstrengthentheirownposition.accordingtheacf therewillnormallybetwotofivedifferentadvocacycoalitionswithinagivenpoliticalsubsystem. Onthebasisofthethreepillars,itbecomesclearthatitishighlyunlikelythatpolicyparticipantswill change their core policy beliefs voluntarily. Hence, the ACF argues that altering core policy beliefs of policy participants can happen through two paths defined as policy oriented learning and external perturbations.policyorientedlearningsuggeststhatpolicyparticipantsmayaltertheirbeliefsonthe basisofthenewinformationtheyattainduringpolicyimplementation.giventhatdeepbeliefsarevery normativeandthusdeeplyengravedinthemindsofthepolicyparticipants,newinformationthrough policyorientedlearningwillrarelyinduceanymajorpolicychanges,butratherminorpolicychangesin whichcoalitionschangetheirsecondarybeliefs. Externalperturbationsinsteadareproposedtobenecessarybutnotbyitselfsufficientformajorpolicy changes.itincludesdisasterssuchaschangesinthesocioeconomicenvironmentandregimechanges. Such events can shift the attention of the public, change agendas and capture the attention of key decisionmakers. Accordingly, the most important aspect of such is that it creates a redistribution of resourcesoropening/closingofcertainvenueswithinapoliticalsubsystem,ultimatelyshiftingaround the positions of dominating and minority coalitions. This can ultimately can lead to a change in the dominatingcoalition scorepolicybeliefs,henceinduceamajorpolicychange. ApplicationoftheACFtocasestudiespost1999hassuggestedthatthereareotherimportantpathsto major policy change, which include internal shocks and negotiated agreements. Internal shocks arise withinthepoliticalsubsystem,whichwillsubsequentlyinduceastrengtheningofthepolicycorebeliefs within the minority coalition. Negotiated agreements on the other hand describes how negotiations betweentwoopposingcoalitionscanprovenecessaryinasituationofstatusquoandcompromisescan thusalterthecorepolicybeliefsofthecoalitions.forthisaspect,theconceptofa hurtingstalemate is key,whichentailsthatinorderforsuccessfulnegotiationstohappen,allpartiesmustbedissatisfied withthecurrentstatusquoandthuswillingtogiveupsomethingtomoveon. 19

20 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco TheACFcapturesmanyimportantfactorsofwhatdrivescoalitions,lobbyingeffortsandwhyitcanbe difficulttoalterdeeplyengravedagendasofcoalitionswithinspecificpoliticalsubsystem.wewillapply thistheoreticalframeworkinordertoidentifyprominentcoalitionswithinthepoliticalsubsystemsof tobaccoandalcoholregulationasameanstouncoverthelobbyingeffortsconductedwithintheseat EUlevel. We will complement this theory with the exchange model of lobbying, which has been put forwardbyheikeklüver Exchange(model(of(lobbying( TheexchangemodeloflobbyingbyHeikeKlüver(2011;2013)aimstoexplainwhysomeinterestgroups are capable of influencing policymaking in the European Union while others are not. Klüver s model rests on the assumption that interactions between interest groups and the EU take the shape of an exchange relationship between interdependent actors. Within the framework, Klüver (2011; 2013) argues that the basic instinct of interest groups such as associations and companies is to survive. To achieve this goal, companies have to remain profitable and associations rely on steady membership increases.companiescanachieveacompetitiveadvantageovertheirclosestcompetitorsbyinfluencing policymakingintheeutowardsaregulatoryenvironmentwhichbenefitsthemtoalargerextentthan theircompetitors.tothis,itisproposedthatmaximisingpoliticalinfluenceisofcrucialimportancetoall interestgroupsasitenablesthemtoinfluencepolicymakingtoalargerdegree.further,klüver(2011; 2013)arguesthatinordertofullycomprehendandunderstandhowinterestgroupsgaininfluencein policymakingintheeuitisimperativetounderstandthetypeofgoodsthatareexchangedbetween theinterestgroupsandeuinstitutions. ThethreemaininstitutionsoftheEUaretheCommission,theParliamentandtheCouncilandthemain driverfortheseissimilarlytointerestgroupsarguedtobesurvival.theinstitutionshavedifferentways toreachthisend;thecommissionformulatesanddraftspolicyproposalswhichcanbepassedtogiveit morecompetences.themepsallseekreelectionintheparliament,whereastheofficialsinthecouncil all seek reelection in their own national constituencies. However, for all institutions, three types of resourcesareofgreatimportance,namelypolicyinformation,citizensupportandeconomicpower.the interestgroupscanprovidetheofficialswithallthese,inreturnforpoliticalinfluence.therefore,the degreetowhichinterestgroupscaninfluencepolicymakingisdependentontheirabilitytosupplythe threetypesofresourcesoutlinedabove. Klüverfurtherelaboratesonthethreeresources,byproposingasetofinputneedsforEUinstitutions. Firstly,thekindofinformationwhichtheEUinstitutionsareinterestedinistechnicalexpertisewhich 20

21 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco they can apply when drafting a policy. The Commission requires the technical expertise in order to formulateaproposaladdressingaspecificpolicyissue,whereastheministersoftheparliamentandthe Council require information, which enables them to evaluate proposals set forth by the Commission. The Commission and MEPs themselves are unable to gather the information needed due to understaffingoroccupationwithothermatters.thesameconceptappliesforthecouncilinwhichthe governmentofficialsmayrelyoninformationprovidedbytheirnationalgovernments,whichoftenalso isprovidedbyinterestgroupslobbyingonanationallevel.generally,interestgroupsareabletosupply this precious information, as they are highly specialised within different policy areas, giving them extensive understanding and thus enabling them to provide very detailed and highly valuable information. Thesecondresourceisdefinedascitizensupport,bothofwhichMEPsandgovernmentofficialsofthe Councilareheavilydependentuponinordertoensurereelection.Therefore,theyseektopasspolicy proposals,whichhavethesupportandpopularityoftheirvoters.duetotheissueof democraticdeficit intheeu,thecommissionalsoincludesvarioussocietalactorsthroughconsultationduringtheproposal processinordertostrengthenitslegitimacyandachievewidesupportfromthepublic.concurrently,in ordertoavoidpubliccriticismandachievereelection,mepsandgovernmentofficialsofthecouncilwill seektoadoptproposals,whichrepresentthepreferenceofthemajorityofcitizens.thismainlyapplies tomajorpolicydecisions,whichdrawlargeamountsofpublicattention.generally,citizens attentionto EUpoliciesisprettylow,thusprovidingleewayforinterestgroupstoassistinfacilitatingandfostering moreattentiontowardstheirowncauseandthepoliciesthattheywishtoinfluence. EconomicpoweristhethirdinputrequiredbyEUinstitutions.Manycorporationshavelargeeconomic influenceandbecauseofthis,mepsandnationalgovernmentofficialsofthecounciloftenseeksupport fromtheseactors.thisisbecausetheirfutureactionscanhavelargeimpactonjobsecurityintermsof employment, general economic growth and job creation. All these factors are generally of significant importanceforvoterswhenassessingthedifferentpoliticalparties.beingawareofthedependenceof MEPsandtheCounciloneconomicpower,theCommissionseekstopresentpolicyproposal,whichare intheinterestofcorporationsandtheindustry,asthisincreasestheirchanceofapprovalfrommeps andthecouncil. Similar to Sabatier and JenkinsSmith, Klüver argues that for a complete analysis of interest groups influenceonpolicymakingintheeu,itisinsufficienttosimplyassesstheexchangeofgoodsbetween 21

22 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco interestgroupsandinstitutions.becausethereareoftenseveralinterestgroupstryingtoexertinfluence on policymaking,coalitionsformedaroundspecificpolicyissues mustbeconsideredthemainactors. Thismakestheexchangemodeloflobbyinghighlyapplicableincombinationwiththeadvocacycoalition framework by Sabatier (1988), as they both agree that lobby efforts should be analysed in terms of coalitions. However, the theories provide different approaches to assess how interest groups attain influenceoverpolicymaking NeoJfunctionalism( The integration theories of neofunctionalism and liberal intergovernmentalism will primarily be leveraged to explain the subsystemic level of policymaking in the EU. Neofunctionalism is a pluralist theory of international politics developed by Ernst Haas, which aims at explaining why states are mergingwithothercountries.thetheorybelongstothemoreliberalpartofintegrationtheoriesand seesintegrationasanincrementalprocess.withinthetheoryitisassumedthatthestateisnotaunified actor and states are not the only actors on the international political stage. Neofunctionalists try to explainwhynationalstatesaremergingwithneighbouringcountries,therebylosingsovereigntybutat thesametimegainingnewmethodsforsolvingconflictsbetweencountries.theyfurtherbelievethat the activities nation states participate in internationally, is the outcome of pressures from different interest groups and bureaucratic actors exerted on the national governments. According to neo functionalists,nonstateactorsareofgreatimportancewhenshapinginternationalpolitics.themost importantinternationalnonstateactorintheviewofneofunctionalismisthecommission;ithasthe power to initiate legislation. Furthermore, the Commission is in a unique position because it can manipulatebothdomesticandinternationalinterestgroupstoexertpressuresonnationalstate,which could make them agree to further integration, even when the government might be hesitant (Bache et.al,2011). Neofunctionalists explain how countries become further integrated, after subsequently having taken thefirststep,bytheconceptofspillover.aspillovereffectdescribeshowgovernmentsbecomemore integrated, because the initial integration has created a need for further integration. Within neo functionalisttheorythreekindsofspillovereffectexists;thefunctionalspilloverincorporatestheidea that when a country integrates one part of their economy, other sectors will follow because there is interconnectednessbetweenthesectorsthatwillforcetheothersectortobeintegrated.anotherspill overeffectispoliticalspillover,inwhichitispresupposedthatinterestgroupsaremoreinterestedin lobbying institutions at the European level like the Commission, instead of national governments 22

23 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco becausetheycangainmoreinfluenceatthislevel.thelastspillovereffectconsistsofthenotionof cultivated spillover. This deals with explaining how the Commission can cultivate the integration processasasupranationalinstitutionitself,byactingasamediatorbetweengovernments,whichcould fosterfurtherintegration(bacheet.al,2011) Liberal(intergovernmentalism( Liberal intergovernmentalism set forth by Andrew Moravcsik follows the tradition of intergovernmentalism originated by Stanley Hoffmann, but is built upon liberal theory of domestic politics. It is in many ways a counterargument to neofunctionalist theory. Within liberal intergovernmentalism it is believed that governments play a twolevel game; at the domestic level national interests are determined and on the basis of these national interests, governments can negotiateinternationally(bacheetal.,2011). Liberal intergovernmentalists believe that integration is the outcome of a threestage process; first, whenmajordecisionsaremadeinfavouroftheeu,thisisduetopreferencesofthedifferentnational governments,ofwhichpreferencesareoftenbaseduponeconomicinterest.thuspreferenceformation of institutions is set by the national governments and not by supranational institutions. Second, outcomesofnegotiationsbetweenmemberstatesoftenreflectthepowerstrugglethatexistsbetween MemberStates.Thestatewiththemostpowerrelativetotheotherstateshasthelargestbargaining power and can therefore ensure that its economic preferences are implemented into the major decisions made within the EU. Third, liberal intergovernmentalists believe that the reason why some decisionmaking authorities are delegated supranational entity reflects that governments want to ensure that the commitments made by all Member States will be carried out in a proper manner. LiberalintergovernmentalistsbelievethatMemberStateswillalwaysbeinfullcontroloftheintegration processandthusarguethateuinstitutionsarepassivestructures MultiJlevel(governance((MLG)( Thepointofdepartureforthemultilevelgovernanceapproach(MLG)isthenotionthatcompetencies mutuallyoverlapbetweencertainlocal,regional,nationalandsupranationalpoliticalactorsthateach haveuniquepolicyfeatures (Marks, 1996). An example, and what will be assessed specifically in this paper, is European polity, where local governments, national Member States and the supranational regulationoftheeuallhavetocoexistandoperateaccordingtoeachother smandates.theeuropean UnionisapoliticalsystemwithaEuropeanlayer(Commission,CouncilandParliament),anationallayer and a regional/local layer. These layers interact with each other both across different levels of 23

24 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco government (vertical dimension) and with other relevant actors within the same level (horizontal dimension). Inturn,thestructureofpoliticalcontrolisvariableandinconsistentacrosspolicyareas,ofwhichthe areasoftobaccoandalcohollegislationisaperfectexample,astheyinflictuponmultiplepolicyareas, such as health, taxation and the internal market. In this context, it is important to understand the principleofsubsidiarity,whichplacesdecisionsascloseaspossibletothecitizensandensuresthatthat actionateulevelisjustifiedinlightofthepossibilitiesavailableatnational,regionalorlocallevel.as willbediscussed,fortobaccoandalcohol,differentstakeholderspromotedifferentpowerstructures withregardtomlg. MLGfurtherpositsthatthepolicyprocessofsettingtheagenda,formulatingpolicy,decidingonand implementing such policy, lies among others in the hands of epistemic communities and policy communities,whoareespeciallyimportantforthetwofirststagesoftheprocess.forthisthesis,the perspective on advocacy coalitions can rightly be asserted as such, and the focus within alcohol and tobaccointheeuwillthusbeontheagendasettingandpotentialpolicyformulation. The consequences of multilevel governance have in recent years been debated, with the framework havingbeenproposedtoaggravatecorruption(treisman,2000),leadtogridlockandlegitimacyissues (Scharpf,2009)andstimulatemoralhazard(Rodden,2006).Itisimportanttoemphasisethatthemulti levelgovernanceframeworkforthisthesiswillbeleveragedasanexplanatoryvariabletoencompass andunderstandthedevelopmentofalcoholandtobaccoregulationintheeu,aswellasthefutureof such. These consequences will therefore not be dwelled upon outside of the scope of alcohol and tobacco,andmlgwillnotbediscussedasaninstrumentinitselfinthispaper Limitations(of(analysis( Although the limitations to the analysis are sought minimised through proper delimitation of the researchscope,itisimportanttoassesstheremainingconstraintsofthethesis. Firstandforemost,acknowledgingthecomplexityinanalysingandexplainingamovingtarget,whichthe constantlyevolvingareasofeutobaccoandalcoholregulationare,isparamount.aswithallareasof political interest and legislation, the regulation of tobacco and alcohol at EUlevel is a continuous process,whichcanquicklyoutdatethethesisanalysisanddiscussion. 24

25 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Secondly, the complexity is further increased with the intermixing and overlapping levels of analysis, whichisespeciallycriticalforhealthandeconomiclegislation,whichisgovernedatbothlocal,national, EUandinternationallevel.Despitethedelimitationofthispaperproposingapreliminaryfocusonthe EUlevel,theinterlinkednatureoflegislationandregulationwithintheareasoftobaccoandalcoholcan entangletheanalysisinverticalgovernanceclutter,whichissoughttobecircumventedthroughproper definitionofthespecificresearcharea. Thirdly,theaforementionedpredicamentwiththeprimarysourceextractionrelatedtotheinterviewsis important to stress. Interviews will lay the foundation for parts of the analysis and discussion, and althoughawidearrayofstakeholdershasbeenapproached,encompassingdifferentadvocacycoalition participants, only a sample of these has been available for interviews. It is thus important to acknowledge that this can in the end create some degree of bias in the paper. Although most intervieweeshavebeenapproachedintheircapacityasrepresentativeofanadvocacycoalitionorits members,itisalsovitaltorecognisethatselfinterestscanbeperpetuatedintheresponses,whichdoes notnecessarilyreflectthatoftheorganisationoradvocacycoalitionitself.specifically,althoughwehave soughttoincludeperspectivesfromalladvocacycoalitionswithinbothalcoholandtobaccointheeu, wehave,despiteoutreach,beenunsuccessfulinensuringinterviewswiththeeuhealthcommissioner s office, Member of the European Parliament (MEP) Linda McAvan, who was corapporteur of the Tobacco Products Directive (TPD), MEP Glenis Willmott, who was corapporteur of the recent EP Resolution on Alcohol, Smoke Free Partnership, who led the public health community in the TPD revision,pharmaceuticalcompanypfizer,whowasinvolvedinthetpdrevision,aswellastheeuropean Smoking Tobacco Association (ESTA) among others, although outreach was conducted to these stakeholders.albeitrelyingalsoonempirical,secondaryevidenceandsourcestoensureanimpartial analysis,thereisariskoftheanalysis,duealsotothesignificantuseofcertainsecondarysourcesfor specificsections,becomingunintentionallybiased,whichmustberecognised. Another potential limitation to highlight is the theoretical use of the advocacy coalition framework (ACF). The ACF was originally developed from case studies in the U.S. in the 1980s, with a particular focusonwaterandenvironmentalpolicy.thus,ithasthepotentialliabilityofhavingbecomeoutdated to an extent that can impact the analysis. However, with assistance from subsequent scholars, it has changedmarkedlytoreflectitsapplicationtocasesoutsidetheu.s.andinotherpolicyfields(sabatier& Weible,2007;Weibleetal.,2009;2011;Cairney,30/10/2013).Therelevanceoftheframeworkforthis EUtopiccanresultincertainanalyticalshortcomings,althougheffortstocircumventthisaredoneby 25

26 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco incorporating among others Heike Klüver s present ideas on interest group influence and advocacy coalitionstosupporttheanalysis.hence,thepaperseekstodelimittheweaknessesoftheanalysisby establishingatheoreticalframeworkthatincorporatesthestrengthsofbothperspectives.seeingthat thesetheoriesarenotfoundedonthespecificissueofalcoholandtobacco,andasfewscholarsbefore havetriedtoanalysetobaccoandalcohollegislationintheeucollaboratively,itcanresultinfurther limitationsoftheanalysisduetolackoftheoreticalandempiricalevidence. TheACFcontinuestobeoneofthemostambitiouspolicyframeworksseekingtoprovideanoverviewof the entire policy process. Though this is its core strength, it can alsobecomealimitation due to the restricted resources and pages available for the analysis, as well as the increased necessity for highlightingthemostconvincingcomponentsforexamination. A final limitation to underline is the controversial element of tacit knowledge, which for this paper includes the internal practices of lobbying groups. The paper will see to include relevant internal advocacy material published as result of legal matters specifically for tobacco, as well as firsthand interviews with certain key stakeholders, who can further elaborate on advocacy coalitions and strategies.however,the tacitknowledge andinternalsecretwaysofoperatinginanadvocacysetting canbedifficulttouncover,expresslywithinalcohol,whichhasnotseenthesamelevelofpublicscrutiny andthuslegalindictmentsastobacco Reading(guidance( Inordertoensurereadabilityandacommonunderstandingofthepaper sbuild,thisreadingguidance will introduce briefly the structure and main elements of the different chapters. The chapters will linearlybuilduponthethreetaxonomiclevelsofdescription,analysisanddiscussiontobestencompass andstructurethecognitivethinkingandreadingofthepaper. Chapter1willassessandintroducethestructure,sourcesandmethodologyleveragedforthisthesis.It willfurthercompriseanintroductiontothetheoriesused,aswellashighlightpotentiallimitations. Chapter2willintroduceanddescribealcoholandtobacco,itsdifferencesandsimilaritiesintheEU,as wellasaccompanyinglegislationor softlaw thathasbeendescriptiveofthedevelopmentinthepast decades. The chapter will help assist subsequent analysis and discussion, and will ensure a common pointofdepartureforreaders. 26

27 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter 3 will embark on an analysis and discussion of legislation related to alcohol and tobacco. Through Klüver (2011; 2013) and Sabatier s (1988) perspectives on interest group influence and the advocacycoalitionframework,thepotentialkeydifferentiationsandexplanationsforthedevelopment ofthesetwopolicyareasateulevelwillbeassessed. Chapter4willfurthertheanalysisandseetouncoverthewiderimplicationsfromboththeEUsystem andthespecifictobaccoandalcohollegislationthroughtheuseofintegrationtheoriesandmultilevel governanceforassessingtheproblemsandopportunitiesofregulatingtheseareassupranationallyand in conjunction with other levels of responsibility. As such, the chapter will introduce and discuss the broaderdiscussionofhealthversuseconomicpreferences,andtheinternationalpolicydevelopments, thatmayhaveshapedeulegislationandadvocacyopportunitieswithintobaccomorethanalcohol. Chapter 5 will discuss the potential future legislation of these policy fields in the EU. Based on prior analysis,thenextstepsandpossibilitiesforalignmentorfurtherdivergenceofthesetwopolicyareas willbediscussedandaplausiblescenarioforwhattoexpectinthenextdecadeswillbedelineated.in ordertoensurerelevanceandreadabilityofthisthesis,thediscussionwillnotbeundertakenaloneand solely in this chapter, but instead in combination with other thesis segments and thus throughout chapters2,3and4. Chapter6willencompassthepaper sconclusions,leveragingtheanalysisanddiscussionofpreceding chapters.here,thepaperwillsummarisethelearningsandanswertheresearchquestion. Chapter7willcomprisetheperspectivation,inwhichpotentialtopicsandareasforfurtheranalysiswill beuncovered. Finally,thethesis bibliography,appendicesandinterviewtranscriptionswillbeavailableattheendof thepaper. 27

28 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!2! AlcoholandtobaccointheEuropeanUnion E A?,?? E????? I C F A E??CE???.? -?C I C A?? F CE C C? A? A F E??? A E CE C F C F A? AE?? EC H E??I? C? C? E?C 28. C

29 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 2. Alcohol(and(tobacco(in(the(European(Union( In order to establish a common foundation for subsequent advocacy analysis and discussion of the differentregulatorypaths,whichalcoholandtobaccohavefollowed,itisnecessarytointroducethetwo substances and their regulation at EUlevel. Following this introduction, a section on the overlying similaritiesanddifferencesinperceptionbetweenthetwowillbecommencedaspartofthechapter.in its totality, this chapter will serve as background for subsequent analysis and discussion of the two policyareasinthethesis Tobacco(in(the(EU( Research has shown that the consumption of tobacco through smoking and smokeless tobacco products,suchas snus,isthemostprominentpreventablecauseofprematuremortality,amountingto approximately5millionprematuredeathsannuallyworldwide,withasmuchashalfbeingindeveloped countries(theworldbank,02/2011;bump&reich,2012).itisfurthermoreoneofthekeyriskfactors for noncommunicable diseases, such as circulatory disease and cancer, as highlighted by the OECD (2014a)andtheWorldHealthOrganization(WHO,2013).Infact,over13millionEuropeanssufferfrom serious,chronicdiseasesduetotheirsmoking,andapproximately700,000arekilledeveryyearbecause they smoke, equivalent to one in seven of all deaths across EU (ASPECT, 2004; Peeters et al., 2015). Additionally,theeconomiccostofsmokingwasestimatedat billionin2000oraround1%of thegrossdomesticproductoftheeu(bridgeheadinternational,2011).thus,thewhostrivestoreduce theprevalenceofcurrenttobaccouseby30%in2025(2013a;2014b). FromaneconomicperspectiveintheEU,tobaccoisgrownin12EUcountries.Themainproducersare Italy,Bulgaria,Greece,SpainandPoland,althoughtheEUproduceslessthan3%ofglobalyearlyraw tobacco production (EU, 2015b), in sharp contrast to alcohol s impact on the EU economy. Europe's share of world tobacco growing has been declining since the mid1980s, with tobacco growing representingonlyasmallportionofeuagriculturalactivitywith1.3%ofeufarmsproducingtobacco, using0.1%oftheagriculturalland(aspect,2004). Duetothegravityofissuesrelatedtotobacco,controlofthesubstancehasinthelastdecadesbecome animportantissuetoaddress,specificallyinadvanced,westerndemocracies.asaresult,supranational institutionshaveenactedapromotionofantitobaccolegislation(eu,29/04/2014;oecd,2014a;who, 29

30 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 2005)onthebasisofscientificresearch,whichhasservedtoprovethedetrimentaleffectsoftobacco smoking and moreover the harmful effect of exposure to passive smoking (WHO, 2013; 2014b). In addition,governmentsaroundtheworldandespeciallywithintheeuhaveimplementedlegislationto reducetheconsumptionoftobaccoduetothetoxicityoftheproductandaddictiveeffectsofnicotine (RANDEurope,2012). Hence,measurestoreducetobaccoconsumptionhaveincreasedconsiderablyoverthepast30years andantitobaccoinitiativeshavebecomeanimportantissueontheagendaofseveralsupranationaland internationalagreements,suchaseuropeanuniondirectives(eu,29/04/2014),worldbankdocuments (TheWorldBank,1999;02/2011)andWHO sframeworkconventionontobaccocontrol(fctc)(2005). However,asoutlinedinthedelimitationssectionofthispaper,wewillprimarilybefocusingontobacco regulationrelatedtotheeuropeanunion Regulation(of(tobacco(at(EUJlevel( Tobacco regulation in the European Union (EU) dates back to 1972 and started as a way to protect national tobacco growers, manufacturers and to generate public revenue through the regulation of production,sale,use,tradeandpriceoftobacco.almostadecadelater,intheearly1980s,effortswere made to establish a cooperative harmonisation of tax levels in the European Community (EC). Nevertheless, this proved to be a difficult task with continuous disagreements and compromises betweenthelargesttobaccogrowingandtobaccomanufacturingcountriesintheec. The first traces of the EC taking an active role towards tobacco regulation driven by concern of the detrimentalhealthissuesrelatedtotobaccoproductsratherthaneconomicinterestswasinthesecond halfofthe1980s.atthistime,theecintroducedits EuropeAgainstCancer initiative,whichwasthe firstcommunityprogramme,aimedatreducingtobaccoconsumptionthroughtheimplementationof several actions. Subsequently, the Single European Act (SEA), Maastricht Treaty and the Amsterdam Treaty all considered tobacco regulation an important part of their agenda, which included work on directives, recommendations, resolutions and accession rules for new Member States as well as organised media campaigns in order to control tobacco and to display its toxicity. Concurrently, individual Member States started introducing national policies on the use and regulation of tobacco products,whichresultedinsharedauthoritybetweentheeuropeanunionandeachindividualmember Stateonthisspecificmatter(ASPECT,2004). 30

31 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Tobacco(directives(related(to(the(Single(European(Act( In1992, almosttwodecadesafter theoutsetofthefirsttaxregulationoftobaccoproducts,asetof commondirectiveswereestablishedasameanstoharmonisetaxlevelsacrossmemberstatesinthe EU.Thedirectiveswerecreatedasasteptowardsthevisionofcreatinga SingleEuropeanMarket in 1992,inwhichgeneralharmonisationacrossallindustrieswasofprimaryconcern.Thedirectivespassed in 1992 created conciliation between the specific tax and ad valorem tax schemes through a tax structurewhichincludedseveralcomponentssuchas;anexcisetax 6,valueaddedtax(AT)andmost popular price category (MPPC). The directives required that the combined value of ad valorem and specifictaxwouldbenolessthan57%oftheretailpriceofthemppc.atthetime,theatwassetat 13%andthereforetheminimumoveralltaxationontobaccoproductswouldbe70%.Lastly,Member Stateswerefreetodecidethebalancebetweenhowmuchshouldbetaxedusingspecifictaxandhow muchbetaxedusingadvaloremtaxaslongastheformerfellintherangeof5%55%ofthetotaltax includingtheat(aspect,2004). Theadvaloremtaxprovidedthebenefitsofenablingcigarettepricestostayintunewithoverallprice inflationinthemarket,byautomaticallyindexingcigarettepricesandtobaccorevenueforinflation.one disadvantage of the ad valorem tax was that it made the taxation vulnerable to coordinated pricing strategieswithintheindustry,meaningthatifallproducersloweredthepricesoftheirproducts,they wouldallpaylessinadvaloremtax.incomparison,specifictaxhadthebenefitofprovingmoredifficult toavoidbyjointeffortofmanufacturerssuchaspricingstrategies,ascheapcigaretteswouldbetaxed thesameasexpensivecigarettes.inturn,thiswoulddiminishtheincentiveformanufacturerstolower pricesandinadditionwouldincentiviseconsumerstobuycigarettesofhighestquality,astheywouldbe proportionallycheaperasopposedtoundertheadvaloremscheme.thedisadvantageofthespecific tax scheme was that it did not take into account price fluctuations as the ad valorem tax did. The differenttaxschemeswerepreferreddifferentlydependingonwhatkindofmemberstateinquestion; primarymanufacturingmemberstatesgenerallypreferredthespecifictaxschemeasitensuredmore stabilityinbudgetrevenues,whereasprimarytobaccogrowingmemberstatesfavouredtheadvalorem taxschemeasitservedasaprotectivemeasurefortheirlowerqualitytobaccoharvest(aspect,2004). AlthoughthemajoreffortstoalignpricesacrossMemberStateswithintheEuropeanUnion,thetobacco regulative directives of the SEA were ultimately unsuccessful and led to price increases in some 6 Theexcisetaxwasimposedeitherasa%ofsomevalue,advaloremtax,orasaspecificamountpercigarette, specifictax. 31

32 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco countries.italsofailedtoeliminatethelargepricedifferencesbetween MemberStates ascigarettes werestillmanufacturedandsoldatverylowpricesinsomememberstates (Tobacco(Product(Directive( In 2001, the Commission addressed the public health issues related to tobacco consumption directly throughthepassageofthetobaccoproductdirective(tpd).muchlikeitspredecessors,thetpdof2001 wasestablishedpartlywiththepurposeofincreasingtaxharmonisationoftobaccoproductsacrossthe MemberStateswithintheEU.TheTPDheightenedtheminimumtaxrequirementforMemberStates andwasspecificallydesignedtodriveverycheapbrandsoutofthemarketandreducepricedifferentials withintheeu.infebruaryof2002,thecommissionadoptedadirectivewhichintensifiedthe57%rule established under the directives of the Single European Act (SEA) in 1992 by requiring that the total excisetaxcouldnotbelessthan 60per1000cigarettesinthemostpopularpricecategory(MPPC), risingto 64per1000cigarettesintheMPPCby1July2006.Asanotheroption,MemberStatescouldbe exemptfromthe57%ruleiftheyhadaminimumtotalexciseof 95per1000cigarettesintheMPPC ( 101per1000cigarettesfrom1July2006).ThesecondimportantpartoftheTPDwastheincreased focusonhealthissuesrelatedtotheconsumptionoftobaccoproductsandtheunderstandingthatthis neededtobeaddressed.thetpdrequiredhealthwarningsonthepackagingoftobaccoproducts,it bannedtheuseofdefinitionssuchas mild, light and lowtar ontobaccoproductsandforcedtobacco producers to inform consumers of the toxicity and fatal followings resulting from the usage of their productsbyrequiringthemtoprovideextensiveinformationdescribingthecontentoftheirproducts. Lastly,theTPDspecifiedacapamountregardingtar,nicotineandcarbonmonoxidetobeallowedin cigarettes(eu,18/07/2001). However, despite the efforts of the TPD to reduce the consumption of tobacco and ultimately the fatalityoftheproduct,deathsrelatedtotobaccoconsumptionboththroughprimaryconsumptionand passive smoking remains a huge problem. Every year, 650,000 people in the European Union die prematurelyasaresultoftheconsumptionoftobaccoproducts(aspect,2004).moreover,thediseases andfatalitiesrelatedtotheconsumptionoftobaccoproductsisahugeburdentosocietyasawhole, bothdirectlyandindirectlyasitcreatesenormouseconomiccostssuchasthoserelatedtohealthcare fordiseasesrelatedtosmoking(directly)andthelowerproductivityandefficiencyprevalentamongst peoplewhosmokeorareheavilysubjectedtopassivesmoking(indirectly). 32

33 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco (Framework(Convention(on(Tobacco(Control( In2005,theWorldHealthOrganization(WHO)establishedasetofguidelinesoninteractionsbetween governments and the tobacco industry aimed at reducing the industry interference with tobacco legislation and public health policies. This evidencebased treaty, referred to as the Framework ConventiononTobaccoControl(FCTC),aimstoreaffirmtherightofallpeopletothehigheststandardof health(who,2008).moreoverthefctcsoughttorestricttobaccopoliciesinthreecoreareas,namely illicittradeintobaccoproducts,salestoandbyminorsandtoprovisionthesupportofeconomically viablealternativestotobaccoconsumption(who,2005).thefctcwasaresponsetotheworldwide tobacco epidemic, which is spread through many different channels such as crossborder trading, liberalisationofforeigndirectinvestmentaswellasfosteredthroughtobaccoproducers usageofglobal marketing,transnationaladvertisingandtheinternationalmovementofsmuggledcigarettes. Ofspecificrelevance,article5.3oftheFCTCstatesthat in%setting%and%implementing%their%public%health% policies%with%respect%to%tobacco%control%( )%parties%shall%act%to%protect%these%policies%from%commercial% and%other%vested%interests%of%the%tobacco%industry%in%accordance%with%national%law (WHO,2005).Article 5.3 also includes a comprehensive set of guidelines on how government officials shall interfere with tobacco industry personnel, ban industry payments and contributions and raise awareness of the addictivenessandfatalityoftobaccoproductsamongstothers. TheEUandallofitsMemberStatessignedtheFCTCenactmentin2005andarethereforeobligedto implementalloftheprovisionswrittenintothetreaty.despitethisenactment,difficultiesineffectively implementing the FCTC continue to persist, and the% interference% of% the% tobacco% industry,% including% through% legal% challenges% brought% against% governments,% remains% the% most% prevalent% obstacle (Nikogosian & Silva, 2015). Additionally, lacking political support, intersectorial coordination and resourcescomprisefurtherproblemswithimplementationofthefctcinsomecountries,aswellasthe evolution of ecigarettes and water pipes. This also presented itself as an additional element of consideration in the revision of the Tobacco Products Directive (Public Affairs Agencyemployee interview,30/03/2015),aswillbeelaborateduponsubsequently. However,Nikogosian&Silva(2015)alsoalludetothestrongimpactoftheFCTConnationallegislation anditssignificanceasthefirstbindingtreatyundertheauspiceofthewho.ithasalreadybeenratified by 180 countries, with 80% of these having implemented strengthened or new tobacco control legislation after the ratification in 2005 (Conference of the Parties to the WHO FCTC, 25/06/2014). 33

34 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Additionally,ithasbeenarguedtopromotetheambitionofgovernmentstoendthetobaccoepidemic (Nikogosian&Silva,2015),throughincreasedmeasurestocurtailtobaccoadvertisementatpointsof sale,banningsmokingfromcertainindoorandoutdoorfacilitiesandintroducingplainpackagingamong others (revision(of(the(Tobacco(Product(Directive( The idea of further enforcing the legislative impact of the Tobacco Products Directive (TPD or the Directive)of2001blossomedin2007andlaterin2009whentheCommissionformallybeganthereview ofthedirective.therevisioncameasareactiontotherapiddevelopmentoftobaccoandnontobacco products such as ecigarettes, which had not been covered in the TPD of 2001, as well as recent scientific evidence suggesting that the tar and nicotine levels indicated on the tobacco products packagingcouldmisleadconsumerstobelievethattheywerelessharmfulthantheywereinreality.in addition,severalstudiessuggestedthattheimpactofconsumptionoftobaccoproductsonthesociety intermsofeconomiccosts,asmentionedabovebothdirectlyandindirectlyweremuchgreaterthan anticipated when the TPD was signed in Moreover, the WHO also enacted the Framework ConventiononTobaccoControl(FCTC)in2005aimedatreducingtheharmoftobaccoonpublichealth, towhichtheeuandallofitsmemberstatesweresignatories,whichlegallyobligedthemtoimplement the provisions of the treaty. It took the Commission almost 5 years to revise the TPD and after noticeabledelaystherevisionofthedirectivewaspassedbytheparliamentinfebruaryof2014and lateradoptedbythecouncilunderthecodecisionprocedureinmarchof2014.allelementsincludedin thefinalproposalpassedinmarch2014areexpectedtobeimplementedby2016(eu,29/04/2014). The proposal sought to established new rules on the practices related to manufacturing of tobacco productsaswellasthemethodsusedforbrandingandsalesofsuchproductsinordertoreducethe differentapproachesprevalentinthedifferentmemberstates.thenewproposallaiddownrulesfor cigarettes, cigars, cigarillos, smokeless tobacco, RollYourOwn tobacco (RYO) and ecigarettes. The proposalthussoughttoprotectpublichealthwithintheeuandputabanontheusageofflavoursto characterisetobaccoproductsandrequiredthatgraphic health warnings increased from 35%40%to 65%ofthetobaccoproductspackage,bothfrontandback(EU,29/04/2014).Inturn,thenewproposal aimedtoimprovethefunctioningoftheinternalmarketthroughincreasedpriceharmonisationwhile committingtheeutoahighdegreeofhealthprotection. 34

35 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Asmentionedabove,thenewproposaladdressedaproductcategory,whichwasnotinexistenceduring thepassageoftheoriginaltpd,namelynicotinecontainingproducts.thiswasduetothelargeinfluxof especially electronic cigarettes (ecigarettes), which still contained large amounts of nicotine and thereforewerecrucialforthecommissiontoaddressintherevisionofthetpd.theissueofecigarettes andhowtoregulatethemwasahighlydebatedtopicunderthenewproposal.itremainedadifficult product to regulate from a supranational level, as regulation at the time of the proposal was very differentineachmemberstate.moreover,atthetimeoftheproposal,ecigaretteswerearelatively newandunknownproducttowhichtherehadnotbeenconductedmuchresearchonintermsofhealth effectsoftheconsumptionoftheproduct.initially,thecommissionsuggestedunderthenewproposal that NCP% (nicotine>containing% products)% that% have% a% nicotine% level% exceeding% 2% mg,% a% nicotine% concentration%exceeding%4%mg%per%ml%or%whose%intended%use%results%in%a%mean%maximum%peak%plasma% concentration%exceeding%4%mg%per%ml%may%be%placed%on%the%market%only%if%they%have%been%authorized%as% medicinal% products and that NCP% with% nicotine% levels% below% this% threshold% can% be% sold% as% consumer% products% provided% they% feature% an% adapted% health% warning (European Commission, 2012a).% Lastly, according to the final proposal, it is stated that ecigarettes should be legislated either as medical products or tobacco products. If legislated as tobacco products, they cannot have a nicotine concentrationgreaterthanthesetthresholdof20mg/ml(eu,29/04/2014). TheCommissionreportedthatthemarketforecigarettesmainlyconsistedofsmallproducersbutthat itwasanticipatedthatlargertobaccoproducerswouldenterthemarketduetothehighpopularityand thereforewouldseektohaveaninfluenceinthewayofthedirective.moreover,giventhatecigarettes mightbetreatedasmedicinal productsinalegislativecontext,pharmaceuticalcompaniescouldalso haveaninterestintheoutcomeoftherevisionofthedirective.lastly,citizensandconsumersraised theirvoicesforlegislatorstoheartheirconcernaboutthefutureregulationofecigarettes.hence,it becomesevidentthatduringtherevisionofthetpdtherewerenumerousinterestsforthecommission toconsider,manywithdifferentpreferencesandpositions. Ultimately,therevisionoftheTPDwassubjecttoenormouslobbyingeffortsbyindustryinterestparties andthefinaldirectiveendedupweakerthantheinitialdrafts.duringtheprocessofthedraftingofthe revision, the current Health Commissioner John Dalli was forced to resign under claims of tobacco industryinterference,resultingintherevisionofthetpdhavingbeenarguedtobe the%most%lobbied% dossier%in%the%history%of%the%eu%institutions (Corlett,23/09/2013).Theeffectivenessofindustryinterests in drafting the revised TPD dates back to the reforms known as Better or Smart Regulation which 35

36 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco were implemented in the EU in mid2000s (European Commission, 2006). The Smart Regulation reforms sought to soften the burden of legislative acts on corporations and further to improve corporations competitiveness through impact assessments. Additionally, as referred to by the MEP rapporteur on the TPD, Linda McAvan (2015), court challenges of the TPD has been undertaken followingitsintroductionbyboththetobaccoandecigaretteindustryaswellasbypoland. Asthesectionabovesuggestsitisevidentthatindustryactors lobbyingeffortshavealargeimpacton thelegislativeenvironmentoftobaccoproductsintheeu.thiswillbeelaborateduponinthefollowing chapter,applying thetheoreticalperspectivesoftheadvocacycoalitionframeworkandthe exchange modeloflobbyingtoanalyseanddiscusstheinfluenceofthedifferentadvocacycoalitionsinthetpd revision.however,priortosuch,legislationofalcoholateulevelmustalsobeintroduced Alcohol(in(the(EU( Oppositetobacco,alcoholhasnotbeensimilarlyregulatedatEUlevel.Thereasonsforthisarearguably plentiful, but will in this paper be examined as a consequence of public perception and advocacy differencesforthetwodrugs.however,priortoengaginginsuchanalysisanddiscussion,itisnecessary tounderstandtheprimarilysoftlawmeasuresthathavebeenputforwardateulevel,especiallywithin thelastdecade,tocircumventtheburdenofalcoholandalcoholrelatedharmintheeuropeanunion History(of(alcohol(in(the(EU( AlcoholhasbeenproducedandconsumedinEuropeforseveralmillenniums,withfermentedalcohol and spirits having been used for pleasure, as well as medicine for centuries until the introduction of modernmedicineintheearly20 th century.forthesamematter,lawsonalcoholineuropewereinearly days solely a product pertaining to public order or market regulation rather than to promote public health(anderson&baumberg,2006). However, through medieval and early modern Europe, societal development in the shape of industrialisationandproductionofincreasinglystrongerbeveragesmeantthatalcoholandasaresult publicdrunkennessbecamegraduallymoreaffordableandpossibleforlowerclasses.thisdevelopment led to bigger calls among European elites to transform and regulate alcohol, with temperance movementsarisingasaproductofalcohol sincreasinginfluenceonsocieties.althoughthetemperance 36

37 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco movementshavesincedecreasedininfluence,thisdevelopmenthasstillresultedindifferentdegreesof alcoholpoliciesacrosseuropeancountries,whichstillpersiststoday. Today,Europecomprisesawidearrayofapproachestoandusesofalcohol,fromdietaryinclusionin southern European Member States to being a significant part of rites of passage in many, especially western and northern European Member States. Drinking behaviour has become as much as ever a grownpartofeuropeancultureandavariablecapableofcommunicating anevent sformalityorthe divisionbetweenworkandsparetime(anderson&baumberg,2006). Meaningsandpracticeshoweverstillvarywithinaswellasbetweencountries,sometimeslinkedtothe identitiesofdifferentgroups,whichisalsomanifestedindifferenteumemberstatesapplyingdifferent policies to alcohol, in the lack of coherent policy formulation of the field at EUlevel. Due to the differenceinnationalapproachesandsensitivityoftheissue,aswasthecasecenturiesago,thedebate aroundthepublichealthmovementandtheeconomicintereststosocietyconcerningalcoholcontinues tobeadelicatematterforeupolitics Alcohol s(impact(on(the(eu(today( Alcohol is a major and particularly European determinant for health in the EU today. Empirical data suggeststhatpeopleinthewhoeuropeanregiondrinkalmosttwicetheamountofalcoholcompared totheworldaverage,althoughaverageconsumptionlevelsfellby10%from to (WHOEurope, 2013; WHO, 2014a). In fact, the decline has been taking place since the early 1990s, althoughithasnotbeenevenacrosseumemberstates.inboththenordicandeasternmemberstates declinesinthe1990swerefollowedbyincreasesinthenextdecadetoahigherlevelthanbefore(greer etal.,2014). AlcoholisconsideredtobethethirdlargestriskfactorforillhealthintheEU(EuropeanCommission, 2009), but similarly it is found to be a major part of European society, to some extent as result of historicalprecedence.thisimportanceisunderlinedbyboththesector seconomiccontribution,which includesthefactthattheeuproducesmorethanhalfoftheworld swine(ec,2014a)andaquarterof theworld salcohol(anderson&baumberg,2006),aswellasitscentralculturalantecedence. Alcohol is a key economic commodity associated with considerable tax revenue to governments and consumer expenditure. In this regard, Europe can be considered the centre of the global alcohol industry,actingasboththelargestmarketandthemajorproducerofalcoholicdrinks.70%ofalcohol 37

38 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco exportsandjustunderhalfoftheworld simportsinvolvetheeu,withthetradeinalcoholcontributing around 9billiontotheEU sgoodsaccountbalance(anderson&baumberg,2006).theeconomicrole of the alcohol industry is furthermore considerable in many European countries, with excise duties amountingto 25billionin2001,aswellasjobsprovidedintherangeofthreequartersofamillion fromdrinksproductionbesidesotherpartsofthealcoholsupplychain(anderson&baumberg,2006). Due to the high proportion of drinkers and the significant levels of alcohol consumption per capita, alcoholrelatedharmishoweveralsoanotablepublichealthconcernintheeuandanacknowledged risk factor for chronic diseases (WHO, 2013). It is linked to more than 60 diseases, including cancer, cardiovasculardiseases,liveranddigestivediseases,alcoholusedisordersandbraindiseasessuchas alcoholdependenceanddepression,reproductivedisordersandprenatalharm(whoeurope,2012). Halfofthe2.32millionannualdeathsfromharmfuldrinkingarefromchronicdiseases 7 (WHO,2013), anditisfurtheraccountableforover15%ofalldisabilityadjustedlifeyears(dalys 8 )amongmenand 4%amongwomen,withsocialcoststotheEUamountingtoanestimated 155.8billionin2010(Rehm &Shield,2012).Thesesocialcostsandconsequencescanstemfromdrinkdriving,fatalitiesonEUroads, violence, crime, family problems and social exclusion, as well as low productivity (WHOemployee interview,14/04/2015;rehm&shield,2012;who,2014a).alcoholrelatedharmisalsoaccountablefor morethan7%ofallillhealthandearlydeathsineurope(eu,2015a).inresponse,memberstatesareto varyingdegreesimplementingpopulationbasedpolicymeasuresidentifiedbywho,suchasrestricting access to retailed alcohol, raising taxes on alcohol and enforcing bans on alcohol advertising (WHO, 2014b), albeit critiqued by the industry as the proper approach to curtail alcoholrelated harm (SpiritsEUROPEemployeeinterview,09/04/2015) Legislating(alcohol(in(the(EU( Alcohol as a substance has, as mentioned earlier, been subject to significant variation in legislate prowess across EU Member States, due to the multitude of positive and negative effects of the substance.perhapsasresultofsuchvariationinpreferenceandperception,alcohollegislationatthe hands of the EU institutions, hereunder the Commission has been limited and defensive during its existence. The EU has made progress in addressing behavioural determinants for health, but most 7 Noncommunicablediseases(NCDs),alsoknownaschronicdiseases,arenottransferablebetweenpeople. However,theyareoflongdurationandusuallyslowprogression,withthefourmaintypesbeingcardiovascular diseases,diabetes,cancersandchronicrespiratorydiseases(who,2013). 8 DALYsrefertoliveslosteitherduetoprematuredeathordisability. 38

39 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco stronglyforsmoking.fortheparticularlyeuropeanissueofalcohol,actionhasbeenlimitedtoproviding informationandleavingchoicestoindividuals(greeretal.,2014). OnepotentialreasonforitsdiminutivestatusfromaregulatorystandpointcomparedtotobaccoatEU levelwillinthispaperbeexaminedasthedifferentcontextand advocacyproficiencyconcerningthe two.however,severalsoftlawdevelopments,especiallyinthelastdecadehavebeencharacteristicof thecommission sapproachtoaddressingalcoholsupranationallyintheeu.thecommission,whichis theprimaryinitiatoroflegislativeproposalsateulevel,isthusalsotheprimaryholderofpowerand prowesstodeterminethedevelopmentofalcoholregulationandlegislation,orthelackofsame.thus, whenreferringtotheeu,unlessotherwisenoted,thereferenceismadetothecommission. ThispowertodeterminelegislativedevelopmentwithinalcoholisevidencedbytheEUAlcoholStrategy, whichthecommission,despitecallsbytheparliament,thecouncil,thepublichealthcommunityand thealcoholindustryforarenewalofthestrategy,recentlydeterminednottomoveforwardwithduring itscurrentmandate EU'Alcohol'Strategy' ThefirstandsoleattempttoputalcoholspecificallyontheEuropeanpoliticalagendadidnotoccuruntil 2006,withtheintroductionoftheEUAlcoholStrategy(EuropeanCommission,2006).Asanemployeeof SpiritsEUROPE states (interview, 09/04/2015), when% it% was% adopted% in% 2006,% it% was% quite% ground> breaking,%because%there%was%nothing%there%at%eu>level%before.thissoftlaw,whichprovidesuggested, voluntaryguidelinesfornationalalcoholpoliciestofollow,wasthefirstemphasisfromthecommission on alcohol, and primarily focused on five areas including; protecting young people, children and the unborn child, reducing injuries and death from alcoholrelated road accidents; preventing alcohol relatedharmamongadults,andreducingthenegativeimpactontheworkplace;informing,educating and raising awareness on the impact of harmful and hazardous alcohol consumption, and on appropriate consumption patterns; and developing and maintaining a common evidence base at EU level.inaddition,theeualcoholstrategyintroducedthecommitteesonalcoholdata,indicatorsand Definitions,and onnationalalcoholpolicy and Action (CNAPA), aswell as theeuropeanalcohol and HealthForum(EAHF),withthetwolatterbeingofparticularrelevanceforthelegislativeandadvocacy environment around alcohol at EUlevel (European Commission, 24/10/2006). The CNAPA consists of representatives from national governments of the EU Member States, and promotes sharing of knowledge and good practice on reducing harmful alcohol consumption (EU, 2015a). The EAHF is a 39

40 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco platformfordialogueamongalcoholstakeholdersincludingthealcoholindustryandthepublichealth communityonapproachesandcommitmentstoaddressingharmfulalcoholconsumption(eu,2015a). However,duetothevaryingperspectivesonalcohol,theEU sstrategyregardingalcoholandhealthis, therefore, much more nuanced and limited than EU policy measures for tobacco. Even for the more targetedeualcoholstrategy,themeasuresintroducedaresignificantlymorelenientthanfortobacco, suchassupportingguidelines,exchangesofgoodpractice,researchandmonitoring,ratherthanactual hardlawandlegislation(greeretal.,2014).therehasofcoursebeenharderlawintroducedaround alcohol,inparticulartheeurequirementthatallalcoholicdrinksshowthestrengthofalcoholontheir label(europeancommission,1987),aswellasfromthecouncilandparliament,suchastheaudiovisual MediaServicesDirective2010/13/EU(EU,15/04/2010).TheEuropeanUnionhasalsoplacedrestrictions on the advertising of alcoholic beverages on television with Council Directive 89/552/EEC (European Council, 1989). However, as have been argued, there% is% little% enforcement% of% this% directive,% and% the% European% Union% common% market% rules% have,% in% fact,% been% used% to% weaken% national% advertising% restrictions % (WHO, 2004). Other examples of more hard law directives include Council Directive 92/83/EEC (European Council, 31/10/1992a) and Council Directive 92/84/EEC (European Council, 31/10/1992b) specifically emphasise alcohol and approximation of excise duty rates across Member Statesasanotherhardlawinstrument.However,byandlarge,theEUdirectivesandregulationshave hadalcoholasasubpartoflargerlegislativeprocedureswithinbroaderpolicyareasandcontexts,and especially the Commission has not emphasised alcohol in its policies relative to tobacco, despite Member State calls for increased emphasis on the substance (Latvian EU Presidency, 20/04/2015; EuropeanCouncil,18/06/2015)andCouncilConclusions(EuropeanCouncil,12/12/2009;01/12/2011). These calls are in line with the Parliament, who has also made strong pushes for the Commission to embark on a new EU Alcohol Strategy, most recently by adopting a Resolution on Alcohol Strategy (EuropeanParliament,22/04/2015;Eurocare,29/04/2015). The EU nevertheless formally recognises its role in addressing the most burdensome risk factors for chronicdiseases.article168ofthetreatyonthefunctioningoftheeuropeanunion(tfeu,168.5)and article127ofthelisbontreatyestablishestheeu sactionsinthefieldofpublichealth,includingthe protection%of%public%health%regarding%tobacco%and%the%abuse%of%alcohol %(EU,2007;2012a).Despitethis remit,theeualcoholstrategyranforonlysixyearsandwasnotrenewed.thishappenedeventhough thefinalassessmentoftheaddedvalueoftheeualcoholstrategysupportedfurtherfocusonalcoholat 40

41 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EUlevel, arguing that the% aims% of% the% alcohol% strategy% have% not% yet% been% fully% reached% and% alcohol> related%harm%remains%a%concern%in%all%member%states.%(as%result)%coordination%and%support%at%eu%level% should%be%continued%and%geared%towards%ways%to%enhance%effectiveness%of%actions%and%implementation% structures (COWI&Milieu,2012). Asmentioned,itwasapurposefuldecisionnottomoveforwardwitharenewalofthestrategybythe Commission,despitecallsbytheParliament,theCouncil,thepublichealthcommunityandthealcohol industry for the contrary. The Commission has instead committed to address alcohol within a wider strategyonchronicdiseases(euractiv,03/06/2015),whichhasalreadytriggeredoutcriesofdispleasure fromamongothersthepublichealthcommunity(eurocare,21/05/2015).anemployeefromeurocare hasargued, Our%concern%is%that%if%we%go%under%the%chronic%disease%agenda,%it%is%very%disease>oriented,% and% we% want% to% have% the% social% aspect% included% as% well (interview, 09/04/2015). Additionally, the decisiontoabolishanyrenewalofthestrategy,albeitonlyrelyingonsoftlawmeasuressuchaspolicy coordinationandbestpracticeexchanges,bythecommissionhasledtolargepartsofthepublichealth communityresigningfromtheaforementionedeuropeanalcoholandhealthforum(eahf)(euractiv, 03/06/2015;EPHA,02/06/2015).TheEAHFwasalreadyunderscrutinybythepublichealthcommunity, due to gridlock and lack of progression and leadership of the forum (WHOemployee interview, 14/04/2015;Eurocareemployeeinterview,09/04/2015),andthenewsfromtheCommissionernotto renew the strategy during the EAHF meeting in May (EurActiv, 22/05/2015) can thus arguably be deemedthefinalstrawforthengos.theresignationeffectivelydissolvesthefoundationofthemulti stakeholderforum,withtheconsequencesfortheeahfandcommissionapproachtoalcoholremaining tobeseen. Inparallel,theCommitteeonNationalAlcoholPolicyandAction(CNAPA)hasbeenworkingasanother softlawinstrumenttopromoteknowledgeandbestpracticeexchangebetweenmemberstates.among others, the group in 2014 submitted a Scoping Paper calling on the Commission for a new and comprehensivestrategytotackleharmfuluseofalcoholandalcoholrelatedharm(cnapa,10/12/2014), as well as a twoyear EU Action Plan on Youth Drinking and on Heavy Episodic Drinking (CNAPA,16/09/2014),asameanstobridgethedevelopmentofanewEUAlcoholStrategy.TheAction Plan,albeitsupportedandendorsedbytheCNAPA,hasnotbeenofficiallysupportedbytheCommission andthusremainsaninternaldocumentapplyingsolelytocnapamembers(spiritseuropeemployee interview,09/04/2015). 41

42 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco The soft law approach by the Commission further extends to funding of research projects and knowledgeexchange forums such as the EU Joint Action on Alcohol Related Harm (RARHA) 9 and the Alcohol Public Health Research Alliance (AMPHORA) 10, as well as the inclusion of alcoholharm preventivemeasuresin its healthprogramme(eu,21/03/2014).forthismatter,although acknowledgedasamajorhealthdeterminant,itcanreadilybepostulatedthateuactionwithinalcohol isseverelylimitedcomparedtotobacco.greeretal.(2014)hassuggestedthatakeyreasonforthisis the broad%social%consensus%on%combating%tobacco%across%europe%that%does%not%exist%for%alcohol,%which% clearly%affects%the%feasibility%of%europe>wide%measures.additionally,itissuggestedthattherelationship betweenpublicpolicyandalcoholconsumptionisnotstraightforward,whichmeansthatapproaches vary greatly between Member States and the impact of restrictive measures depends on the social contextandnorms,withnormsinsomeinstancestakingprecedenceoverformalpoliciesongoverning alcoholconsumption(andersonetal.,2013).nevertheless,althoughthesignificantcomplexityofthe relationship,evidencestillunderlinesthatmorerestrictivealcoholpolicydohaveanimpactinreducing harmfromalcohol(who,2014a;oecd,2015) International'institutional'recommendations'for'alcohol'policies' Atinternationallevel,bothWHO(2010;2012b),OECD(2015)andtheInternationalLabourOrganization (1996) have in several instances supported more focus on alcohol, as well as populationbased approachestocircumventalcoholrelatedharm,andcalledupontheeutoimplementpreventivecross bordermeasuresthatcandecreasealcohol sburdenonhealthandproductivity. HarmfuluseofalcoholhasbeenespeciallyimportanttoaddressfortheWHOsincetheearly1990s.In 1992,thefirstEuropeanAlcoholActionPlanwasadopted,callingforintensificationandbroadeningof alcoholpoliciesineurope(assemblyofeuropeanregions,2010).in1999,whoeuropeapprovedthe adoptionofarevisedeuropeanalcoholactionplan (whoeurope,2000),withtheaimof increasing awareness around alcoholrelated harm and reducing the risk alcoholrelated problems. Followingthisactionplan,theFrameworkforAlcoholPolicyintheWHOEuropeanRegionwasadopted 9 RARHA,cofundedbytheHealthProgrammeoftheEuropeanUnion,isa3year( )JointActionaiming atsupportingmemberstatestotakeforwardworkoncommonprioritiesinlinewiththeeualcoholstrategy.it furtherseekstostrengthenmemberstates'capacitytoaddressandreducetheharmassociatedwithalcohol. 10 AMPHORAisaresearchprojectaimingtoproducenewevidenceonunexploredareasofalcoholconsumption andalcoholrelatedharmineurope.amphoraisafouryearprojectcofinancedbytheseventhframework ProgrammeofresearchoftheEuropeanCommission. 42

43 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco in 2005 (WHO, 2006), emphasising thefact that there%is%( )%a%need%for%concerted%action%at%regional% level.%strong%expectations%exist%that%who%and%other%international%and%intergovernmental%organizations% will%take%effective%initiatives%to%prevent%or%reduce%alcohol>related%problems. This clear introduction of regional and supranational frameworks for initiating actions to circumvent alcoholrelatedharmwassubsequentlyelaboratedinthewhoglobalstrategytoreducetheharmful UseofAlcohol,whichwassignedin2010.Inthisstrategy,WHOrecommended10keyalcoholpolicy action points to curb alcohol related harm (WHO, 2010), including (1) leadership, awareness and commitment; (2) health services response; (3) community and workplace action; (4) drinkdriving policiesandcountermeasures;(5)availabilityofalcohol;(6)marketingofalcoholicbeverages;(7)pricing policies;(8)reducingthenegativeconsequencesofdrinkingandalcoholintoxication;(9)reducingthe publichealthimpactofillicitalcoholandinformallyproducedalcohol;(10)monitoringandsurveillance. On this backdrop, the WHOEurope (2012) further developed its European action plan to reduce the harmful use of alcohol , which, following costeffectiveness analyses concluded that combinedandconcertedpoliciesarethemostcost effectiveinreducingalcoholrelatedharm,rather thanpiecemealpolicyapproaches. Inadditiontothesespecificalcoholstrategiesandactionplans,theWHOMemberStateshavealsosince 2013agreedtoreachavoluntarytargetof10%reductionintheharmfuluseofalcoholby2025inorder to circumvent the burden of noncommunicable diseases, which is deemed the world s biggest killer (WHO,2013).Thenoncommunicable,orchronic,diseasesareespeciallyimportanttoconsiderinlightof theeuropeanhealthcommissioner,ytenisandriukaitis,havingproposedalcoholtobecomepartofa moreholisticchronicdiseasestrategyintheeumovingforward(euractiv,22/05/2015).however,inthe WHOactionplantopreventandcontrolnoncommunicablediseases,thereisalsosignificantdifference in targets for the various risk factors, with targets for reducing tobacco use being 30% by 2025, as opposed to the 10% decrease for alcohol in the same time span (WHO, 2013). This could further emphasisetherelativedissimilarityinapproachtothesetworiskfactorsatinternationallevel,inturn affectingthecontextinwhichthedifferentadvocacycoalitionswithintobaccoandalcoholinteract Comparing(perceptions(of(alcohol(and(tobacco(as(substances( Inordertoassessthelegislativedevelopmentofalcoholandtobacco,itisnecessarytounderstandand grasp the perception similarities and differences between the two substances, which can be a 43

44 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco denominatorforthedifferentpathsofregulationforthetwo.subsequently,intheproceedingchapter, ananalysisanddiscussionoftheadvocacyframeworkwillbeembarkedupontoexplaintheinherent traitsofthetwosubstancesfromaneuadvocacyperspective.asthelocusofthispaper,theperception and advocacy similarities and differences of the two substances can be argued to comprise both the core element of their distinctive legislative paths, but similarly become the amalgamating factor for eventualuniformtreatmentateulevel. Alcohol,althoughsharingenvironmentalfactorswithtobacco,suchasbeinglegallyavailableandeasily obtainable in many EU Member States, is in many, especially Mediterranean countries culturally implementedinthedietandarguedtopositcertainbeneficialhealthoutcomesatlowdrinkinglevels, includingreducingtheriskofcardiovasculardisease(rimm&ellison,1995).thisculturallegitimisation andfeature,althoughcontestedincreasinglyinrecentyearsbyamongothersthewho(whoemployee interview,14/04/2015),hasbeenproposedasakeyvariabletoexplainingthedifferenceinregulationof tobaccoandalcoholateulevel,astobaccoisharmfulfromthefirstdragofacigarette(eclemployee interview, 11/06/2015; Public Affairs Agencyemployee interview, 30/03/2015). This differentiation is furtherunderlinedbyboththealcoholindustry(spiritseuropeemployeeinterview,09/04/2015;new Europe,30/06/2014)andinastudyconducted onbehalfofthecommission in2004 (ASPECT,2004), whichproposesthat cigarettes%are%uniquely%harmful,%in%that%they%kill%even%when%used%precisely%as%the% manufacturer%recommends.%no%other%product%does%this.%alcohol,%cars%and%even%food%products%(given%the% obesity%epidemic)%kill%people,%but%only%when%abused.%in%addition,%( )%the%sheer%scale%of%the%harm%done%by% tobacco%is%unprecedented.%it%is%this%public%health%threat%that%has%led%to%increasingly%severe%limitations%on% tobacco's%consumer%marketing.tobaccoasasubstanceisthusarguedtoberelativelymoreharmful thanalcohol,whichneedstobetakenintoaccountwhenassessingtheirlegislativedifferences. Thefactthattobaccolegislationandtheextentofsuchhavebeensosevereinthelastdecadecould further amount to what this paper will deem path deviation within alcohol legislation at EUlevel. In continuanceoftherisingeuroscepticismdueinparttoexternaleconomicfluctuations(torreblanca& Leonard, 2013), socalled EU micromanagement of a policy area, which many European citizens feel passionately about and against, can be increasingly hard to promote. The increasingly progressive tobacco legislation in the EU can consequently become a hindrance rather than support for further legislative measures within alcohol at EUlevel. Thus, path deviation can become an evident term to describeeualcohollegislation,orlackofthesame,intheaftermathofthetobaccoproductsdirective andtobaccolegislationintheeu. 44

45 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Theaddictivenessofthesubstancesisfurtherproposedtobeadistinguishingfactorbetweenalcohol and tobacco (Public Affairs Agencyemployee interview, 30/03/2015). Withdrawal symptoms from smokingoccuratearlierstagesduetothenicotine,whereaswithalcoholasafelevelofconsumption withoutriskingwithdrawalispossible,leavingouttheexamplesofalcoholdependencyandaddiction. Healthyindividualscanthushaveanormallevelofalcoholconsumptionwithoutassumingdependency, dissimilartotobacco.however,dependenceofthetwosubstanceshavebeenscientificallyproventobe correlated, with alcohol dependent patients being three times more likely than those in the general populationtobesmokers,andtobaccodependentpeoplebeingfourtimesmorelikelythanthegeneral population to be dependent on alcohol (National Institute on Alcohol Abuse and Alcoholism, 2007). Alcoholandtobaccoarealsoincreasinglytreatedinunisonbyinternationalinstitutions,astheybothare among the top risk factors and causes for cancer and preventable deaths in Europe (WHOEurope, 2015a;WHO,2013;2014b;Rechel&McKee,2014;Kringosetal.,2015). Similarly,theissueofpassivesmokinghasbeenincreasinglyappliedasaseparatorbetweenalcoholand tobacco(publicaffairsagencyemployeeinterview,30/03/2015).alcoholhashoweverbeensuggested to possess similar traits by the WHO (WHOemployee interview, 14/04/2015) and Room (2013), who positsthat much%of%the%harm%from%alcohol%is%not%to%the%drinker,%but%to%others% %whether%family,%friends% or%strangers% %and%includes%social%as%well%as%health%harms.%the%extent%of%this%harm%to%others%is%at%the% same% order% of% magnitude% as% the% harm% to% the% drinker% % much% greater% than% the% harm% to% others% from% tobacco (Room,2013). ThisresemblanceisalsoextendedtothepolicymeasuresemphasisedatEuropeanleveltocircumvent theburdensofthesetwosubstances.albeitatdifferentstagesoftheirlegislativepaths,asevidencedin preceding sections, populationbased measures, such as on pricing, taxation and advertising are mutually proposed to decrease the harms from alcohol and tobacco (WHO, 2014a; Bridgehead International,2011),whichhasbeendisputedasacorrectapproachbyespeciallythealcoholindustry (SpiritsEUROPEemployeeinterview, 09/04/2015).Agrowingbodyofevidencehoweversuggeststhat manyoftheseinterventionshavethepotentialtobebothcosteffectiveandbeneficialinthelongterm tosocieties(mcdaid&suhrcke,2012).asanemployeeofthewho(14/04/2015)advocates, there%are% many% similarities% and% the% policy% measures% are% very% similar% for% tobacco% and% for% alcohol,% such% as% availability,%marketing%and%pricing.%the%best%buys%are%thus%the%same.%i%think%the%reason%for%why%tobacco% has%seen%extensive%legislation,%is%because%there%has%been%much%more%focus%on%passive%smoking%already% 45

46 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco starting%20>30%years%ago.%that%has%not%been%the%same%with%alcohol,%although%we%also%have%figures%now,% which%shows%that%roughly%3>4%%of%all%alcohol>related%deaths%in%europe%is%due%to%harm%to%others. Inlightofthesesimilaritiesintermsofproposedpolicyregulation,industrialandadvocacydifferences betweenthealcoholandtobaccoindustryhasbeenarguedtocomprisepartofthereasonfordifferent regulatory paths of the two substances. The EU Commissioner for Health, ytenis Andriukaitis, has amongothers also postulatedatarecenteuropeanalcoholandhealthforum meeting(18/05/2015) thatheisawareofconflictofinterestsinthetobaccoarea,althoughforalcoholissuesallstakeholders should be involved, as the focus is on alcoholrelated harm and not alcohol intake when consumed responsibly. Additionally, it has been suggested that the alcohol producing industry is represented in multiplecountries,whilethetobaccoindustryisonlyrepresentedinfew,whichhasbeenproposedas potentiallydescriptiveofthevariationinpolicyapproach(eclemployeeinterview,11/06/2015).this willbefurtherelaborateduponinthefollowingchapterontheadvocacycoalitionswithintobaccoand alcohol Conclusion( Alcohol and tobacco have evidently treaded distinct paths in terms of legislative development in a Europeancontext.ThefirstchapterhasexplainedthecurrentlegislativeactionsatEuropeanlevelthat governs alcohol and tobacco, and sought to further describe certain perception similarities and differencesofthetwosubstances.thisperceptionaspectisimportanttouncover,butcanonlygosofar inexplainingwhylegislationhashappenedtosuchgreatextentwithintobaccoasopposedtoalcohol. Although acknowledging the arguably distinct properties of alcohol and tobacco is important, the substancescanformanyreasonsbetreatedinunison,asproposedabove.theproductssharemany similar characteristics, which leads to the use and comparison of the two in the advocacy coalition contextofthispaper.althoughthisisperhapsovertlysimplifying,itallowsforuniquecomparisonofthe two substances advocacy context as descriptor of their variable legislative development in the EU, which will be engaged upon in the following chapter. An extensive amount of interest groups lobby policyanddecisionmakersateuleveltoimpactpolicyoutcomes,whichunderlinestheimportanceof evaluatingtheirinfluenceasaparametertoexplaintheeupolicymakingprocessaroundalcoholand tobacco(dür,2008a). 46

47 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Subsequentchapterswillagainbroadentheanalysisanddiscussiontoencompasstheaforementioned perceptiondifferencesandfinallyelaborateonaplausiblescenarioforalcoholandtobaccolegislationin theeumovingforward. 47

48 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Chapter!3! Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Interestgroupinfluenceandadvocacycoalitionswithintobaccoand alcoholintheeu?? IC C? C EA? E??C E A? E? C?? A A CC C? C??E EAC F? I? C? C E E F A E I C F? E C A? E? C??? C EA? E? AE A C C HA???? F I F E? A I? ( 1 )D 1 48

49 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 3. Interest(group(influence(and(advocacy(coalitions(within(tobacco(and( alcohol(in(the(eu( Lobbying is becoming increasingly pertinent at EUlevel. Recent figures suggest that lobbying has becomeabillioneuroindustryinbrussels,withatleast30,000lobbyistswalkingthecorridorsoftheeu institutions, matching almost exactly the number of employees in the Commission (The Guardian, 08/05/2014). This concentration puts Brussels only second to Washington in terms of stakeholders seeking to affect legislation, and allowsbysomeestimatesforinfluenceofapproximately75%ofeu legislation(theguardian,08/05/2014). Incontrast,publicinterestintheEUremainslow,withvoterturnoutatEuropeanelectionsin2009for EUentrantslikePolandandSlovakiabeingfewerthanthreeinten,andeveninGermany,oneofthe EU'sfoundingmembersanditsbiggestMemberState,only43percentvotedattheelectionsin2009 (Reuters,18/03/2011).DespitethewaningpublicinterestintheEUinstitutions,thecompetencesofthe EUareincreasing(Pollack,2000;Heidbreder,2011),withscholarlyrecommendationsinsomecirclesfor evenfurtherexpansionofsuchattheexpenseofnationalsubsidiarity(garben,2015).lobbyismisthus becomingincreasinglycriticalateulevelforactorsinterestedinaffectinglegislation,andlobbyismcan to a great extent be used to explain the process of EU legislation. Indeed, a recent study involving quantifiable data, found that in 2010 the Commission s draft documents of the Tobacco Products Directive(TPD)weremorecloselyinlinewiththeviewsofpublichealthgroups,butwhenthelegislative documentwentthroughtheparliamentin2014asignificantpolicyshifttowardsmoretobaccoindustry languagehadbeenincluded(costaetal.,2014). SpendingonlobbyisminBrusselshasalsoincreasedsignificantlyformanysectors,ledbythebanking and IT sector, who in some cases have increased expenditure on lobbyism 30fold from 2013 to 2014.Tobaccocompaniesontheotherhandhaveinthesametimespandecreasedtheirspendingon Brussels lobby activities (EU Observer, 29/04/2015). As will be proposed in subsequent sections, a reasonforthisdecreasedspendingcouldbethepublicallyscrutinisedfoulprocessoftobaccoindustry lobbyingoneulegislation,suchasthetpd,withinthelastfewyears.yet,thesectorremainsinvolvedin lobbyism at EUlevel, with total spending by Philip Morris, Japan Tobacco, Imperial Tobacco, and SwedishMatchcomprising 2.8millionin2014(EUObserver,29/04/2015). The rise of EU lobbyism in its totality has also led to calls by the European Parliament for increasing scrutinyoflobbyistsinbrusselsandmandatoryregistrationintheeutransparencyregister(euractiv, 49

50 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 16/04/2014),whichregisterslobbyactivitiesbyprivateactorsatEUlevel.However,theregisterremains voluntary, although recent amendments have banned actors, who do not include information about their lobby activities, from meeting with EU commissioners and their cabinet staff (EU Observer, 29/04/2015). These private actors and interest groups encompass all stakeholders interested in affectinglegislationateulevel,andthuswithinalcoholandtobaccocomprisebothindustryandpublic healthadvocates Interest(group(influence(on(EU(institutions( Given the sheer number of interest groups that lobby decisionmakers in Brussels with the aim of impactingpolicyoutcomes,assessingtheirinfluenceisessentialforunderstandingtheeupolicymaking process(dür,2008a).forthismatter,influencedescribestheabilityofanactortoshapeadecisionin alignmentwithitspreferences. Thepossessionofcertainresources,suchaseconomicwealth,legitimacy,politicalsupport,knowledge, expertise and information, has been proposed to empower an interest group s ability to influence decisionmakers (Klüver, 2013). These resources can be held to varying extent, with some groups owningrelativelymoreresourcesandinturnbeingmoreinfluentialthanlessendowedinterestgroups. Thesize,typeofmembership,theinternalorganisation,andthelevelofgeographicalconcentrationof themembershiparecharacteristicsthatdeterminethevalueofresources 11. Asecondfactorforinterestgroupinfluenceisthepoliticalinstitutionsinwhichitoperates.FortheEU, the potential for influence from interest groups is muddled in a discussion of on one hand the intergovernmentalcooperationateulevelenhancingthepowerofmemberstates,withthedivisionof power making it increasingly difficult for interest groups to shape the policymaking process. On the otherhand,itisarguedthatthemultilevelgovernanceoftheeusystemmayincreaseinterestgroups influencebypresentingalargenumberofaccesspoints(dür,2008b). However,duetothemultilevelgovernance,anotherconflictarisesonthegroundsofbothappointed and elected decisionmakers, such as the Commission being appointed, whereas the Parliament and Council remain publically elected. This suggests that appointed public actors may be less inclined to submit to interest group influence, as they do not seek reelection and are less vulnerable to public 11 Asexample,aninterestgroupwithmanymemberscanmoreeasilydemandheightenedpoliticallegitimacy,due toitsbroaderpublicscopeandeffect.similarly,aninterestgrouporcoalitioncomposedoffirmsmayincurgreater monetaryresourcesthanngos,andifsaidfirmscontrolinvestmentsinmultiplecountries,theymayhavemore extensiveknowledgeandinformationthanthatofothersactors. 50

51 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco mobilisation.instead,interestgroupsseektoinfluencetheseinstitutionsthrough insidelobbying inthe shapeofinformationexchangeandpersuasionindirectcontact(princen,2007).indeed,suchactivities areleveragedwithinbothalcoholandtobaccoandacrossadvocacycoalitions(eclemployeeinterview, 11/06/2015; SpiritsEUROPEemployee interview, 09/04/2015; Eurocareemployee interview, 09/04/2015).TheappointednatureofcertainEUpublicofficialscouldalsoincreasetheirattentiveness tointerestgroupstoo,duetoalackofelectoraloversight(dür,2008b).forthecommission,thishas been postulated to be the case for the tobacco industry as opposed to the public health community (ECLemployee interview, 11/06/2015), although subsequent public disclosures and transparency measureshaveminimisedsuchimpact(euobserver,29/04/2015).otheraforementionedcriteriacan howeveralsohavecontributedtotheindustrygainingexcessiveaccesstothecommission,suchasits levelofresourcesandeconomicimpact. Elected public actors, such as MEPs, can instead see their capacity to yield to interest groups asks decreased,astheyhavealreadyprovidedtheiropiniononanissuetothepublicduringanelection,and asaresultcannotmodifyeasilytheirpositionaccommodatingtherequestsofprivateactors.asbouwen (2002)hasposited,MEPsareelectedatnationallevelandthus,theymaintainstrongconnectionswith theirnationalelectorateandneedtobeawareoftheirpreferencesinordertobereelected. Thefinalelementtodescribeinterestgroups influenceisthecharacteristicsofthepolicyissueathand, suchaspolicytype,degreeoftechnicalityandpublicsalience(klüver,2011).whereasthepolicytype concernsthenatureofthepolitics,beitdistributive,redistributiveorregulatorypolicy 12,thedegreeof technicality proposes that the influence of interest groups is larger on highly technical issues, as politiciansaremoredependentforthesemattersontheinformationprovidedbyinterestgroups.with regardtopublicsalience,interestgroupscanfinditdifficulttomanoeuvrewhenpublicattentionona policyisparticularlyhigh. If decisionmakersfavour concentrated interests, they may be punished by electors (Dür, 2008b). For alcohol and tobacco in the EU, the policy type is argued to be primarily regulatory, in which concentrated benefits and costs to certain groups of society can cause conflict between groups with alternate perspectives, in turn allowing for more influence through coalitions ratherthanindividualgroups.asexample,thetpd,whichintendedtoregulateasetofproducts,canbe 12 Forredistributivepoliciesthatyieldconcentratedbenefitsforaspecificgroupanddiffusecosts,interestgroups thatrepresentconcentratedinterestsarearguedtousuallywinwhilediffuseinterestloose.aregulatorypolicy insteadbringsconcentratedbenefitsforagroupandconcentratedcostsforanotherone,causingaconflict betweenatleasttwogroupswithdifferentinterestsandlimitingtheinfluenceofindividualgroups.the redistributivepolicy,whichproducesdiffusedcostsandbenefits,maylimitinterestgroupsinfluencealtogether (Dür,2008b). 51

52 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco categorised as a regulatory policy. The legislative procedure of the TPD revision was the ordinary legislativeprocedure(olp),whichinfersthatthecommissionsubmitsaproposalthatissubsequently scrutinisedbytheparliament,viatherelevantcommittees,andthecouncil,viaitsworkingpartiesand COREPER(appendix,figure1).Ifagreedonbybothinstitutions,thetextcanbeadoptedatfirstreading, butincasetheydonotreachanagreement,theproposaladvancestothesecondandpotentialthird readings.intheeventthatthetwoinstitutionsfailtoagreeonatextatthethirdreading,theproposalis annulledandcannotbeadopted 13 (Bacheetal.,2011;Nugent,2010). There is also a certain level of complexity involved within these areas, due to the knowledge necessitated of the government officials to understand the benefits and consequences of both the health and economic aspect of the substances. Public salience is also high, due to the influence and sensitivecontextofthetwosubstancesacrosseurope,albeitarguablyhigherfortobacco,duetoitslack oflegitimisationandincreasedlegislation Input(needs(for(EU(institutions( AsKlüver(2013)posits,EUinstitutionsneedthreetypesofgoodsorlegitimisationfrominterestgroups; technicalknowledge,citizensupportandmarketprowess.technicalexpertiseisnecessaryinorderto draftapolicy,withthecommissiondemandingitforconstructingapolicyproposal,andthemembersof theeuropeanparliament(meps)andnationalgovernmentsinthecouncilneedingspecificinformation tograspthecommission sproposal.however,duetounderstaffingandcommonbusynessofespecially the Commission and the MEPs, information from expert interest groups with deep knowledge of a specificpolicyareaiswelcomed 14.Infact,thishasevenbeendescribedasacommonprocessbetween interestgroupswithinthesamecoalitionaswell(spiritseuropeemployeeinterview,09/04/2015).the abilitytosatisfyinstitutions needscanthusbeseenasadeterminantofanindustrygroup sinfluence. CitizensupportisthesecondneedforespeciallynationalgovernmentsandMEPsseekingreelection, whichklüver(2013)proposes.asthecommissionisawareoftheelectoraldependence,itcanusethis advantage to gain support and public legitimisation to its proposal by stakeholders whose policy preferencesareusuallyacceptedandwhositonanimmensemembershipbase.iainitialconsultations aimingtofacilitatewidesupportamongthepublic,thecommissioncanputpressureonthenational 13 TheOLPencouragesinterinstitutionalbargainingbetweentheCommission,ParliamentandCouncil,and,dueto theseusuallyaimingforproposalstoturnintolegislation,cooperationbetweentheinstitutionsisparamount (Nugent,2010). 14 TheEuropeanCouncilcaninsteadrelyonexpertisefromtheirnationalgovernmentalorgans.However,these organstosomeextentrelyondomesticinterestgroups. 52

53 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco governments and MEPs to accept its proposal in order to avoid public criticism on the part of being inattentivetopublicopinionandthusrisktheirpotentialforreelection 15. Thethirdgood,whichtheinterestgroupscanprovidetoEUinstitutions,ismarketpower(Klüver,2013). Ashavepreviouslybeenproposed,theprobabilityofinterestgroupsbeingsuccessfulinshapingapolicy proposal is strongly affected by its relative market power, id est the economic weight in terms of generatinggrowthandcontrollingjobs,visàvisotherinterestgroups(lindblom,1977;klüver,2011). Companyperformanceisastrongdeterminantofpoliticsaseconomicgrowthoragonyintheshapeof risingunemploymentorinflationcanleadtooppositionfromcitizens.therefore,nationalgovernments and MEPs tend to accommodate the interests of important market actors to certain extent, as evidencedbypeterson(1991),sandholtz&zysman(1989)andcowles(1995).inadditiontothecitizen support,thecommissionisalsoawareofsaidrelianceandtriestomelditsproposalstoaccommodate theinterestsofpowerfulindustrysectorsinordertogetthenecessaryapprovalfromthecounciland theparliament. Thus, policy preferences of an interest group and the outcome of the policymaking process are considered an imperative factor for influence, insofar as the societal actors properties are to be associated with the policy outcome. If this link exists, it is plausible to assume that interest groups influenced the policymaking process (Klüver, 2013). However, in order to assess interest group influenceoneuinstitutionsandlegislationwithintobaccoandalcohol,itisnotenoughtoconsiderthe goods provided only by individual groups. As multipleinterestgroups seek to influence the decision makingprocesssimultaneously,itisessentialtoconsiderthecoalitionsthatareformedaroundthese policyissues(sabatier,1988;1998;klüver,2013) Advocacy(coalitions( Advocacy coalitions are important actors to describe the aggregated behaviour of organisations and individuals involved in a policy subsystem and their resulting influence on policymaking at EUlevel (Sabatier,1998;Sabatier&Weible,2007;Klüver,2013). Anadvocacycoalitionisagroupofactorslocatedonthesamesideofthepolicyspaceandwhothus sharethesamepolicygoal(klüver,2011).accordingtoweible&sabatier(2007),thesepolicygoalsare 15 Thisargumenthoweveronlyappliestopoliciesofinteresttothepublic.Asmentioned,citizenattentiontoEU policiesisusuallylow,butaninterestgroupcanboosttheirsalienceinordertomobilizepublicopinionforitsown purpose. 53

54 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco especiallyuniforminacoalitiononthepolicycorebelieflevel,andincludeapplicationsofthedeepcore beliefs 16 thatspananentirepolicysubsystem,suchasalcoholandtobaccopolicyintheeu.sabatier& Weible (2007) also underline that specific variations in attitudes and beliefs can occur within an advocacy coalition on the secondary belief level 17, socalled policy core policy preferences, without losing the unification of the coalition. One example of such could be the Brewers of Europe, a trade associationfortheeuropeanbrewers,introducingvoluntarynutritionallabellingonitsproducts,despite other parts of the alcohol industry advocacy coalition being more hesitant to introduce and applaud such measures (BeverageDaily, 01/04/2015). As will subsequently be discussed in more detail, the alcoholindustryadvocacycoalition,albeitsharingmanybeliefs,isweaklyalignedacrosscertainpolicy core policy preferences (SpiritsEUROPEemployee interview, 09/04/2015), which to some extent similarlydescribesthepublichealthcommunitywithinalcohol,asopposedtotheequivalentcoalition withintobacco(publicaffairsagencyemployeeinterview,30/03/2015). Within a policy subsystem, such as alcohol or tobacco, there will generally be two to five advocacy coalitions (Sabatier & Weible, 2007), in turn profiling its interests towards policymakers to ensure maximised impact on EUlegislation. This is a necessity, due to the European institutions being confronted with a wide variety of policy asks and interest groups seeking to shape the content of a policy proposal. As such, the aggregated information supply, citizen support and market power of a coalitionofinterestgroups,whosharethesamepolicygoalrelativetoitsopposingadvocacycoalitions, isincreasinglyimportanttoaffecteulegislation(klüver,2011). The advocacy coalition framework, which Paul Sabatier introduced almost thirty years ago (Sabatier, 1988)toexplaintheinfluenceofadvocacycoalitions,furtherbuildsonthepremiseofthreefounding pillars; the macrolevel, the microlevel and the mesolevel 18. These three levels then impact policy changeandthedependentvariablesofthesystemviapolicyorientedlearningandinternalandexternal interruptions and shocks (Sabatier & Weible, 2007). Whereas policyoriented learning can alter secondarybeliefs,externalshocksaretheprimarywaytoinflictchangestoapolicycore 19.Inabroader context, which will also subsequently be dwelled upon, the perception of economic versus health 16 Thedeepcorebeliefsincludemoregeneralperceptionideasofsociety,humannatureandfundamentalvalues, suchasliberalismversussocialism,orthecompetenceoftheeuversusmemberstateswithinselectpolicyareas. 17 Secondarybeliefsarethenarrow,specificbeliefsrelatedtoforexampledetailedrulesoraspecificlegislative proposal.assuch,thesearelessdifficulttochange. 18 Seesection1.6.1.foranindepthdescriptionoftheselevels. 19 Importantly,thisnotionofknowledgegenerationnotbeinglinearorcertainisinlinewiththecriticalrealist philosophyofscienceunderpinningthethesis. 54

55 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco preferences in the aftermath of the global financial crisis can be deemed an external shock that has strengthened the focus on economic efficiency and growth at the expense of investment and attentivenesstohealthrelatedmatters. ThefollowingsectionswillanalysetobaccoandalcohollegislationatEUlevelinanadvocacycontext. Specifically,theTobaccoProductsDirective(TPD)willbefocuseduponfortobacco,whereasforalcohol, there is no one definitive directive implemented yet at EUlevel. Although this can be noted as a conclusion in itself, the advocacy coalition analysis will thus take place on the grounds of soft law measures that have occurred at EUlevel within the last decade. Attention will be given to the EU AlcoholStrategy anditsrelatedinventionoftheEuropeanAlcoholandHealthForum(EAHF), aswellasamongotherstheprocessoftherecentparliamentresolutiononalcohol,whichsawheavy lobbying from the different advocacy coalitions. Through analysis and discussion of the advocacy coalitionswithinthetwoareas,thecapacitytodescribethelegislativedifferencesbetweentobaccoand alcoholateulevelwillbecomprehendedandassessed Alcohol(in(the(EU(J(interests,(advocacy(coalitions(and(policy(preferences( Evidenced in previous sections, alcohol has not seen the same extent of legislation at EUlevel as tobacco.thus,theanalysisanddiscussionofthedifferentinterestswithinalcoholfollowamorebroad analysisofongoingpolicyinitiatives,inwhichthedifferentinterestsoperateandaccumulate.forthis matter,itispossibletoidentifythefollowingmainadvocacycoalitions 20 thathaveconsequentlybeen vocalontheirmessagesfromtheintroductionoftheeualcoholstrategyasthefirstcommissiondriven toolforemphasisingalcoholrelatedharmateulevelin Public(health(community(and(NGOs( Thepublichealthcommunityhas,similarlytotobacco,beeninstrumentalinadvocatingforincreased measuresateuleveltocurbalcoholrelatedharm.additionally,thiscommunityhasbeenvocalinthe EuropeanAlcoholandHealthForum(EAHF)(Eurocare,2015a;EuropeanCommission,11/04/2014)and within the last years continuously called for the adoption of a new EU Alcohol Strategy (Parliament Magazine,03/06/2015;EPHA,2015a;Eurocare,2015b;AlcoholPolicyYouthNetwork,02/06/2015). 20 Itisimportanttoacknowledgethatseveralsmallerinterestgroupsandsubsetsofthesemainadvocacy coalitionshavebeenexcludedforsimplificationmeasuresintheanalysisanddiscussion,duetothelackof involvementinthefullspectrumofalcohollegislativeproposalsanddecisions.suchgroupsincludebutarenot limitedtofootballassociations,socialinsurancegroupsandtransportationassociations,someofwhichare membersoftheeahf. 55

56 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco The public health community consists of several NGOs and patient organisations focused either primarily on alcohol or secondarily through its morbidities. The European Alcohol Policy Alliance (Eurocare)istheonlymajorEuropeannetworkorganisationsolelyfocusedonalcoholpolicyissuesand has national members throughout Europe 21 (Eurocareemployee interview, 09/04/2015), whereas multipleotherngosoftheeahfamongothers,areinvolvedwithalcoholinasecondarycapacity.these includetheeuropeanpublichealthalliance(epha),theeuropeanassociationforthestudyoftheliver (EASL), United European Gastroenterologists (UEG), the Standing Committee of European Doctors (CPME),theRoyalCollegeofPhysicians(RCP)andtheEuropeanCancerLeagues(ECL).EspeciallytheECL isaninterestingpartner,asitwasalsopartofthetobaccocontroladvocacycoalitioninvolvedinthetpd revision. The coalition further consists of the European Mutual Help Network for Individuals and FamilieswithAlcoholRelatedProblems(EMNA),theAlcoholPolicyNetworkinEurope(APN)andthe AlcoholPolicyYouthNetwork(APYN). As posited, the pharmaceutical industry, represented by Lundbeck and Biohit, is also part of this coalition(eurocareemployeeinterview,09/04/2015),duetoitsinvolvementintherecentparliament ResolutiononAlcohol(Politico,27/05/2015;FiercePharma,28/05/2015), whereitpartneredwiththe publichealthcommunityonkeymessages.lundbeckhassimultaneouslycollaboratedwiththepublic healthcommunityoncoalitioninitiativesateulevel,suchastheawarenessweekonalcoholrelated Harm (AWARH, 2015) and a recommendation paper for EU policymakers (Health advocacy coalition, 2013). The interest of the pharmaceutical industry lies in the product portfolio, as Lundbeck among others has an alcoholism drug on the market in many European countries (Politico, 27/05/2015) and thuspromoteanintegratedapproachtoreducethehealthandsocialburdencausedbyharmfulalcohol consumption,frompreventiontointerventionandtreatment(lundbeck,2013).themutualinterestsof thepharmaceuticalindustryandthepublichealthngosissimilarwithintobacco,wherepharmaceutical companiesincludingnovartisandpfizerandthepublichealthngosfavouredhavingnicotinecontaining products,suchasecigarettes,regulatedasmedicalproductsratherthantobaccoproducts. The public health community within alcohol is an established coalition, as is argued by a Eurocare employee(interview,09/04/2015); Yes,%we%do%(work%in%an%advocacy%coalition).%The%voice%gets%stronger% with%more%organisations%on%board,%so%normally%we%work%closely%with%other%ngos%that%are%interested%and% share% same% interests,% mainly% on% prevention.% Then% we% also% have% the% health% NGOs,% such% as% the% heart% 21 Infact,someofEurocare snationalmembersarealsomembersoftheeahfintheirowncapacity,suchasthe ScottishHealthActiononAlcoholProblems(SHAAP),theEstonianTemperanceUnionandEurocareItaly. 56

57 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco network,% the% cancer% league,% European% Public% Health% Alliance% (EPHA),% the% liver% doctors,% medical% associations%etc.%it%depends%a%bit%on%what%we%are%working%on.thiswasevidencedbytherecentaligned resignationoftwentypublichealthngosfromtheeahftoprotestagainstthecommission srefusalto deliveraneweualcoholstrategy(euractiv,03/06/2015;eurocare,03/06/2015). Thededicatedaimofthecoalitionistoreduceandpreventalcoholrelatedharm,broadlyinlinewith theofficialpositionofthealcoholindustry(spiritseurope,2015a;brewersofeurope,2015a),although themeanstoachievethisobjectivevariessignificantlybetweenthesecoalitions.forthepublichealth community,populationbasedmeasuresincludingadvertising,taxationandpricingarepromotedasthe most effective and costefficient to prevent and reduce alcoholrelated harm (Eurocare, 12/05/2015; Alcohol Policy Network, 17/02/2015; Eurocareemployee interview, 09/04/2015; WHOemployee interview, 14/04/2015). Many of these populationbased measures are further supported by internationalinstitutionssuchaswho(2014a;2015a)andoecd(2015),aswellasbymemberstates andtheeucommitteeonnationalalcoholpolicyandaction,whounderlinesthecommission srolein addressing these issues (CNAPA, 10/12/2014). However, taking into account Sabatier (1998) and Sabatier&Weible s(2007)belieflevels,thereareunderlyingdifferencesinpolicycorebeliefswithinthe public health community for alcohol, namely the debate around abstinence and prevention versus reduction.althoughthisshouldpotentiallyaccentuatetheemergenceofadistinctcoalitioninitself,the reason for collating these interests within the same coalition in this paper stems from these distinct interests officially being part of the same broad and only major European public health NGO within alcohol, Eurocare. As a Eurocareemployee from Eurocare alludes to, Some% of% Eurocare s% members% want%to%compare%alcohol%and%tobacco,%while%others%argue%that%they%cannot%be%compared,%so%we%have%to% work%in%the%middle.%( )%You%want%to%ban%tobacco,%and%all%tobacco%control%NGOs%would%be%happy%if%all%the% tobacco%industry%would%just%disappear,%because%that%is%to%some%extent%the%goal.%for%most%of%eurocare s% members%that%is%not%the%goal%for%alcohol.%we%do%not%want%to%get%rid%of%the%alcohol%industry.%many%of%the% Eurocare%members%enjoy%a%glass%of%wine%or%spirit%or%beer,%and%that%is%not%our%goal.%( )%Eurocare%also%have% members% that% want% to% get% rid% of% the% industry,% but% they% are% a% minority. (Interview, 09/04/2015). Acknowledging the different preferences within the public health community for alcohol in terms of abstinenceversusreduction,isimportantasakeydifferentiatorbetweenthepublichealthcommunities within tobacco and alcohol, as for tobacco control NGOs, which the Eurocareemployee proposes in abovecitation,thereismorealignmentonasksandthusmorecoherenceinitsapproachtowardseu institutions(publicaffairsagencyemployeeinterview,30/03/2015). 57

58 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Thepublichealthcommunitywithinalcoholhoweverleveragessimilartoolstoinfluencepolicymakers asthetobaccocontrolngos,namelytheprovisionoftechnicalinformationanddocumentstosupport policymakersonmattersrelatedtoalcohol(eurocareemployeeinterview,09/04/2015).asaeurocare employeehasposited,eurocareandthecoalition try%to%influence%as%early%as%possible%in%the%process,%as% that%is%where%you%potentially%have%most%influence.%( )%We%try%to%be%early%and%follow%discussions,%and%we% do%that%by%having%formal%meetings,%informal%meetings,%organise%events%ourselves,%deliver%position%papers% etc. % (interview, 09/04/2015). These activities are primarily targeted the European Parliament, as evidencedintherecentparliamentresolutiononalcohol(europeanparliament,22/04/2015;eurocare, 29/04/2015),aswellastheCommission,althoughentrancetoandinfluenceontheCommissionprove significantly more difficult (Eurocareemployee interview, 09/04/2015). The public health community amongothersprovidedinputtotheeuropeanparliament senvironment,publichealthandfoodsafety (ENI) Committee members on the Resolution on Alcohol in the form of amendments targeting specificallylabelling,agelimitsandtheoverallsupportforaneweualcoholstrategy(healthadvocacy coalition,12/03/2015) Alcohol(industry( Comparabletothepublichealthcommunity,thealcoholindustryhasalsohadimportantinfluenceon alcohollegislationateulevel.althoughithasbeenarguedthatthedifferentinterestswithinthealcohol industry are not engaged in a formal advocacy coalition (SpiritsEUROPEemployee interview, 09/04/2015), this paper proposes that an informal, weakly aligned coalition still spans the different coalitionstakeholdersandgovernsthepolicycorebeliefsofthesector.subsetsofspecificinterestsat thepolicycorepolicypreferencelevelstillexplainsdistinctvariationinapproachestocertainspecific legislationissues, suchasnutritionallabelling.however,asisevidencedintheeuropeanalcoholand HealthForum(EAHF)amongothers,thedifferentsegmentsofindustryoperatesalongacommonlinein termsofpolicyasksforindustryinclusion,targetedmeasuresandsafelevelsofalcoholconsumption (SpiritsEUROPE,2015b;CEE,2015a;BrewersofEurope,2015a). The alcohol industry coalition consists of a number of European sectorspecific trade associations, including SpiritsEUROPE, Brewers of Europe, Comité Européen des Entreprises ins (CEE) as well as severallargealcoholmanufacturersintheirownright,suchasanheuserbuschinbev,heineken,bacardi Martini, Diageo and PernodRicard 22 (European Commission, 11/04/2014). In turn, FoodDrinkEurope 22 AllofthesealcoholmanufacturersarefurthermembersoftheEAHFintheirownright,besidesbeing representedbyrelevanteuropeantradeassociations(europeancommission,11/04/2014). 58

59 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco representsbothspiritseuropeandbrewersofeurope,whichisabroadeuropeanorganisation working% within% the% regulatory% framework% to% ensure% that% all% food% and% drink% issues% are% dealt% with% in% a% holistic% manner %(FoodDrinkEurope,2015). Besides the alcohol manufacturers, it is argued that the alcohol industry coalition further comprises wholesalers and retailers via the European Federation of Associations of Beer and Beverages Wholesalers (CEGROBB) and the umbrella association of Hotels, Restaurants and Cafés in Europe (HOTREC),aswellasadvertisers,includingtheWorldFederationofAdvertisers(WFA).Thereasonfor including these interest groups in the alcohol industry coalition is the reliance on similar terms in advocating for prevention of alcohol abuse rather than antialcohol, populationbased measures (CEGROBB,2015).Additionally,thepromotionofselfregulationandrejectionofadvertisingbansisa commondenominatoracrossthecoalitionforthesamesetofgeneralpolicycorebeliefsadvocatedto EUinstitutions.ThisisexemplifiedbytheResponsibleMarketingPact,acommitmentundertheEAHF involvingthewfa(wfa,16/04/2012)alongwith eight%leading%alcohol%producers%as%signatories%and,%as% associate%partners,%the%trade%organisations%of%the%spirits,%wine%and%beer%sectors%as%well%as%advertisers%and% sponsorship%associations %(EAHF,26/04/2012).ThisissupportedbyCEGROBB(2015)andSpiritsEUROPE, whoarguesthat the%industry%reinforces%its%commitment%to%responsible%marketing%communications%( )% advertising%does%not%impact%consumption,%let%alone%alcohol>related%harm %(SpiritsEUROPE,2015b).The crosssectorialindustrycoalitionbearssimilaritiestothetobaccoindustrycoalition,wherethetobacco industry consist of manufacturers of tobacco products, as well as tobacco growers, manufacturers, distributorsandsellers,whoarelikelytobeaversetoeffectivetobaccocontrol(who,2008). ThemessagesofthecoalitionatEUlevelprimarilyrevolvearoundthesupportforselfregulationand targeted measures to reduce alcoholrelated harm and hazardous drinking, through soft law and awarenessraisingordirectedactions,suchastowardsdrinkdriving,underagedrinkingandpregnancy drinking(spiritseurope,2015a;euractiv,01/06/2012),allofwhicharealreadyimpliedintheprevious EU Alcohol Strategy (European Commission, 24/10/2006). As result, the alcohol industry coalition unequivocallysupportsarenewaloftheeualcoholstrategywithemphasisonthesametopicsasthe previous (SpiritsEUROPEemployee interview, 09/04/2015; SpiritsEUROPE, 2015a; CEE, 2015a; EurActiv, 22/05/2015; UK House of Lords, 2014), in accordance with the 2012 external assessment reportbycowi&milieu(2012). 59

60 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Thepolicymessagesofthecoalitionbuildonthepresumptionthatamoderateuseofalcoholmayhave health and social benefits, as argued by coalition partners (CEE, 2015a; Brewers of Europe, 2015a), whichhasbeenacknowledgedbytheoecd(2015b)amongothers.thus,populationbasedmeasures, suchastaxationandminimumunitpricing(mup),assuggestedasthemostcostefficientpoliciesbythe public health community, will be inefficient and harm the entire European population. Indeed, the ScotchWhiskyAssociation,SpiritsEUROPEandCEEhavetakenproactiveactionintheformofalegal challengeagainsttheproposedintroductionofmupinscotland(euractiv,08/09/2014).thechallenge hasbeenreferredtotheeuropeancourtofjusticeontheindustrygroundsofitbeinganillegalbarrier totrade(scotchwhiskyassociation,30/05/2012;ukhouseoflords,2014).asspiritseuropestates, population>based%measures%are%not%the% silver%bullet %to%solve%alcohol%related%harm.%instead%of%(unfairly)% penalising% the% entire% population,% measures% that% target% specific% problem% drinkers% and% risky% drinking% patterns%will%reduce%alcohol>related%harm%more%effectively (SpiritsEUROPE,2015a). The alcohol industry coalition at EUlevel lobbies towards all three main EU institutions of the Commission,ParliamentandCouncil,althoughtheCouncilactivitiesaremorelimited,duetoitslargely nationalscope(spiritseuropeemployeeinterview,09/04/2015).amongothers,ithasbeensuggested thatthealcoholindustrylobbiedtheeualcoholstrategyin2006toanextentthatwas unprecedented in its intensity (Romanus, 2006), with specific changes successfully applied including the narrowed scope from the negative impact on the entire economy to a focus on the workplace specifically. Additionally,ithasbeensuggestedthatalcoholindustrylobbyismensuredthattheroleoftheEUwas weakenedinthefinalstrategy,aswellasalcoholadvertisingbecomingselfregulatoryandthearguably protectivebenefitsofalcoholoncoronaryheartdiseasebeingreferencedtoagreatextent(romanus, 2006). Tools leveraged by the alcohol industry coalition for the Parliament Resolution on Alcohol include meetingswithmepsandtablingofamendmentstotheresolutiondraftviameps.infact,ithasbeen proposedthatroughly280amendmentstabledinthepublichealthandfoodsafety(eni)committee of the Parliament stemmed from the industry (Eurocareemployee interview, 09/04/2015). For the meetingswithmepshowever,asanemployeeofspiritseuropesuggests(interview,09/04/2015), the% reason%why%we%met%with%meps%is%very%simple;%it%is%a%new%parliament%with%new%meps%coming%in.%in%the% ENI%Committee%you%have%some%familiar%faces%but%also%a%lot%of%new%people,%and%they%were%discussing%a% resolution% on% the% EU% Alcohol% Strategy,% which% started% in% 2006% and% although% carried% through,% it% should% have%finished%in%2012.%the%people,%who%were%taking%a%decision%on%whether%or%not%the%eu%alcohol%strategy% 60

61 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco has% worked% and% whether% it% should% continue% and% how,% had% no% experience% or% knowledge% on% what% has% happened%in%the%last%six%years.%what%we%have%been%doing%in%the%debates%with%the%parliamentarians,%is% very%much%to%go%and%explain%what%has%been%going%on%for%the%past%six%years.%( )%You%had%a%lot%of%people% who%needed%to%make%decisions%and%give%guidance%without%knowing%the%history,%so%it%was%very%much%an% informational%meeting. Additionally,theindustryisabletoinfluenceMEPsthroughindustrygroups,Parliamentintergroupsand informalpartnerships.asexample,thebrewersofeuropehostandtechnicallysupporttheparliament Beer Club, whose membership includes a number of MEPs (Brewers of Europe, 05/11/2014; EP Beer Club,2015a).Activitiesoftheclubincludebriefings,Parliamentevents,beertastings,breweryvisitsand reportlaunches,aswellasinformationtools,suchasnewslettersandbackgroundbriefingssharedwith MEPmembers(EPBeerClub,2015b).Theimpactisalsoevident,withtheMEPandthenvicechairman of the EP Beer Club, Astrid Lulling, in 2007 being responsible for a report proposing the abolition of minimumexcisedutiesforalcohol,whichhoweverwasrejectedbytheeuropeanparliament(eurocare, 23/05/2007). Another example is the Wine, Spirits and Quality Foodstuffs Intergroup, whose last meetinginmay2015wassupportedbytheitalianwineassociation,federvini(europeanparliament, 04/05/2015),whoisalsopartofthepanEuropeanwineassociation,ComitéEuropéendesEntreprises ins(cee,2015b).thisintergroupconsistsofmultipleparliamentmembersandprovidesaforumfor MEPs to be informed by and about the wine, spirits and food industry (European Parliament, 2015; SpiritsEUROPE,11/06/2015).Ashavebeenargued,theintergroupsareafurther lobbying%tool%( )%with% the%organization%of%conferences,%briefings%or%exhibitions,%intergroups,%and%more%specifically%stakeholders,% seek%to%build%a%network%of%meps%who%can%be%mobilised%when%necessary,%to%convey%messages%on%a%topic% under% discussion% or% to% shed% light% on% an% issue% in% order% to% convince% the% European% institutions% to% act (AliénorEU,11/2014). Thegeneraltoolsandresourcesbetweenthealcoholindustrycoalitionandthepublichealthcommunity havebeenarguedasakeydifferenceintermsofinfluencetowardseuinstitutions(eurocareemployee interview, 09/04/2015), which is supported by Klüver s presumption that interest group influence dependsamongothersonthepossessionofresourcesandeconomicwealth(2011;2013).thealcohol industry coalition is seemingly empowered by more market prowess and resources than the public healthcommunity. 61

62 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Theinformalityandweaknessofthecoalitionisimportanttoassessinthiscontext.Asanemployeeof SpiritsEUROPEhasargued(interview,09/04/2015),thealcoholindustrygroupsdonotworkincoalitions perse,butratheronanadhocbasis,throughinputfromrelevantindustrypartnerswhenneeded; we% work% with% other% partners% at% Brussels% level,% so% we% can% leverage% on% their% expertise,% such% as% within% advertising.thisunderlinessabatier&weible snotion(2007)thatthespecialisationnecessitatedby policymakinghasbecomeincreasinglycomplex,bothsubstantivelyandlegally,andthustheparticipants must seek external input on areas outside their primary scope. However, Klüver argues in her framework (2011, 2013), that it is possible to recognise coalitions despite the lack of an alliance or coordinatedlobbying.instead,thedeterminingfactoristhattheirlobbyeffortsaredirectedtowardsa common policy goal. This is further underlined by the belief levels proposed by Sabatier (1988) and Sabatier & JenkinsSmith (1988), in which the policy core beliefs that frame a coalition empirically proves that the alcohol industry including all aforementioned interest groups comprise a coalition in Sabatier ssenseoftheterm.thedifferencesbetweenthecoalitionpartnersareonalowerpolicycore policy preference level, such as the recent voluntary measure to include nutritional labelling on its products by the Brewers of Europe (EurActiv, 30/03/2015). This measure was rejected by both SpiritsEUROPE and CEE as being misleading due to the dissimilar nature of their products (Politico, 29/04/2015; EurActiv, 30/03/2015). However, the industry agrees on widely opposing mandatory labelling (Politico, 29/04/2015), which suggests that the disagreement around voluntary nutritional labellingisminorandbasedsolelyonapolicycorepolicypreference Tobacco(in(the(EU(J(interests,(advocacy(coalitions(and(policy(preferences( Differing from alcohol, several hard law developments at EUlevel have occurred for tobacco within recentdecades.tosimplifyandconcentratethesubsequentdiscussion,theinterestgroupandadvocacy coalition analysis within tobacco will focus on the recent revision of the Tobacco Products Directive (TPD). The TPD revision entered into force in 2014, thirteen years after the publication of the first directivein2001(eu,18/07/2001).therevisionfollowedextensiveandrepeatedcallsbythecouncil andparliamenttoaddresstheweaknesses,gapsandloopholesintheexistingrules(eu,2015c). Interestgroups,bothproponentsandopponentsoftobaccoregulationandcontrol,hadgraveimpacton theoutcomeoftherevisionofthetpd.especially,certaintobaccocompaniesactedboththroughtrade 62

63 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco associationsandindividuallyasinterestgroupsthemselves,suchasphilipmorrisinternational(pmi) 23, andbritishamericantobacco(bat) 24.Particularlytheformerinvestedmassiveamountsofcapitaland effort to influence the revision of the TPD towards an outcome that would prove beneficial to the tobaccoindustry.inadditiontothedirecteffortsbythetobaccoindustrytoinfluencetherevisionofthe TPD,thetobaccoindustryalsoemployedthirdpartyinterestgroups,interestgroupswithnodirectlink tothetobaccoindustry,whichlobbiedinfavourofthetobaccoindustry spreference. OtherimportantinterestgroupsundertherevisionoftheTPDincludepublichealthnongovernment organisations(ngos)suchasthesmokefreepartnership(sfp)alongwithotherofitscoalitionpartners. These interest groups sought to influence the revision of the TPD to ensure that tobacco regulation wouldbecomemorecomprehensiveinthefuture. Following,ananalysiswillbeconductedofthepolicypreferencesandbeliefsoftheadvocacycoalitions aswellasthestrategiesappliedtoreachtheirgoal The(tobacco(industry( Aspreviouslymentioned,thetobaccoindustrywasheavilyinvolvedinlobbyingtherevisionoftheTPD as they considered a revision of the Directive a huge threat to their industry. Amongst the most influentialactorswerepmiandbat,andthus,togaugetheactivitiesthoroughly,muchofthiscoalition partwillrelyonthesetwoascasestudiesandconsidertheirpreferencesandstrategiesasapplicableto thetobaccoindustrycoalitioninitstotality.theopportunitytoanalysetheseactivitiesindetailstems fromthereleaseofthousandsofinternaltobaccoindustrydocumentsasresultoflitigationandwhistle blowers(hurtetal.,2009;peetersetal.,2015;ucsf,2015). ThetobaccoindustrycoalitionduringtherevisionofTPDconsistedofinternationaltobaccocompanies, such as Philip Morris International and British American Tobacco along with other major tobacco corporationsandeuropeantradeassociations,includingeuropeansmokingtobaccoassociation(esta), European Smokeless Tobacco Council (ESTOC) and European Cigar Manufacturers (ECMA) (European Commission, 06/01/2012; Tobacco Tactics, 2015a; 2015b). Specifically, the coalition was in favour of weaker tobacco regulation postrevision of the TPD, and equally negative of its final content (Philip Morris International, 2015). This is further evidenced by Peeters et al. s (2015) mapping of PMI s 23 PMIisanAmericantobaccoproducinggiantdomiciledinSwitzerlandandproducerofbrandssuchasMarlboro andl&m. 24 BATissimilarlytoPMIoneofthelargesttobaccoproducingcompaniesintheworld,producingbrandssuchas PallMallandLuckyStrike. 63

64 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco lobbyingcampaignduringtherevisionoftpdtoattempttoinfluencepolicymaking,rangingfromthe highestechelonsofthecommissionthroughtheparliamentandtothecouncil.especiallytheentrance to the highest levels of the Commission has been suggested to have been reserved to the tobacco industrycoalitionratherthanthepublichealthcommunity(eclemployeeinterview,11/06/2015).the lobbycampaign,primarilydrivenbypmi,aimedatdelayingtheproposalandultimatelyblockingpolicy events,whichwasconsideredextremeandathreattothetobaccoindustry,suchastheintroductionof standardisedpackaging,pointofsalesdisplaybanandingredientsban(peetersetal.,2015).moreover, in relation to the TPD, BAT was already in the 2000s proponent of passing the Smart Regulation Framework, anticipating that it would become an important channel for industry parties to lobby through (Tobacco Tactics, 2015b). Ultimately, through the required public stakeholder consultations, this framework allowed PMI to delay the TPD revision and to some extent block elements such as standardisedpackaging,pointofsalesdisplaybanandingredientsban(peetersetal.,2015). The Smart or Better Regulation Framework implemented in the mid2000s was established as an initiative to enhance competitiveness of EU corporations by easing the burden that corporations are subjecttoafternewregulatoryrequirements(europeancommission,2015a).theframeworkseeksto dothisbyimplementingpoliciesandlawsthatareformulatedinsuchasawaythatrequirementscanbe achieved through minimum costs. Further, the Smart Regulation Framework ensures that the preparation,implementationandreviewofpolicymakingareconductedinfulltransparency,inwhich thepolicyisformulatedwiththesupportofinvolvedstakeholdersandonthebasisofthebestavailable evidence. To ensure the efficiency of policymaking in the EU, the Commission further established an impact assessment, which assesses the impact of the proposed policy actions in terms of potential economic,socialandenvironmentalconsequences(europeancommission,2015b).lastly,andlikelythe mostimportantentrypointforthetobaccoindustryandotherindustrylobbyists,thesmartregulation Framework established public consultations of stakeholders, which would be affected by the policymaking.thisgavestakeholders,ipsofacto,industryactorstheabilitytovoicetheiropinionofa policy over its entire lifecycle, meaning that stakeholders are allowed to provide feedback and comments on the policy from the initiative, during the impact assessment and roadmaps of the Commission. In turn, stakeholders are allowed to submit views on proposals that have already been adoptedbythecommission(europeancommission,2015b). Duringthemid2000s,BATwasaproponentoftheSmartRegulationFramework,reflectedinitlobby activitiestoensurethatitwouldbepassedasageneralframeworkapplyingtoallindustriesintheeu 64

65 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco (Smith et al., 2015). It has been suggested thatbatanticipated the benefits ofthe Smart Regulation Framework to the tobacco industry as the impact assessment and stakeholder consultations opened anotherwaytovoicepreferencesandinfluencepolicymaking(peetersetal.,2015).inturn,thiswould makeitharderforthecommissiontopassproposalsenhancingpublichealthlegislationanddecreasing thepowerofthecommissionanditsdirectorategeneralforhealthandfoodsafety(dgsanté).as such, despite PMI having led the tobacco industry coalition in the revision of the TPD, BAT provided valuable preliminary footwork to ensure the possibility of their comprehensive lobby campaign, by initially realising the potential of the Smart Regulation Framework for industry interest groups to influencepolicymaking PMI s'lobby'strategy' AshavebeenproposedbyWHO(2008a),muchevidencedemonstratesthattobaccocompaniesusea wide array of tactics to interfere with tobacco control. These strategies include direct and indirect political lobbying, financing of research, attempting to affect the course of regulatory and policy machinery,suchasthroughinformationaloverloadingofpoliticalinstitutions(greeretal.,2014),and engaging in social responsibility initiatives as part of public relations campaigns. Efforts to weaken legislationhavefurtherbeenprojectedasacommonindustrytacticundertakeningermany(grüning& Gilmore,2007),Switzerland(Lee&Glantz,2001)andtheEU(Bittonetal.,2002).Tothisend,athen SenioricePresidentofPMI sworldwideregulatoryaffairsstatedin1995that our%overall%approach%to% the%issues%is%to%fight%aggressively%with%all%available%resources,%against%any%attempt,%from%any%quarter,%to% diminish%our%ability%to%manufacture%our%products%efficiently,%and%market%them%effectively%( )%In%short,%we% are%very%clear%about%our%objective an%unyielding%and%aggressive%defence%of%our%rights%to%make%and%sell% our% products% and% our% consumers % rights% to% have% a% free% marketplace% so% that% they% can% choose% and% use% those%products. (PMI,29/04/1995;WHO,2008) DuringtheTPDrevision,lobbyeffortsweremassiveandPMIemployedmorethan160lobbyist(Peeters etal.,2015)andspent 5.25milliononlobbyingduringtheyearthattheParliamentwasinvolvedwith the revision of the TPD (International Business Times, 01/10/2014). These lobby activities took place despitethe2005whoframeworkconventionontobaccocontrol s(fctc)restrictionstoprotectpublic health policies from commercial and other vested interests of the tobacco industry. In fact, PMI increased its lobbying budget from 1.25 million to 5.25 million during the year of Parliament involvementwiththerevisionofthedirective.thisarguablydemonstratesthelackofacknowledgement ofthefctc,andthestrongemphasisandoppositiontothedirectivefromwithinthetobaccoindustry. 65

66 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco AccordingtoastudybyCostaetal.(2014),PMI sstrategyduringtherevisionofthetpdwaseitherto amend or delay the proposal, or to block any events which they considered extreme, identified as genericpackagingoftobaccoproducts,salesdisplaybanandabanonproductingredients.accordingto thestudy,pmihadadetailedsetofactiontobeappliedtoeachstageoftherevisionofthetpd,while inthehandsofthecommission,pmisoughttoblockthepolicyoptionsproposedbythedirectorate General for Health and Food Safety (DGSANTÉ) as they considered these a threat to the industry. Moreover,whileintheParliament,PMIaimedtocreateoppositioninordertobreakthefullcontrolof the dossier, which was held by the Public Health and Food Safety (ENI) Committee. Lastly, in the Council,PMIplannedtocreateablockingminoritytoensureoppositionagainstanyextrememeasures. Asmentioned,PMIemployedmorethan160lobbyistsduringtherevisionoftheTPD;bycomparison Brusselsbasedhealthadvocateshad5fulltimepositionsworkingontheDirectivewithaslightincrease in2012whentheproposalwasannouncedtothepublic(peetersetal.,2015) PMI'and'the'Commission' In line with the ordinary legislative procedure (OLP), the Commission holds the right of initiative for tobaccolegislation,whichmakesitincreasinglydifficultfortheparliamentandcounciltomodify.asa meanstoimprovetransparencyandaccountabilityofeupolicymaking,thecommissioninstead,during thepolicyformulationphase,holdsinstitutionalisedpublicconsultations,asperthesmartregulation Framework.Hence,thepolicyformulationphaseisthemostconstructivephaseforinterestgroupsto influenceapolicyoutcome(klüver,2013),asevidencedbythetobaccoindustry slobbyeffortstowards thecommission. LargelyattributedtoeffortsbyPMI,thecomprehensiveimpactassessmentoftherevisionoftheTPD, whichwaspartoftheeu ssmartregulation,wasdelayedforseveralyears,from2010to2012.peeters et al. (2015) argue that this was due to primarily two factors; firstly, there was strong industry opposition against a study conducted by RAND Europe, which served as the ground pillar for the Commission s impact assessment. Secondly, the stakeholder consultation, which DGSANTÉ was requiredtoholdaspartofthesmartregulationframework,servedasanimportantpointofentryfor thetobaccoindustrytodelayandinfluencetherevisionofthedirective.duringoneofthestakeholder consultationsheldin2010,morethan85,000submissionswerereceived,afterwhichthecommission stated no%previous%public%consultation%launched%by%the%european%commission%has%ever%registered%such% significant% participation % (European Commission, 2011a). Although, only approximately 2000 of the submissions could be directly linked to the tobacco industry, previous studies by the Commission 66

67 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco revealed that 57% of the submission were duplicates and mainly submitted by tobaccoindustry led campaigns in Italy and Poland (European Commission,2011b), while internal PMI documentssuggest that the majority of the more than 85,000 submission were known by the company (Peeters et al., 2015). InadditiontousingtheSmartRegulationtotheirbenefitthroughthestakeholderconsultation,PMIalso lobbiednonhealthcommissionersandotherdirectoratesgeneral(dgs)withtheaimofchangingthe debatefromprimarilyhealthorientedtoaneconomicdebate.asresultofsuccessfullobbyingof the higheststrataofthecommission,itsinternalconsultationwiththedgs(interserviceconsultation)was delayed by the request of SecretaryGeneral Catherine Day and Legal Service s DirectorGeneral Luis RomeroRequenaclaimingthatsubstantialissuesneededaddressingbeforeproceeding(Peetersetal., 2015).Additionally, correspondencein2012betweenDGSANTÉandCatherineDaysuggeststhat plain packaging and a point of sales display ban were removed from the proposal as a result of this (Peeters,etal.,2015).Theinterserviceconsultation(ISC)wasdelayedfurtherasaresultofconcernsof Catherine Day and Chief of Commission President Barroso s Cabinet, Johannes Laitenberger that it would be wiser to wait until after a Council meeting scheduled for October to avoid unnecessary controversy.however,inoctober2012,daysbeforetherescheduleddate,theiscwasdelayedagain duetothe Dalligate controversy,inwhichthenhealthcommissionerjohndalliwasforcedtoresignby PresidentBarroso(TobaccoTactics,2015c),duetoallegationsofcorruption 25.Forthisreason,President BarrosopreferredtoconducttheISCfollowingtheappointmentofanewHealthCommissioner 26. The above suggests a strong industry influence, even in the highest chambers of the Commission (EurActiv,07/07/2014),whichissupportedbyevidencesuggestingthatCatherineDay,theLegalService andbarroso scabinetheldatleast12tpdrelated meetings withthetobaccoindustrybetween2010 and 2012 (Peeters et al., 2015). These meetings were in direct violation of article 5.3 of the WHO Framework Convention on Tobacco Control (FCTC) framework, as no minutes of the meeting were disclosed to the public, unlike the meetings held between DGSANTÉ and the tobacco industry. The 25 Specifically,thecorruptionallegationsincludedhisbusinessassociateSilvioZammithavingattemptedtoreceive financialgains(allegedly 60million)fromthecorporationSwedishMatch(ajointventureofPMI),whoinreturn wouldgetdallitoliftthebanonthenonsmokingtobaccoproduct snus. 26 FollowingDalli sresignation,itbecameclearthattheallegationswereinfactbroughtforwardbyswedish Match.MichelPetite,theproxybetweenCatherineDayandSwedishmatchandformerHeadofLegalServicesfor thecommission,approachedthesecretarygeneralwiththeaccusationsfollowedbyawrittencomplaint,which DayrespondedtowithaninvestigationbyGiovanniKessler,theDirectorGeneraloftheEUAntiFraudOffice (OLAF).TheOLAFreportultimatelyfoundZammitguilty,althoughnoconclusiveevidenceforDalli sdirect involvementhasbeenfound(tobaccotactics,2015c). 67

68 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco evidenceofstrongindustryinfluenceisfurthersupportedbythispaper sinterviewwithanemployeeat EuropeanCancerLeagues,inwhichitisstatedthat we%saw%that%there%were%a%lot%of%industry%contact%and% plenty%of%meetings%with%the%secretary%general%of%the%commission%and%president%barroso%(then%president% of% the% European% Commission),% and% there% were% a% lot% of% delay% of% the% Directive% at% the% request% of% the% Secretary%General.%We%were%not%able%to%be%in%contact%with%the%highest%level%of%the%Commission,%but%the% industry%was%certainly%there,%and%they%obtained%quite%some%delays%of%the%directive.%the%forced%resignation% of% Commissioner% Dalli% in% October% 2012% has% been% seen% as% their% biggest% success,% but% it% worked% more% against% them,% because% at% the% end% of% the% day,% the% Commission% still% proposed% the% TPD % (interview, 11/06/2015) PMI'and'the'Parliament' PMIandthetobaccoindustrycoalition sstrategyintheparliamentwastobreaktheenicommittee s solecontroloverthetpdrevision,throughtheappointmentoftheinternalmarketcommitteeasaco leadparliamentarycommitteealongsideeni.thismeasurewastakeninordertoshiftthediscussion from a purely healthoriented debate to an economic debate, similar to the approach towards the Commission (Peeters et al., 2015). PMI sought to do this via massive direct lobbying of MEPs, approaching 257 MEPs in the process, primarily at national levels to circumvent EU protocol, and systematicallyassessingtheirpositiononanumberofitemsrelatedtotobacco(peetersetal.,2015;eu Observer 12/09/2013). In addition, MEPs concerned with health and thus proponents of increased tobacco regulations were approached by third parties disguising their connection to the tobacco industry,whereasmepsinfavourofthetobaccoindustrywereinstructedtoinfluenceotherimportant MEPswithintheirownparties(TobaccoTactics,2015c).Ultimately,however,theappointmentofthe Internal Market Committee as colead of the parliamentary committee was unsuccessful as result of Dalligate, which materialised an all in favour mentality for moving the TPD forward as quickly as possible(peetersetal.,2015). Lastly,asameanstocreateashifttowardsaneconomicdiscussion,PMIattemptedtocreateopposition within the five appointed Parliamentary Committees in the areas of International Trade, Internal Markets,LegalServices,AgricultureandRuralDevelopment,andIndustry,ResearchandEnergy PMI'at'national'level'and'in'the'Council' At national level, PMI sought to exert influence in the TPD Regulatory Committee, a committee consistingofnationalministriesofhealthofalleumemberstatesandthedgsanté,whometsemi annually to discuss the progress of the TPD revision. Despite lack of clarity on this activity s 68

69 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco effectiveness,an exchangebetweenpmiandthedutchministryofhealthsuggeststhatitwould implementthesuggestionsofpmi(peetersetal.,2015). Another point of entry for PMI to exert influence or delay the TPD revision was through national parliaments and the Council. Applying EU s Subsidiarity Principle, in which national parliaments can underminealegislativeproposalsetforthbythecommissiontoensurethatitmeetstheprinciple,pmi attemptedunsuccessfullytogenerateenoughnegativeopinionstocausewhatisreferredtoasa yellow cardsystem,bywhichthecommissionwouldhavetoredrafttheproposal(peetersetal.,2015). Lastly,PMItriedtoestablishablockingminoritywithintheCouncilbasedonthenegativeeffects on employmentinthetobaccoindustry,whichprogressivetobaccoregulationwouldresultin.moreover, PMIarguedthattheseemploymenteffectswouldspilloverintoothersectorsoftheEU(Peetersetal., 2015).SomeEasternEuropeanMemberStatesincludingBulgaria,CzechRepublic,PolandandRomania, due to their involvement in tobacco production, proactively opposed the proposal. Especially Poland voicedoppositiontotheoverarchingthemeofhealthpolicyintherevisionofthetpdandthelackof competitiveness of the European tobacco industry in international markets (ECLemployee interview, 11/06/2015; Peeters et al., 2015). Prior to the Council s vote on the TPD proposal as part of the co legislativeroletogetherwiththeparliament,polishmediahadrevealedhowthepolishprimeminister, andnowpresidentofthecouncil,donaldtusk,hadbeenactivelylobbiedbythepolishtobaccoindustry indecemberof2012(radiopoland,31/01/2013).thefinaldecisionofthecouncilwasacompromise, whichslightlyweakenedtheproposalfromthecommission.thelargeoppositionfoundwithinthefour easterncountriesmentionedaboveissupportedbyourinterviewwithanemployeeateuropeancancer Leagues who stated that if% you% look% at% the% big% exporters% of% cigarettes,% you% will% see% that% Poland% and% Germany% are% large% exporters% and% thus% defend% industry% interests.% The% same% is% true% for% countries% like% Bulgaria,%Romania%and%the%Czech%Republic.%We%had%four%countries%against%the%TPD,%which%was%Poland,% Bulgaria,% Romania% and% the% Czech% Republic,% all% of% which% have% big% tobacco% interests.% The% one% going% to% court%against%the%tpd%is%poland %(interview,11/06/2015).thechallengebypolandrelatesspecificallyto theeubanonflavouredtobaccoproducts(euractiv,22/06/2014).especiallymentholcigarettesareof greatinterestinpoland,wherenearlyoneineveryfivecigarettessoldismentholflavoured,compared tooneinteninswedenandbelowoneinahundredinspain,austriaorslovakia(reuters,21/07/2014) PMI'and'the'thirdEparty'subEcoalition' AnotherimportantpartofthelobbystrategyemployedbyPMIandthetobaccoindustrycoalitionduring therevisionofthetpd,wastheestablishmentofathirdpartysubcoalition.duringthetpdrevision, 69

70 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco PMI sought to exert indirect influence by establishing thirdparty coalitions with associations and companiestowhompmiclaimedthattheregulationpassedintherevisionofthedirectivewouldspill over into subsequently (The Guardian, 07/09/2013; Peeters et al., 2015). Through leveraging a third party subcoalition, PMI and the tobacco industry aimed to gain the political support of nonhealth Commissioners by applying emphasis on intellectual property, ingredients, retailers and smokeless tobacco.specifically,pmiemployed15associationsand2companiesascoalitionmembers,including the European Tobacco Growers Association (Unitab), European Federation of Food, Agriculture and TourismTradeUnions(EFFAT)andtheEuropeanFederationofTobaccoProcessors(FETRATAB)leading ontheingredients platform,andtheeuropeanassociationoftobaccoretailers(cedt)ontheretailers platform. According to the study by Peeters et al. (2015), 12 out of the 15 third party coalition partners were actively involved in lobbying the Commission and the Parliament and worked to mobilize forces to oppose the revision of the Directive. As example, the European Confederation of Tobacco retailers (CEDT) established a TPD Working Party for European retailers, which mobilised Member State retail organisationsagainstthetpdrevision.moreover,aconsiderablenumberofassociationsandcompanies had economic ties to the tobacco industry and voiced opposition to the TPD through industry stakeholder meetings with the Commission and MEPs, as well as participated in working groups to establishcounterstrategies,signingantitpdpetitionsandgivingcriticalstatementstothemedia.to thispoint,evidencesuggeststhatpmiandbatparticipatedinmeetingsheldbybusinesseuropeandthe Dutchbusinessassociation,theConfederationofNetherlandsIndustryandEmployers(NONCW),with theintentionofestablishingalobbypresencewidelyintheeuropeanbusinesssector,stressinghowthe passage of the TPD revision could possibly have spillover effects on industries such as food and alcohol 27 (Peetersetal.,2015).Assuch,intermsoftheadvocacycoalitionframework,theperspectives leveragedbypmiandthetobaccoindustryinordertoestablishthesubcoalitionwerepredicatedona setofunderlyingcorebeliefs,whichspannedpolicyareas.althoughthesesubcoalitionpartnerswere notpartoftheadvocacycoalitiononothertobaccospecificmeasuresandactivities,thepotentialfor the TPD revision to affect other policy areas seemed to unite industry interests across a number of policyareastoensurethepriorityofeconomicinterestsoverhealth. 27 AnexampleofthisstrategyincludesGermantobaccocompanieshavingsentchocolateSantaClauseswiththe textsaying chocolatemakesyoufat,similartothehealthwarningsontobaccopackages,togermanmepsasgifts tovisualizethethreatofpossiblespillovereffectsofthetpdrevisiononthefoodandalcoholindustry(tobacco Tactics,2015d). 70

71 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Public(health(community( The public health community within tobacco have also played an important role in EU regulation of tobacco products, albeit with limited resources compared to the tobacco industry (ECLemployee interview,11/06/2015).severalactorsplayedalargepartinthiscoalitionduringtherevisionofthetpd, namelythengossmokefreepartnership(sfp),europeanheartnetwork(ehn),cancerresearchuk, AssociationofEuropeanCancerLeagues(ECL),EuropeanRespiratorySociety(ERS)andEuropeanPublic HealthAlliance(EPHA).Additionally,SFPestablishedin2014aformalcoalitionwiththeaforementioned associations,aswellasasubsetofindependenteuinstitutionsandnationalorganisationscontributing withtechnicalexpertiseinregardstopoliciesregulatingtobacco(smokefreepartnership,2015a).asan employeeateuropeancancerleagueshasconfirmed(interview,11/06/2015), the%lead%organisation% for% the% coordination% was% Smoke% Free% Partnership% (SFP),% so% we% worked% with% them,% European% Heart% Network,% European% Public% Health% Alliance% (EPHA)% and% some% national% organisations% among% others.% As% such,%we%did%work%in%a%coalition%of%organisations.itwillfurtherbeproposedthatthepharmaceutical sector was part of this coalition, due its similar policy core beliefs, albeit certain policy core policy preferences differ between these coalition partners (Public Affairs Agencyemployee interview, 30/03/2015). Under leadership of the SFP, the common goal of the coalition is to formulate advocacy strategies, whichfurtherstringenttobaccoregulationinordertosupportandpromotesmokingpreventionwithin theeu.ontheirwebsitethefollowingisstated, led%by%sfp,%coalition%partners%work%together%to%promote% and%support%smoking%prevention%through%the%development%of%advocacy%strategies%that%deliver%specific%eu% tobacco% control% policies% as% well% as% to% promote% and% support% smoking% prevention% at% international,% European%and%national%level%through%the%development%and%implementation%of%the%FCTC,%its%protocols%and% guidelines and the%main%priorities%of%the%sfp%coalition%will%be%to%continue%promoting%forward>looking% and%evidence>based%tobacco%control%legislation%in%order%to%support%the%implementation%of%the%fctc%in% specific%and%cross>cutting%policy%areas%with%an%overarching%goal%of%improving%health%and%reducing%health% inequalities%among%eu%citizens %(SmokeFreePartnership,2015a).Bothquotessuggestthatthepolicy corebeliefsrevolvearoundenhancedsmokingandtobaccopreventionanditcanthereforebeinferred that the coalition s secondary beliefs during the revision of the TPD was to establish a coordinated strategyaimedatensuringstrictertobaccoregulation. The tools leveraged by the public health community for influencing policymaking within tobacco regulationattheeulevelincludetheprovisionoftechnicalassistanceanddocumentstoeuinstitutions 71

72 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco (ECLemployee interview, 11/06/2015). Additionally, it assists its partners on matters of policy developments towards smoking prevention as well as acting as a facilitator to the exchange of informationbetweenthepartnersofthecoalitioninordertohaveitactunitedonmattersofeuand nationaladvocacyonsmokingpreventionandtobaccocontrol.moreover,thesfpisinchargeoftraining partnersofthecoalitiontoensurethattheyinteractwiththeeuinanorganisedanduniformfashion. Thisunificationinaskshasbeensuggestedasakeydistinctionbetweenthepublichealthcommunity withintobaccocomparedtoalcohol(publicaffairsagencyemployeeinterview,30/03/2015),andcould potentiallybepartoftheexplanationfortheadditionallegislationateulevelwithintobacco. AccordingtoanemployeeatEuropeanCancerLeagues(interview,11/06/2015),thecoalitionlobbiedat Commission,ParliamentandCouncillevelduringtherevisionoftheTPD,stating in%the%beginning%it%was% mainly%at%the%commission>level.%it%took%quite%a%long%time%before%we%had%the%proposal%of%the%commission.% I%do%not%know%if%it%was%2008%or%2009%when%consultations%began,%where%we%met%with%the%Commission%and% provided%reports%to%them,%but%in%the%beginning%it%was%at%commission>level.%afterwards,%when%it%was%sent% to% the% Parliament,% we% had% contact% with% the% rapporteur% (MEP% Linda% McAvan),% with% Members% of% the% European%Parliament%of%the%different%political%groups%and%I%was%also%in%contact%with%the%Irish%Presidency% of%the%council%working%group%on%the%tobacco%products%directive%and%the%belgian%representative%in%that% field.thefactthatthepublichealthcoalitionwithintobaccolobbiedpreliminarilyatcommissionlevel underlinestheroleofthecommissionintheordinarylegislativeprocedureoftheeu,whichinfersthat thecommissionhastherighttoinitiativeofpolicyproposals.lobbyingatcommissionlevelthusshould be seen as an effort by the coalition to establish the proposal and revision in the first place, subsequently lobbying the Parliament and Council to ensure commitment and inclusion of relevant paragraphsintheirrevisionoftheproposal. DuringtherevisionoftheTPDin2012,representativesofthecoalitionmetwithHealthCommissioner JohnDalliandotherofficialsoftheDirectorateGeneralforHealthandFoodSafety(DGSANCO).Here,it wasunderlinedthatnicotinecontainingproducts,andspecificallyecigarettes,werecurrentlynotunder anysafetyrulesandconcernwasexpressediftheseproductsweretoberegulatedastobaccoproducts instead of pharmaceutical products (European Commission, 06/03/2012). The propharmaceutical regulation of nicotinecontaining products is confirmed by a position paper conducted by the SFP CoalitioninconjunctionwiththeEuropeanCancerLeaguesandstatesthatnicotinecontainingproducts and ecigarettes should% only% be% sold% as% quitting% aids% and% comply% with% specific% safety% and% quality% requirements%under%the%same%regulatory%framework%as%pharmaceutical%products%rather%than%under%the% 72

73 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco scope%of%the%tobacco%product%directive (SmokeFreePartnership&EuropeanCancerLeagues,2012). FromtheminutesofthemeetingbetweentheNGOslistedaboveandHealthCommissionerJohnDalli,it canbeinferredthatthepreferenceofthengosistohavenicotinecontainingproductsandinparticular ecigarettesregulatedaspharmaceuticalinstrumentsratherthanastobaccoproducts. Saidpolicycorebeliefissimilartothepharmaceuticalindustry,inthatnicotinecontainingproductsasa recentadditiontothetpdshouldberegulatedaspharmaceuticalproducts,duetotheincreasedcontrol ofsuchoverregulartobaccoproductsandthereby,thepreferenceforhealth.thus,itwillbearguedin thispaperthatthepharmaceuticalindustryactorsconcernedwithtobacco,similarlytoalcohol,ispart of the public health community. This is underlined by the argument that in% tobacco% control,% the% pharmaceutical%industry%tends%to%align%very%closely%with%the%public%health%ngos%and%patient%groups.%( )% there%might%be%some%issues%regarding%plain%packaging,%ip%issues%and%so%on,%but%in%terms%of%where%they% stand,% pharmaceutical% companies% ( )% tend% to% align% with% the% tobacco% control% community% and% health% advocates.%i%do%think%however%that,%especially%for%an%industry,%which%tends%to%be%negatively%perceived,%the% pharmaceutical% industry% played% a% rather% small/backburner% role,% mostly% following% the% discussions% and% meeting% people% when% necessary (Public Affairs Agencyemployee interview, 30/03/2015). The quote suggests that the public health community within tobacco was supported by the pharmaceutical industryatthepolicycorebelieflevel,duetotheirmutualunderstandingandpreferenceforhealthto guide the TPD revision. The similarity, and thus coherence in coalition, is specifically evident for the messagesregardingthenicotinecontainingproducts,whichbecameanimportantelementinthetpd revision. However, evidence of more broadly defined similar core beliefs in terms of health over economicinterests 28 canalsobefoundinthepharmaceuticalindustrysponsoredequippreportamong others(bridgeheadinternational,2011). SpecificallytotherevisionoftheTPD,concerningthenewlyintroducednicotinecontainingproducts, the pharmaceutical industry played a part in the attempt to influence policymakers to regulate e cigarettesaspharmaceuticalproductsinsteadoftobaccoproducts.thereasonforthisrecommendation by the pharmaceutical industry was that pharmaceutical products are excessively controlled and regulatedcomparedtoregulartobaccoproducts.asthepublichealthcommunityposited,thenicotine containingproductsshouldmerelybesoldasquittingaids(smokefreepartnership&europeancancer 28 Thisnotioncanofcoursebequestionedonthegroundsoftheeconomicincentiveofthepharmaceutical industryinteamingwiththepublichealthcommunity.severalofthepharmaceuticalindustryactorsinvolvedin tobaccohavemarketedproductsforsmokingcessation(i.e.pfizer,21/01/2014),towhichsaidtpdmeasurescan furthercontributetotheirprofitability. 73

74 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Leagues, 2012). In this regard, the pharmaceutical industry was already manufacturing alternative smokingcessationproducts(i.e.pfizer,21/01/2014),andthusregulatingnicotinecontainingproducts, suchasecigarettes,underadifferentpolicy,wouldarguablyyieldunfaircompetitivebenefitstothese productsoverthepharmaceuticalindustry salternatives. The most important actors from the pharmaceutical industry was GlaxoSmithKline (GSK), Novartis, Johnson&Johnson(J&J),Pfizer,theEuropeanFederationofPharmaceuticalIndustriesandAssociations (EFPIA), as well as the Association of the European SelfMedication Industry (AESGP) (European Commission, 20/10/2010; European Commission, 06/05/2013). In a meeting between the pharmaceutical industry actors above and DGSANCO in October 2010 before the proposal by the Commission, the industry actors suggested that non>tobacco% nicotine% products% should% be% put% more% firmly% into% the% medicinal% area% and% consequently% fall% into% the% scope% of% pharmaceutical% regulation % (EuropeanCommission,20/10/2010).Subsequently,aftertheproposalwassetforthbytheCommission, anothermeetingwasheldbetweenthepharmaceuticalindustryactorsanddgsancoin2013inwhich the industry actors welcomed the proposal, although stressing the importance of having nicotine containingproductsregulatedaspharmaceuticalproducts.therefore,itwasofgreatimportancethat the 4mgnicotineperml thresholdwasabolished,asthiswouldclassifyallnicotinecontainingproducts aspharmaceuticalproductsratherthanonlythosewhichexceedednicotinelevelsgreaterthan4mgper ml.moreover,aesgpsupportedthisrequestbystatingthatanylevelofnicotinehadamedicinaleffect andthatthethresholdthereforewouldcreateambiguityofthedifferentproductsaboveandbelowthe threshold for consumers. This wouldin turn create unequal standards in terms of safety, quality and efficacyforproductsaboveandbelowthethreshold(europeancommission,06/05/2013).asproposed, thisacknowledgementofnicotinecontainingproducts,andspecificallyecigarettes,aspharmaceutical productsratherthantobaccoproducts,wasfurthersupportedbytheotheradvocacycoalitionpartners (EuropeanCommission,06/03/2012) Outcomes(of(advocacy(coalition(influence( TheoutcomeoftheTPDhasalreadybeendiscussedindetail(seechapter1).Fromanadvocacycoalition perspective,despitecostaetal.(2014)findingthecommission sinitialdraftofthetpdwerewatered downbythetobaccoindustryandinferencesonthepartofeconomicintereststrumpinghealthinthe revision (Public Affairs Agencyemployee interview, 30/03/2015), the tobacco control NGOs find the outcomeofthedirectivepositiveanddirectlyresultingfromtheireffortsandlobbyingactivities.asan employee at European Cancer Leagues argues (interview, 11/06/2015), we% wanted% to% have% 80%% 74

75 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco pictorial%health%warnings%covering%the%front%and%back%of%the%cigarette%packs,%but%ended%up%having%65%,% which%was%the%minimum%of%what%we%could%live%with.%we%would%of%course%have%appreciated%more,%and% also%we%did%not%have%a%ban%on%slim%cigarettes,%but%overall%we%secured%the%directive,%and%thus%certainly% improved% the% situation.% It% could% have% been% better,% but% we% are% certainly% pleased% that% we% had% the% Directive.ThepublichealthcommunitywithintobaccowasthuspositiveoftheoutcomeoftheTPD revision,whichititselfwascampaigningforintroducinginthelate2000s. Intermsofthenicotinecontainingproductsandregulationaspharmaceuticalproducts,acompromise agreementwasreachedbetweenthecommission,parliamentandcouncilonthegroundthatitshould beregulatedasamedicine,ifcompanieschoosetomakeaclaimthatecigaretteshelpsmokersquit smoking.however,ifnohealthclaimismade,itmustsolelyberegulatedasaconsumerproduct,witha limit on nicotine strength of 20mg/ml, as well as certain quality and purity standards, and the same advertising bans as for cigarettes (European Commission, 26/02/2014; EU, 29/04/2014). The TPD revisionwillallowforatwoyeartransitionperiod,inwhichthesenewrulesatnationallevelaretobe implemented.itisthusplausibletoarguethatthefinaloutcomeofthetpdrevisiondoesnotreflect completely the position of any coalition, as underlined by the statement above. Instead, evidence suggeststhatthereisinfactapositivesumgameinvolvedwithnegotiationbetweenadvocacycoalitions ateulevel.theinfluenceofadvocacycoalitionsonthetpdrevisionsisnoteworthy,andcantoacertain degreemanifesttheapplicabilityofthisframeworktodescribetheprocessofthetpdrevision. Foralcohol,inlackofconcretelegislationatEUlevel,severalsecondarydevelopmentscanbeattributed tolobbyismandadvocacycoalitions,includingthepushesforaneweualcoholstrategy,aswellasthe ParliamentResolutiononAlcohol.However,thecontinuedresistancefromtheCommissiontosubmita neweualcoholstrategyandhardlawinitiativeswithinalcoholsuggeststhatthealcoholindustryhas beenincreasinglysuccessfulwithinthisareacomparedtotobacco,astheyproposeacontinuationofthe focal points of the current strategy (EurActiv, 22/05/2015; SpiritsEUROPEemployee interview, 09/04/2015)andacceptthattheAlcoholStrategywillnotcontinueper%se(EurActiv,22/05/2015).Thisis furtherunderlinedbythepublichealthngos,whohavestatedthatthecommission sdecisiontocancel aneweualcoholstrategyreflectsthe%neglect%of%public%health%and%the%prioritisation%of%alcohol%industry% interests (Parliament Magazine, 03/06/2015). Nevertheless, the alcohol industry has underlined that thereisnoconspiracybehindthelackofanewstrategy,insteadreferringtoitasamatterofcalendar 75

76 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco and scheduling 29 (SpiritsEUROPEemployee interview, 09/04/2015). In this regard, it is interesting to takeintoaccounttheideabehindeconomictheoryofregulation.thistheorypostulatesthatregulation iscapturedbytheindustryanddesignedforitsbenefit(baldwinetal.,2012),asresultoftheindustry havingmoretogainandlosethantheregulator.inturn,concentratedinterestswithhighmaterialstake willtendtotrumpdiffuseinterests,therebycapturingtheregulation.foralcohol,thisseeminglyreflects to a greater extent the current state of EU legislation than tobacco, and can explain the industry coalition ssuccessinlobbyingwithinalcohol. IncomparisontotobaccoandtherevisionoftheTPD,thecurrentoutcomeofadvocacycoalitionsin terms of EU legislation on alcohol largely reflect the position of the alcohol industry, which can be explainedbyseveralfactorsdelineatedinthefollowingsection Comparing(the(advocacy(coalitions(within(tobacco(and(alcohol( As evidenced in previous sections, the interests within alcohol and tobacco can be ordered into two distinctadvocacycoalitions,focusedbroadlyonahealthcoalitionandanindustrycoalition.foralcohol andtobacco,thepolicytypeisarguedtobeprimarilyregulatory,inwhichconcentratedbenefitsand coststocertaingroupsofsocietycancauseconflictbetweengroupswithalternateperspectives,inturn allowing for more influence through coalitions rather than individual groups (Bouwen, 2002). This identification of advocacy coalitions rather than specific individual interests has been suggested by Sabatier(1988;1998),Sabatier&JenkinsSmith(1988)andKlüver(2011;2013),inturnbeingempirically accentuatedfortobaccoandalcoholinaforementionedsections.thesecoalitionshavebeenidentified onthebasisofacommonsetofpolicycorebeliefsalthoughsecondarybeliefs,intheformofpolicycore policypreferences(sabatier,1988;sabatier&jenkinssmith,1998),existtovaryingextentswithinthe coalitions.throughanalysis,itcandefinitivelybepostulatedthatadvocacycoalitionswithintobaccoand 29 AsanemployeeofSpiritsEUROPEposits,thepreviousCommissioninitiatedanevaluationprocessoftheEU AlcoholStrategy,butwereabsorbedbytime; They%(Commission)%did%numerous%groups%and%interviews,%as%well%as% checks%and%evaluations%of%reports%etc.,%to%come%with%a%very%comprehensive%report%in%2013,%which%stated%that%the% priorities%are%the%right%ones,%that%the%strategy%had%delivered%results,%and%that%one%of%the%problems%is%that%member% States%do%not%collect%proper,%up>to>date%data.%( )%Then,%in%the%middle%of%2014,%it%was%the%end%of%the%Commission,% because%in%order%to%come%up%with%a%strategy%like%that,%it%will%take%two%years%at%a%minimum.%therefore,%it%would%not% have%made%sense%for%the%past%commission,%knowing%all%the%political%changes%in%europe%and%that%six%months%later,% they%would%basically%all%change%jobs,%would%embark%upon%creating%a%new%eu%alcohol%strategy.%then%you%had%the% elections,%and%now%is%now (interview,09/04/2015). 76

77 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco alcoholhaveinfluencedlegislationateulevel.however,thereislargerelativedisparityininfluenceof thecoalitionswithinalcoholandtobacco,aswellasbetweenthem. Among the industry and health coalitions within tobacco and alcohol, differences persist in terms of resources and prowess. As Klüver (2011) has proposed, EU institutions need three types of goods, namely technical knowledge, citizen support and market prowess, to which the interest groups can assist and thereby impact. Across the two policy areas, it is evident from previous analysis that the resources,andtherebymarketprowessofthepublichealthcommunityissignificantlysmallerthanthat of the industry coalitions. This relates mainly to the economic effect of the industry s activities compared to the health community, and can increase their influence on higher strata of the EU institutions,ashavebeensuggested(eclemployeeinterview,11/06/2015).instead,thecoalitionswork using similar official tools and thus provide similar levels of technical expertise to the policymakers, whilethecitizensupportdifferssubstantiallyacrossthetwosectorsandintraregionallywithintheeu. Equallyinterestingforansweringtheresearchquestionofthepaper,thestrengthofadvocacycoalitions between tobacco and alcohol also differ substantially, and can partially describe the difference in legislationofthetwo.leveragingklüver s(2011)perspectivethatinterestgroupinfluencedependson thepossessionofcertainresources,thepoliticalinstitutionsinwhichitoperatesandthecharacteristics ofthepolicyissueathand,severaldifferencesunfoldbetweentheindustrycoalitionsofthetwosectors, aswellasbetweenthepublichealthcommunities. Intermsofresources,oneofthemostperseverantdifferencesbetweenthealcoholindustrycoalition andthetobaccoindustrycoalitionisthepoliticallegitimacy.ashavebeenargued,thealcoholindustry has%more%political%support%and%positions%itself%as%solution>oriented%and%willing%to%cooperate,andthey are not%as% bad %as%the%tobacco%one,%its%products%is%not%as%harmful%and%yet%it%is%still%positioning%itself%in%a% matter%that%the%legislators%and%the%community%cannot%reproach%them (PublicAffairsAgencyemployee interview, 30/03/2015). In comparison, the tobacco industry has been increasingly rejected from the political legislative sphere and lost its legitimacy through among others the WHO Framework ConventiononTobaccoControl(FCTC)(WHO,2006),dueinlargeparttothedifferentleaksofinternal documents detailing its foul activities (Hurt et al., 2009). Partly as result of this difference in legitimisation, and as it is present in more EU countries (Greer et al., 2014; ECLemployee interview, 11/06/2015),ithasfurtherbeenproposedthatthealcoholindustrycoalitionismorepowerfulthanthe tobacco industry (WHOemployee interview, 14/04/2015). Finally, as evident in previous analysis, the 77

78 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco alcoholindustryseemstoleverageitseuropeantradeassociationsextensivelycomparedtothetobacco industry. A suggestion could be that this provides increasingly an arm s length approach from the differentcompanieswithinthecoalitiontowardsexternalstakeholdersandfurtherimprovesimpactand legitimisation towards EU institutions. This could provide impetus for explaining why less alcohol legislationateulevelhastakenplace,incomparisontotobacco. Anotherfactorofinfluenceintermsofresourcesincludesthepublichealthcommunitywithintobacco hasbeenarguedtobestrongerandmoreresourcefulthanitsalcoholcounterpart(eurocareemployee interview,09/04/2015).inaddition,thepublichealthadvocacycoalitionwithintobaccohasbeenfound tobemorecoherentandclearinitspolicymessages.assuggestedbyanemployeeatamajorbrussels basedpublicaffairsagency (30/03/2015), in%terms%of%coalitions%with%the%health%care%community,%on% tobacco%control%i%see%that%we%are%all%on%the%same%page,%agreeing%that%there%is%a%comprehensive%approach% to%tackling%tobacco%(that%includes%labelling,%taxation,%treatment,%education%etc.).%with%alcohol,%working% with% my% client,% you% have% people% even% within% an% organization/ngo% that% are% either% totally% abstinence> focused%or%agree%to%a%certain%safe%level%of%consumption.%in%addition%to%this% abstinence%versus%safe%level,% the%alcohol%control/health%community%further%divides%itself%among%those%that%recognize%the%need%for%an% integrated% approach% to% alcohol% policies% covering% alcohol% excessive% consumption% and% dependency,% and% those%who%only%focus%on%taxation,%labelling/nutrition%and%exclude%the%disease/treatment%%aspect.%that%is% also%a%difference%i%notice%while%working%with%both%products:%my%client%working%on%tobacco%control%will% acknowledge%the%need%for%a%comprehensive%approach%and%will%equally%call%for%measures%within%taxation,% education% and% for% example% smoke% free% environments,% whereas% my% client% focusing% on% alcohol% dependence% may% not% necessarily% go% as% broad% and% all>encompassing% and% tends% to% focus% more% on% one% policy% aspect% of% the% integrated% approach. Such incoherence can have impacted the influence of the public health community within alcohol to the point of disowning its interests towards the EU institutionsandaidingtheiroppositiontoacertainextent.% Asforthepoliticalinstitutionsinwhichitoperates,itisevidentfrompreviousanalysisthatthetargets of lobbyism are largely the same between and across the two policy areas. Both public health communitiesandtheindustrywithinalcoholandtobaccoapproachthesameinstitutionalframework, andseektoexertinfluenceonthesamestructures.similarly,thetacticsusedbearresemblanceofeach other. For the industry, it has been proposed that the process of influencing their regulatory environmentcloselymirrorthatofthetobaccoindustry(bondetal.,2010;gilmoreetal.,2011).the differenceinsteadlaysintheaccessibilityfortheindustrycontrathepublichealthcommunitytocertain 78

79 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco higher strata of the EU institutions. As proposed for tobacco, the industry coalition was significantly moresuccessfulingettingaccesstothepresidentandsecretarygeneralofthecommission,relativeto thepublichealthcommunity(eclemployeeinterview,11/06/2015).however,duetotheshapeofthe EUinstitutions,thecoalitionswithintobaccoandalcoholgenerallyapproachthesameinstitutions,beit the Commission, the Parliament and its Public Health and Food Safety (ENI) committee or to less extent,thecouncil. ThethirdparameterinKlüver s(2011)assessmentofinterestgroupinfluenceisthecharacteristicsof thepolicyissueathand,suchaspolicytype,degreeoftechnicalityandpublicsalience.inbroadterms, the policy types within alcohol and tobacco are the same. Both field regulatory policy to adjust and balance the health versus economic interests. Similarly, these regulatory policies have the ability to create tension between different coalitions (Bouwen, 2002), which is evident between the coalitions within alcohol and tobacco, albeit to varying extent. For tobacco, the tension is proposedly much sharper between the public health community and the industry compared to alcohol (ECLemployee interview, 11/06/2015; Eurocareemployee interview, 09/04/2015; Public Affairs Agencyemployee interview, 30/03/2015). However, the populationbased measures proposed by the public health community towards alcohol are increasingly the same as within tobacco (SpiritsEUROPEemployee interview,09/04/2015;eurocareemployeeinterview,09/04/2015),whichsuggestscoherenceinpolicy typeacrossthetwoareas. Tothisend,thedegreeoftechnicalityisalsocomparable,asbothtobaccoandalcoholareriskfactors foranumberofchronicdiseases(who,2013),butalsobroadlyenjoyedsubstancesthroughouteurope. However, the fact that moderate alcohol consumption has arguably been proposed to bear certain healthbenefits(spiritseuropeemployeeinterview,09/04/2015),thoughrejectedbythewho(who employeeinterview,14/04/2015),increasesthedegreeoftechnicalityforapolicymakercomparedto tobacco,whichisharmfulfromthefirstdrag(publicaffairsagencyemployeeinterview,30/03/2015). However,theintroductionofecigarettesinsteadincreasesthetechnicalitywithintobaccoandnicotine containingproducts,whichwasevidentinthetpdrevision(ross,13/10/2014). Moreover,thepublic saliencecharacteristicforthesetwopolicyareasisarguablymoresignificantfortobaccothanalcohol, despitealcoholincreasinglyexperiencingthesameemphasisinpublicdebate.stemmingfromtheleaks of internal documents (Hurt et al., 2009), the EU public is more aware of tobacco and the tobacco industry s activities, with the notion that tobacco control still has a very strong place in society (Eurocareemployee interview, 09/04/2015). Additionally, it has been suggested that it% (the% alcohol% 79

80 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco industry)%definitely%does%not%have%to%the%notorious%connotation%the%tobacco%industry%has.%you%have%health% MEPs%from%major%EU%countries%that%will%call%for%all%the%measures%possible%against%tobacco%but%will%take%a% more%moderate%approach%to%alcohol (PublicAffairsAgencyemployeeinterview,30/03/2015). ThetimidityoftobaccolegislationatEUlevelandacrossEUMemberStatesisafurtherdifferentiator betweentheregulatorypolicieswithinalcoholandtobacco.tobaccohasseenregulatoryfocusforfifty years (Royal College of Physicians, 2012; ECLemployee interview, 11/06/2015), while alcohol has arguably not experienced the same emphasis yet. As the ACF argues, there is a distinction between mature policy subsystems and nascent ones. Mature policy subsystems are characterised by a set of participantswhoshareanexpertisewithinthepolicydomainandwhohavesoughttoinfluencepublic policyinthatdomainforanextendedperiod(sabatier&jenkinssmith,1999).whereastobaccocanbe seenasamorematurepolicysubsystem,alcoholseemstobemorenascentandthushavelessimpact on policy, as argued by a Eurocareemployee (interview, 09/04/2015). This is a further element in explaining the regulatory difference of the two substances in the EU, although external factors, as acknowledged by Sabatier & Weible (2007) can further assist in describing this difference in development.! According to the ACF, dynamic external factors include changes in socioeconomic conditionsandpolicydecisionsfromothersubsystems(sabatier&weible,2007),whichthewhofctc canbeperceivedas.thishasalsobeensuggestedasakeydenominatorfortheprogressionintobacco legislation at EUlevel, by effectively disbanding one advocacy coalition, the tobacco industry, from legallypartakinginpoliticallobbyism(publicaffairsagencyemployeeinterview,30/03/2015),although evidenceoftheircontinuedinputtothetpdrevisionhassubsequentlyemerged(peetersetal.,2015). In turn, while the public health communities within tobacco and alcohol informally collaborates on certainissues(eurocareemployeeinterview,09/04/2015),thesameisnotthecasefortheindustry.as anemployeeofspiritseuropehasunderlined, we%do%not%have%any%contact%with%the%tobacco%industry% ( )% in% Brussels,% pretty% much% no% one% talks% with% them,% there% is% no% forum,% there% is% no% dialogue,% and% no% reason% to% really% have% anything% in% common% any% way (interview, 09/04/2015). Previous collaboration betweenthetwoindustrieshashoweverbeensuggestedbyinternaltobaccoindustrydocuments(smith etal.,2010) Industry(advocacy(within(alcohol(and(tobacco( (a(final(thought(( An important scholarly discourse to tend to in this regard has been situated on the premise of an industrial epidemic to describe the problems stemming from alcohol and tobacco. The industrial epidemic approach,asarguedbyjahiel&babor(2007)appliestheconceptofthediseasevector(i.e. 80

81 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco thealcoholindustryanditsassociates)tobecomethecentreofpolicyattentionratherthantheagent (i.e. alcohol) or the host (i.e. the problem drinker), in turn attributing the damage from alcohol to upstream sourcesratherthanexclusivelyfocusingontheindividualdrinker. The conceptualisation of an epidemic to describe commercialisation of a dangerous product has previously been used for tobacco (Slade, 1989; Council on Scientific Affairs, 1990) as a means to emphasisetheriskofpublichealthorientedpoliciesbecomingopposedbyindustryintereststosituate the proposition of a health versus profits debate. As such, industrial disease epidemics are led by corporationsandtheirallieswhopromoteaproductthatisalsoadiseaseagent(inthisinstance,alcohol or tobacco), via generational, targeted or transnational epidemics 30 or via endemics. Specifically for alcohol, the situation can be proposed to take the form of an endemic, as it necessitates a steady prevalenceofindustrialdiseasesthroughahigh,ongoinghumanexposuretotheagentandthusthe socialharmderivedfromsuch.indeed,thesituationforalcoholineuropeissuggestedspecificallyby Jahiel&Babor(2007)tocompriseanendemicsincethe19 th century. Theriseofindustrialepidemicsusuallydictatesaneedtolimitorregulateconsumptionofpotentially dangerous products, in turn, creating tension between the industry and public health community. SimilartotheWHO sdescriptionoftobaccoindustrytactics,alcoholindustryresponsestothreatsto theirexistenceintheformofregulationmaytakeseveralforms,suchas silence%about%a%health%problem% suspected%of%being%linked%to%industrial%activity%to%the%commissioning%of%industry>sponsored%research%and% analysis%to%cast%doubt%on%the%scientific%findings (Jahiel&Babor,2007).Indeed,examplesincludethe International Center on Alcohol Policies, which is an industryfunded organisation, and their role in collaboration with alcohol producer SABMiller as a partner and sponsor in formulating policies in especiallydevelopingcountries,duetotheirfragilepoliticalfoundationforpolicyformulationcompared tothewesternworld.ashavebeenarguedinananalysisofnationalalcoholpolicydocumentsinfour Africancountries, the%proposed%policies%serve%the%industry s%interests%at%the%expense%of%public%health%by% attempting%to%enshrine% active%participation%of%all%levels%of%the%beverage%alcohol%industry%as%a%key%partner% in%the%policy%formulation%and%implementation%process (Bakke&Endal,2010).Thiscanbecomparedto Philip Morris International s sound science and good epidemiology campaign (Ong & Glantz, 2001; Muggli et al., 2003) and the tobacco industry s Whitecoat Project (Barnoya & Glantz, 2005) among 30 Generationalepidemicstargetthecorporationneedforreplenishingtheiruserpopulationthroughtargetingofa newgenerationofdrinkers,whereastargetedepidemicsinsteadrefertocorporations focusonspecificgroupsfor increaseduseordevelopmentofnewproducts.transnationalepidemicsdescribethetargetingofforeign countriestoexpandtheirmarketsandtherebyprofits. 81

82 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco others,andconsequentlyseveraljournals,includingplosone,plosmedicineandthebritishmedical Journal sdecisiontobanresearchfullyorpartlyfundedbythetobaccoindustryfromtheirjournals(the Guardian,21/10/2013). Additionally, parts of the alcohol industry uses tactics similar to those of the tobacco industry, in supporting organisations and in some instances politicians that emphasise the social values of the industries products through the liberal championing of individuals rights to make own choices, the oppositionofrestrictionsonadvertisingonthebasisofcommercialfreedomofspeech,thepresentation of biggovernment asintrudingonthelifeofcitizensorthelike(jahiel&babor,2007;who,2009). Indeed, the WHO proposed in their Tobacco industry interference with tobacco control report that effective%tobacco%control%is,%almost%by%definition,%antithetical%to%the%economic%interests%of%the%tobacco% industry,%associated%industries,%and%entities%or%persons%working%to%further%the%tobacco%industry s%agenda% (due%to%the)%triumvirate%of%objectives% %preventing%uptake,%maximizing%cessation%and%prohibiting%smoking% in% public% places% % standing% in% direct% opposition% to% the% commercial% objectives% of% the% tobacco% industry (2009). Asthediseasevector,Jahiel&Babor(2007)arguethatthealcoholindustrymustbecomesusceptibleto apublichealthresponsethroughgovernmentalauthorityto control%exposure%by%limiting%the%supply%of% the% agent% through% controls% on% production,% delivery% and% availability% to% the% individuals% at% risk % and communication of the precautionary principle as a means to settle public policy proceeding with protectingpublichealthevenwhenscientificevidenceismerelysuggestive(2007).inordertoleverage theexampleoftobacco,andwhathasbeenproposedasakeybarrierforalcohollegislationopposedto tobacco (Public Affairs Agencyemployee interview, 30/03/2015), the public health community must build power by establishing alliances with NGOs, citizen groups, labour unions, the media and legislators,whoarewillingtobattletheindustrymightwithinalcohol. ThefoundationforJahiel&Babor sanalysisliesinthepublicreleaseinthe1990sofaround70million pagesofinternaldocumentsduetolitigationproceedings,suchasthe1998tobaccomastersettlement AgreementandlitigationintheUSA(RCP,2012;Gilmoreetal.,2011).Thesedocumentshavestimulated a whole new area of research, which has contributed to the development of effective public policy responses to the global tobacco epidemic, including the WHO Framework Convention on Tobacco Control(FCTC)andtobaccoindustryguidancedocuments(i.e.WHO,2009).AssuggestedbyRCP(2012), 82

83 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco theexistenceofsuchresearchmayhelptoexplainwhytobaccocontrolhasmadegreaterprogressthan othercontemporarypublichealthissuesinvolvingcorporate vectors,suchasalcoholmisuse. Althoughthisshouldbeacknowledgedasapotentialfactorintheexplanationofwhyalcoholhasnot beenlegislatedtosameextentastobacco,arecurringexplanationintheinterviewsconductedseemsto betheconceptofsecondhandsmokeandthelackofa safelevel forsmokingasopposedtodrinking (Public Affairs Agencyemployee interview, 30/03/2015). Although the scientific community has been adamant in recent years about banishing the notion of a safe level of alcohol consumption (WHO, 2015; Nutt, 2011), the public assumption, whether it be lack of ability or willingness to change perception, seems stringent in its approach to alcohol as good in smaller doses, and will likely take decadestoalterforthepublichealthcommunity.thevectorofdiseaseforalcoholhavethushadan easier playing field to leverage its messages, which can potentially keep more progressive legislative measureswithinalcoholateulevelatbay,especiallyalsoasitisincludedinmanyeuropeancountries diets Critique( of( the( advocacy( coalition( framework( and( interest( group( influence( Asasingleframework,PaulSabatier sadvocacycoalitionframeworkandheikeklüver sperspectiveon interestgroupinfluencearesignificanttoolstoportraytheoverallpolicyprocessandtheinfluenceof advocacycoalitionsonpolicychange.however,someproblemspersistintheuseofthesetheoretical stancesasacompletestructureforexplainingalcoholandtobaccolegislationateulevel. SimilartowhatWeible(2006)hassuggestedtheadvocacycoalitionframeworktendstopointoutthe obvious,withlittleinsightneededtogaugethedifferentsidesofanissue,whichshouldeasilyallowfor policymakerstograspandcircumventinterestcapture.theuseofinterestsandadvocacycoalitionsas thesoledescriptoroflegislationarguablyoverlyconstruesthepowerofadvocacycoalitions,whichis furtherunderlinedbytheconductedinterviews.coalitionswithintobaccoandalcoholareestablished andconsolidatedtovaryingdegrees,andthusthedescriptivecapacityoftheframeworkforassessing their influence can yield different outcomes relative to reality. Although empowered with significant influence,asevidencedbyprioranalysis,therigidinstitutionalframeworkwithintheeuropeanunion andthemultilevelgovernanceisnotbuiltuponabasisofopennessinitsapproachtoexternalactors andadvocacycoalitions.thismeansthatagreatsourceofpoweroverpolicychangestilllieswiththeeu 83

84 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco institutions.inturn,ashavebeenargued,theacfshowscertaindeficienciesinexplainingpolicymaking in political systems outside of the US, due to fundamental differences in institutional and political contexts (Nohrstedt, 2010). For EU analysis in general, the framework subsequently lacks prowess in takingintoaccountthesysteminwhichitoperatesandthespecificmacrolevelprocessesthatfurther EU legislation, including integration and competence analysis. The EU is a constantly evolving beast, whichgreatlyvictimisestheacfasaframeworktoexplaintheentirepolicyprocess.thus,theuseofthe advocacycoalitionframeworkinaneucontextmustnecessarilybesupportedbyadditionalempirical and theoretical insight, to grasp the full complexity of jurisdictive competencies towards health and economicinterestswithineulegislationoftobaccoandalcohol. Anadditionalelementoffurtherscrutinyisthecoordinationofactionwithinanadvocacycoalition.The ACFdoesnotprovidejustificationforactorswithsimilarpolicycorebeliefsactuallycoordinatingtheir behaviour into action. This problem is evidenced in the tobacco industry, where the actions of the industry actors, exemplified by PMI, seem to be of own interests rather than coordinated with the coalition. Thus,itisdifficulttogaugethe strengthandcoherenceofthecoalitionoutsideofasetof policycorebeliefs,whicharguablygovernonlypartoftheactivitiesoftheactors Conclusion( ThescholarlyperspectivesofSabatier(1988)andKlüver(2011;2013)oninterestgroupinfluenceand advocacy coalitions can serve as a valuable descriptor of EU legislation of alcohol and tobacco. Both within alcohol and tobacco, two distinct coalitions emerge, arguing for either economic interests or publichealthasapolicycorebelief.thesecoalitionsconsistforbothalcoholandtobaccoofanindustry coalition and a public health community coalition. It is important to acknowledge that, despite agreementonpolicycorebeliefs,thesecoalitionscanhavedifferentopinionsonsubsetsofpreferences, whichsabatier&jenkinssmith(1988)cointhepolicycorepolicypreferences. It is evident in this chapter that advocacy coalitions within alcohol and tobacco have had significant impact on legislation of these two areas at EUlevel. The relative effectiveness of their influence howeverdependsonanumberofcriteria,includingthepossessionofcertainresources,thepolitical institutionsinwhichitoperatesandthecharacteristicsofthepolicyissueathand.thealcoholindustry coalitionseemstopossessmorepoliticallegitimacyandprowessthanthetobaccoindustrycoalition, while the public health coalition within tobacco is more coherent and consistent in its policy asks 84

85 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco compared to the public health coalition for alcohol. In addition, across the two policy areas, the resources,andtherebymarketprowessofthepublichealthcommunityseeminglyissignificantlysmaller thantheindustrycoalitions.thedegreeoftechnicalityandthehigherpublicsaliencefurthercomprises coredifferencesbetweenalcoholandtobacco. Inturn,thepoliticaldecisionsatEUleveldependoncompetenceandpreference,whichwillbeassessed intheforthcomingchapter.asalreadyalludedto,theadvocacycoalitionsmaynotintheirtotalitybe able to explain the process of alcohol and tobacco legislation at EUlevel, although they do provide ample insights and important perspectives on the impactful interests of lobbyists within these areas. Thus,theadvocacycoalitionswithintobaccoandalcoholareimportantelementstoacknowledgewhen assessinglegislationofthetwosubstancesintheeu.however,toapprehendthetotalityofregulatory capacity of the EU opposite to EU Member States, and thus understand completely the basis for legislativedifferencesbetweenalcoholandtobacco,thesupranationalcompetencieswithinhealthand economicinterestsmustalsobeassessed.thisanalysiswillbeundertakeninthefollowingchapter. 85

86 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!4! PublichealthandeconomicinterestsintheEuropeanUnion (?I? E C E C F C E?? C C? C AE ) C E E C? C C?E E CE A E A? C C AE EC HA C C H C (

87 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 4. Public(health(and(economic(interests(in(the(European(Union( Thedebatearoundpublichealthandeconomicinterestshasbeenongoingfordecadesthroughoutthe EU.WiththeintroductionofaneffectiveEuropeanUnionandsubsequentrevisionstothecompetencies withinhealthandeconomicmatters,theintegrationoftheeumustbeassessedinordertounderstand thecomplexityofregulationofalcoholandtobaccoateulevel. Forthismatter,thefollowingsectionwillintroduceabriefoverviewofEuropeanintegrationsinceits inception in the 1950s, before subsequently going into detail onthecompetencieswithinhealthand specificallytowardstobaccoandalcoholateulevel Introduction(to(European(integration( TheearliesttracesofEuropeanintegrationdatesbackto1951intheaftermathoftheSecondWorld War,whensixcountries(Germany,France,Italy,theNetherlands,BelgiumandLuxembourg),signedthe treatyofparis,requiringthemtocooperateintheheavyindustriesofcoalandsteel.thiswasbasedon the SchumanPlan presentedbythefrenchforeignministerrobertschuman,withthemainpurpose beingtopreventwarbetweenthesixcountries,ascoalandsteelweremainproductionmaterialsfor weapons.thetreatyofparisineffectpavedthewayforthefirstmeasurethatwouldlaterbeknownas the European Union; the European Coal and Steel Community (ECSC). In order to manage the new community, the ECSC included a High Authority (today known as the Commission) and a Common Assembly (todayknownastheparliament)(bacheetal.,2011). Subsequently, the ECSC was followed by an attempt to make a common economic market and a commondefencepolicyin1957inordertoincreaseintegrationbetweenthefoundingmemberstates. This culminated with the signing of the treaties of Rome (TFEU), which established the European EconomicCommunity(EEC)andtheEuropeanAtomicEnergyCommunity(Euratom).Theexecutivesof each of the new communities were known as commissions; however, in 1965 the Merger treaty transformed the three communities (ECSC, EEC and Euratom) into one single institutional structure knownastheeuropeancommunities(ec)(bacheet.al2011). In 1986, the Single European Act (SEA) was signed and was the first major revision of the treaties of Romeandcameintoeffectin1987undertheDelorsCommission.Oneofthecoreobjectivesoftheact wastoestablishacommonmarketinsidetheecbefore1992.inordertodothis,searevisedlegislative procedures and introduced the cooperation procedure which gave the Parliament real legislative 87

88 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco powerandtherighttovetothecouncil sdecisions,andextended QualifiedMajorityoting (QM)to mattersofthesinglemarket,thusprovidingthememberstateswithmoreintergovernmentalistpower. Inaddition,fromahealthperspective,theSEAmadeonemajorchange,whichwastoaddpowersfor theeutoadoptbindinglegislationtoprotectthehealthandsafetyofworkers(greeretal.,2014). FollowingtheSEA,theMaastrichtTreatyof1992,knownastheTreatyontheEuropeanUnion(TEU), formallyestablishedtheecastheeuropeanunion(bacheetal.,2011).italsoformalisedcooperationin arangeofareasandintroducedthebulkofeuprovisionsinpursuitofhealth,namelyonenvironment andconsumerprotection,aswellasthehealtharticleitself(greeretal.,2014).themaastrichttreaty furtherestablishedtheeuropeancentralbank(ecb)in1998asthesuccessortotheeuropeanmonetary Institute(EMI)asanimportantinstitutionforthefurthervisionandintegrationofamonetaryunion. The European Monetary Union (EMU) was established in 1999 and entered into full force when the commoncurrency,theeuro,wasintroducedtomembersoftheeurozonein2002(europeancentral Bank,2015). TheEurowasestablishedinordertoreducetransfercosts,businessrisksandwiththevisionofeasing the process of conducting business across national borders within the EU. This in turn meant, that nationalgovernmentsofthememberstatesthatacceptedtheeurogaveuptheircontrolovermonetary policies and placed the responsibilities in the hands of the ECB. As a means to supplement the introductionoftheeuro,thestability&growthpactwasintroducedin1997providingadegreeoffiscal policy control governed on EU level through mandatory requirement and benchmark levels 31 (EU, 02/08/1997).Thepactwasestablishedtoensurethatexcessivedeficitswouldbeavoidedinorderto ensure macroeconomic stability within the union to achieve low inflation and low interest rates, key factorstodeliverjobcreationandeconomicgrowth. As evident above, policy areas, especially concerning economic capacities, that were previously governednationally,arenowbeingextensivelyregulatedatsupranationallevel.inturn,theregulatory powers of the EU institutions, and specifically the Commission, the Parliament and the Council, have increased. 31 TheStability&GrowthPactintroduceda preventivearm,whichdefinedtheproceduresformultilateral budgetarysurveillance,anda correctivearm,whichstatedunderwhichconditionstheexcessivedeficit procedure,shouldbeapplied.theexcessivedeficitprocedureisappliedwhentheeuropeancouncildecidesthata countryisinexcessivedeficitafterwhichitwillmakerecommendationsastohowthememberstateinquestion shouldbringdownitsdebtandestablishadeadlineforsuchmeasure. 88

89 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Drawingupontheintegrationtheoriespreviouslyintroducedinthetheorysection,differentinferences canbemadeastohowthenecessityforcontinuousintegrationdeveloped.neofunctionalistscholars wouldarguethatthecontinuousintegrationofpolicyareastowardstheeuisnotanagreedprocess, butratherduetofactorsbeyondthecontrolofmemberstates.accordingly,ithasdevelopedthrough immense pressure from interest groups and other bureaucratic actors at national level. Neo functionalistsbelievethatnationstatesarenottheonlyactorsontheinternationalstage,butinstead nonstate,supranationalactorssuchastheeuareofgreatimportanceinshapingpolitics.specifically, thecommissionwithintheeuisofgreatimportance,asithastheabilitytoinitiatelegislativeproposals. Thereby, it can manipulate both domestic and international interest groups to exert pressure on MemberStatesatthenationallevel,whichcouldmakethemagreetofurtherintegration,evenwhen governments might be hesitant. In addition, the concept of spillover is paramount for neo functionalists. This concept posits that nation states become further integrated because initial integration increasingly requires further integration of related policy areas in order to function properly 32. Liberalintergovernmentalistsontheotherhandbelievethatnationstatesareinabsolutepowerand arethesoleactorsontheinternationalstage.thus,theybelievethatthecontinuousintegrationofthe EUhappenssolelyduetopreferencesoftheMemberStates.Forthismatter,atwolevelgameexistsin which national interest are initially negotiated on a national level and subsequently brought to an international level in which negotiations can be made amongst national governments. Liberal intergovernmentalistsalsobelievethatactionsareonlymadeinfavouroftheeuandfurtherintegration iftheyarepreferentialtonationstates.inturn,themostpowerfulstateswillhavethelargestbargaining powerinaninternationalnegotiationsetting.moreover,liberalintergovernmentalistsbelievethatthe solereasonwhysomedegreeofcontrolmightbegiventosupranationalinstitutions,suchastheeu,is toensureequalcommitmentfromalleumemberstates Anexampleofthespillovereffectisthedevelopmentofthemonetaryunionandthecommoncurrency,the Euro,whichwascreatedasaspillovereffectoftheSEAandtheinternalmarket.TheStability&GrowthPactis furtheranexampleofaspillovereffectfromthecreationofthemonetaryunion,giventhatintegratingmonetary policiesalonewasinsufficientasfiscalpoliciesisanequallyimportantpartofgoverningeconomicpolitics(bache etal.,2011). 33 Thecommoncurrencyisarguablyanexampleofthis,asitrequiredallmembersoftheEurozonetofollow certainguidelines(bacheetal.,2011). 89

90 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 4.2. Health(policy(in(the(EU(( ThesectionaboveindicatesthattheEUishighlyintegratedandhavesignificantregulatorycompetency on several policy areas, including health provisions through the SEA and Maastricht Treaty among others.whilethisistruetosomeextent,thedrivingfactorbehindintegrationintheeuhasprimarily beenofeconomicinterest(greeretal.,2014)toensureglobalcompetitiveness.thisisalsotrueinthe case of health policies in the EU in which the Commission s health department, DG SANTÉ, plays an important role. Health and tending to the wellbeing of citizens have historically been governed at nationallevelwithineachmemberstateandcontinuetodoso.thedivisionofcompetenciesisstatedat thebeginningofthetfeu(eu,2012a),withtheonlyrelevantareaofsharedcompetencebetweenthe EUandtheMemberStatesis common%safety%concerns%in%public%health%matters (EU2012a,Article4.2). Instead,forthewiderobjectiveofthe protection%and%improvement%of%human%health (EU2012a,Article 6),theEUmustsolelysupport,assistandsupplementMemberStateaction(Greeretal.,2014). For many centuries, European states have sought to balance economic interests with public health 34 (McKee, 2015). The single market of the EU has further imposed threats and opportunities to public health,withthesignificantexampleoftobaccoasalegalsubstance,butwithprevailingimpactonhealth oftheeuropeanpopulation(mckee,2015).tothisend,althoughfinancialconstraintsarearecurring issueinhealthcaresystems,theeffectsofthefinancialcrisisin2008havefurtherbeenwideranging. Despitetheeconomicdownturnhavingpavedthewayforaddedopportunitiesinhealthcaresystems, suchasimplementingefficiencymeasuresorincreasingtaxationontobaccoandalcohol,thenegative consequences of reductions in public spending on health are more prominent, due to frozen or cut healthbudgets(kringosetal.,2015). Healthcare regimes indeed differ greatly within the EU, although commonly funded through taxation schemes.forinstance,thenordiccountriesarewelfarestatesandthereforeoffertheircitizensfullytax fundedhealthcare,whereasingermany,citizensmusteitherobtainapersonalhealthinsuranceorhave oneprovidedbytheiremployer.asmentionedabove,healthcareisgovernedonanationallevel,and thereforetheeuholdsnorealadministrativeprowessorcontrolinthisfield.however,thedgsanté 34 McKee(2015)providesacoupleofvividexampleforthisstatement.Amongothers,inthe14 th century, when% faced%with%the%threat%of%plague,%the%enetian%authorities%required%ships%entering%the%port%of%ragusa,%now% Dubrovnik,%to%wait%for%30%days%on%nearby%islands.%In%time%this%delay%was%extended%to%40%days,%or%quaranta%giorni,% giving%rise%to%the%term%quarantine.anotherexampleisfrom the%19 th %century%( )%when%the%united%kingdom%went% to%war%with%chine%to%assert%its%right%to%export%opium%in%the%face%of%opposition%from%the%chinese%authorities% concerned%about%the%impact%on%the%health%(and%productivity)%of%its%population. 90

91 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco playsanimportantpartinaligningrelevantlawsatthenationallevelbyproposingdirectivesseekingto standardiselawsrelatingtopublichealthandconsumerrightsregardingthesafetyoffoodandother products(dgsanté,2015). Withintheremitofhealthpolicy,severalareasarefurtherincluded.Anareathatislargelylegislatedon anationallevelisdietandnutrition 35.Although,anationalcompetence,theEUcaninfluencethefood availabilitytoeucitizensthroughthefunctioningofthecommonagriculturalpolicy(cap),byimposing highertariffsandquotasoncertainproducts.however,thistoolisarguablyimplementedtocontrolthe functioningoftheinternalmarketandtoensuretheeconomicinterestsoftheeuratherthanforhealth purposes. Direct measures to control obesity and nutrition from an EU level have only been implementedthroughsoftlaw,encouragingnationalgovernmentstoact.however,oneareainwhich theeuhasactedthroughlegislationisonthetopicofnutritionalinformationavailabletoconsumers,by requiringallmemberstatestohavetheirfoodproductsdisplayinformationwithcontentsofenergy, carbohydrates, fats, protein, sodium and allergens (EU, 30/01/2008). Another aspect increasingly debatedateulevelisworkinghours.althoughtheycontinuetobelegislatedatnationallevel,in2003 the Working Time Directive was passed on EUlevel and stipulated a cap on how many hours an employeewithintheeucanwork.additionally,itdeterminedarequiredrestperiodinbetweenworking daysandbreakperiodsduringworkdays 36 (EU,18/11/2003).Theareaofclimatechange,pollutionand environmentalimpactiswithregardstohealthalsonotlegislatedbytheeu,butinsteadkeptatnational level.climatechangehashoweverbeenarguedtobearnoticeableimpactonhealthconditionswhichis notbeingaddressedtoasufficientdegreebytheinstitutionsoftheeu(greeretal.,2014).thelackof EU recognition of health within this area can result from the organisational structures of the EU, in whichenvironmentalpoliciescurrentlyarebeingdealtwithandledbythedgenvironmentratherthan thedgsanté. 35 Dietandnutritioncanbepoliticallyinfluencedthroughtariffsonunhealthyfoods,suchasthetariffonsaturated fatinfoodproducts,adirectivespecificallyimplementedbythedanishgovernmentin2011.thedanish FatTax appliedatariffspecificallyonfoodproductssuchasbutter,milk,cheese,pizza,meat,oilandprocessedfood wheretheproductcontainedinexcessof2.3%saturatedfat(bbc,01/10/2011).thetariffwashoweverlater abolishedin2012asitprovedineffectiveinchangingthedanes eatinghabits. 36 AccordingtotheWorkingTimeDirective,employeescannotworkmorethan48hoursonaverage;theymust have11consecutivehoursofrestperiodinbetweenworkingdaysandrestbreakduringworkinghoursiftheyare atworkformorethan6hoursincludingotherrequirements.althoughtheworkingtimedirectivewaspassedand isapartofeuworkingregulations,itonlystipulatesacapforhowmuchemployeescanwork,whichmeansthat anythingbelowthatisestablishedindividuallybythenationalgovernmentsofthememberstates(eu, 18/11/2003). 91

92 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco AlbeitmuchhasbeenattainedwithinhealthatEUlevel,thecompetenciesfortheEUtogovernhealth relatedmattersremainfragmentedatbest.inturn,formattersofhealthversuseconomicinterests,the EUcompetenciesandactionsusuallysupportstheeconomicandinternalmarketaspectsoverhealth. Thisisevidencedbythefactthatinternalmarketlegislationhasbeensuggestedtoprovideapowerful basisforestablishingfreemovementinwaysthatalsoachievehealthobjectives(e.g.settingstandards for pharmaceutical products), but excessively harder to implement where the health objective is to preventorrestrictsomethingbeingsold(greeretal.,2014).thisstatementwillbefurtherunderlinedin thesubsequentsection. Applyingtheintegrationtheoriespreviouslymentionedtothecurrentfunctioningofhealthpoliciesin the EU and how they are currently being governed yields different explanations. According to neo functionalists,theprimaryreasonforwhyhealthpolicieshavenotbeenintegratedtosuchadegreeas economicpoliciesisduetothepreferenceofinterestgroupsandotherbureaucraticactorsatanational level.moreover,neofunctionalistswillarguethatitisbecausethecommissionhasnotseenitfitto integratethispartoftheeuandthereforehasnotinitiatedlegislativeproposalstowardssuch.however, recentremarksbytheeucommissionerforhealthsuggestthatthecommissionwilllikelyproposesuch inthecomingyears(politico,02/07/2015).lastly,neofunctionalistswillapplytheconceptofspillover toexplainthelackofintegrationinthehealthareaclaimingthatpreviousintegrationhasnotyetmade itnecessaryforfurtherintegrationintohealthpoliciestotakeplace. Liberal intergovernmentalists on the other hand will claim that the lack of integration in the area of healthpoliciesissolelyduetothepreferenceofnationalgovernments.thereasonbehindthelimited integration and primarily soft law legislation in the area of health policies is because the national governments of the EU prefer to keep this policy area within their own control.this notion is highly likelytopersistatnationallevel,althougheumemberstateshaveinrecentyearsincreasinglycalledfor EUwide legislative measures to be adopted on alcohol to complement national activities (European Council, 18/06/2015; 12/12/2009; 01/12/2011; 10/07/2015; CNAPA, 10/12/2014). Intergovernmentalists will thus argue that some slight degree of integration has taken place only becausetheyhaveallowedit,andthisbeendoneinanattempttoaligninterestinthehealthpolicyarea withinthememberstatesoftheeu. 92

93 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 4.3. Tobacco(and(alcohol( (an(eu(or(national(competence?(( AsalcoholandtobaccotoalargeextentarecoveredbythesameregulatoryframeworkatEUlevel,this sectionwillfocusontobaccolegislationinordertoensurecohesiveandthoroughanalysisofwhether these areas are primarily an EU or national legislative competence. The assessment of competence withintobaccoshallthusbeseenasadenominatorforthecompetencytogovernalcoholateulevelas well.asproposedearlier,thereasoningbehinddisparatelegislationofthetwoareasmustinsteadbe accreditedtoadvocacyandperceptionperspectives. The passage of the original TPD in 2001 marked the first time tobacco lobbyists and interest groups startedtotargetlobbyingeffortstowardsthesupranationaleulevel.priortothis,nationalgovernments weretheprimarytargets,duetotheirextensivecompetenciesandlegislativeprowesswithinthefield. TheEUdidnothaveanyformalcompetenceinhealthpoliciesuntilthepassageoftheMaastrichtTreaty in1992,inthewakeoftheseain1986andthus,thetpdwasthefirstextensivetobaccoregulation directiveateulevel.theincreasedcompetencyoftheeuoncertainhealthrelatedissuesalsoincreased theuncertaintyofinterestgroupinfluence.ashavebeenproposed,therearetwodiscoursesconcerning influence of lobbying at EUlevel in the aftermath of the Maastricht Treaty. On one hand, the intergovernmentalcooperationattheeulevelenhancesthepowerofmemberstateswiththedivision ofpowerintheeumakingitincreasinglydifficultforinterestgroupstoshapethepolicymakingprocess. On the other, it is argued that by presenting a large amount of access points, the EU multilevel structureintroducedinthe1990smayincreaseinterestgroupsinfluence(dür,2008b). AlthoughinitiatedbytheCommission,theTPDmetoppositionfromseveralMemberStates,specifically GermanyandAustriaandtosomeextentalsoDenmark,NetherlandsandtheUnitedKingdom(McKee, 2015).Whilethereasonforoppositiontowardstheenhancementofpublichealthforanation scitizens canseemdifficulttounderstand,ithasbeensuggestedthatincertaincasespoliticiansandotherplayers inthedomesticpolicyareahavebeenpaidbythetobaccoindustry.inanarticlebymckee(2015)itis statedthat, in%the%united%kingdom%a%former%health%minister%has%been%a%non>executive%director%of%british% American%Tobacco.%After%being%removed%from%office,%British%Prime%Minister%Margaret%Thatcher%accepted% a% contract% from% Philip% Morris% for% $500,000% per% year% to% advise% them% on% entry% to% emerging% markets% in% Eastern% Europe. These tools have, as previously mentioned, also been leveraged by the tobacco industryateulevel(peetersetal.,2015). 93

94 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco InthewakeoftheFrameworkConventiononTobaccoControl(FCTC)putforthbyWHOin2005andthe further reform of the TPD in 2014, it appears that tobacco regulation has increasingly moved from a national competence towards a supranational EU competence. In such, the Commission initiates legislationandputsforthlegislativeproposals,whicharelaterapprovedorrejectedbytheparliament andthecouncil,aspertheordinarylegislativeprocedure(seeappendix,figure1).thus,manytobacco industryinterestgroupshavemobilisedtheirlobbyeffortsfromaprimarilynationalfocustoanequally supranationalfocus.thisishighlyevidentinthepreviouslydiscussedsectionontherevisionofthetpd in2014andtheenormouslobbyeffortpresentedbyphilipmorrisinternational(pmi)inordertosway theoutcomeoftherevisionofthedirectivetowardsmorebeneficialtermsforthetobaccoindustry. PMIhadmanydifferentstrategiestowardsattainingthisgoal,howevertheunderlyingthemeformany oftheirstrategies,andevidentlysuccessful,wastopushthediscussionfromapurelyhealthoriented discussiontoaneconomicdiscussion.asanemployeeatapublicaffairsagencyinbrussels(interview, 30/03/2015) has suggested for tobacco industry lobbying towards the TPD revisions, in% the% grand% scheme% of% things% it% was% interesting% to% see% (and% sometimes% sad)% that% it% all% really% boils% down% to% an% economic%over%a%health%aspect.thisfurthersupportstheinferencethatthemajorityofeulegislation aims to ensure economic interests as opposed to health, and hence a plausible explanation for the partialsuccessofpmi slobbycampaign. Indeed,Greeretal.(2014)hasarguedthatmuchofthehealthlegislationintheEUisinrealitymeasures toensureeconomicprosperity,awellfunctioninginternalmarketandeconomicgrowthasopposedto primarilybeingfocusedonhealthandtheprotectionofeucitizens.specifically, the%tobacco%products% Directive%(2014/40/EU),%or%TPD,%is%one%of%the%most%important%recent%pieces%of%EU%legislation%for%health,% replacing%previous%tobacco%product%legislation%dating%from%2001.%while%the%legislation%cites%public%health% concerns%as%an%important%base,%a%central%goal%for%the%tpd%is%to%facilitate%functioning%of%the%single%market.% The%text%states%that% lack%of%a%harmonised%approach%to%regulating%the%ingredients%of%tobacco%products% affects%the%smooth%functioning%of%the%internal%market%and%has%a%negative%impact%on%the%free%movement% of%goods%across%the%union,%demonstrating%yet%again%the%importance%of%internal%market%regulation%in%the% field%of%public%health (Greeretal.,2014).ThisisfurtherproposedoftheTPDrevision,inwhichmany partsofthedirectivewereadoptedunderotherarticlesthanhealthitselfsuchastowardsworkplaces (healthandsafetyatwork)andinternalmarketprovisions(labelling,advertising,contentandtaxation oftobaccoproducts).inturn,thiseffectivelyillustratesthefragmentationandconstitutionalasymmetry inregardtohealth.thelimitationsofleveraginginternalmarketprovisionsonhealthregulationshas 94

95 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco previously been illustrated with the termination of the first tobacco advertising directive by the EuropeanCourtofJustice(Weatherill,2011). According to neofunctionalism, the extensive tobacco regulation in the form of the TPD and its subsequentrevisionhaslargelybeenanattemptfromtheeutofurtherintegrationoftheeuduetothe economicinterestofaligningtobaccolegislationthroughouttheunion.theharmonisationoftaxation on tobacco and regulation on labelling and sales display has been considered an important part in maintainingthewellfunctioningoftheinternalmarketfortobaccoasmajordifferenceswoulddistort such.moreover,theadoptionofthe SmarterRegulation frameworkcanarguablybepostulatedtobea resultofthepreferencesandimmensepressureofinterestgroupsatnationallevel,asinterestgroups considered the stakeholder consultation a vital part for future lobbying efforts and for voicing their opinion. Liberal intergovernmentalist will instead argue that the integration of tobacco regulation towardsasupranationaleulevelisduetonationalpreferencesandwasinitiatedasameanstoalign legislationthroughouttheeutothebenefitofmemberstates,ratherthanbecauseitwasapreference fortheeuandthecommissionitself.intotality,itisobviousthatcertainintergovernmental,member State priorities have played its part in, to some extent unsuccessfully, watering down the tobacco regulationateulevel,inturnpartneringwiththetobaccoindustry.ontheotherhand,theregulationof tobacco has within the last decade increasingly become an EUcompetence, as a means to ensure coherence and compliance within a supranational regulatory framework. As such, perspectives from bothneofunctionalistsandliberalintergovernmentalistscanyieldpartialexplanationsforthelegislative developmentwithintobaccoateulevel.instead,amultilevelgovernanceapproach,inwhichnational Member States and the supranational regulation of the EU coexist and operate according to each other s mandates, can be applied. The European Union is a political system with a European layer (Commission, Council and Parliament), a national layer and a regional/local layer. As the MLG framework posits, these layers interact with each other both vertically, across different levels of government, and horizontally, with other relevant actors within the same level. As evidenced for tobacco,differentstakeholderspromotedifferentpowerstructureswithregardtomlg. Although alcohol is detrimental to health to similar extent as tobacco and it is covered by the same regulatoryframeworkastobaccoateulevel,ithasnotbeensubjecttothesamelegislativeactionat EUlevel. Rather, legislation of alcohol policies is mainly governed at national level as a respective MemberStatecompetence.ThiscompetenceisfurtherpromulgatedbytheCommission,who,dissimilar to tobacco, continuously assesses its role towards alcohol regulation as supplementary to Member 95

96 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco States and solely focused on soft law measures, such as coordination, exchange of best practices, monitoringandresearch(pochet,16/06/2015).thiswasalsoevidentintheeualcoholstrategy,which wasputforwardbythecommissionin2006(europeancommission,2006).themereexceptionwithin theeuislongstandingdirectivesonspecificcurtailments,suchasthestrengthofalcoholinalcoholic beverages,whichmustbedeterminedonthelabelofthebottle(europeancommission,30/04/1987). SeveralreasonshavebeensuggestedforthelackoflegislativeactiononEUlevelforalcohol.Oneof themisclaimedtobethatalcohol,unliketobacco,isproducedinamajorityoftheeucountries,making it an important source of economic wealth and employment (ECLemployee interview, 11/06/2015). AlcoholhasalsobeenproposedtobeboundtodistinctsocialnormsandpresidingculturewithinEurope toalargerdegreethantobacco,hencemakingitdifficulttoapplyauniformframeworkaswasdone withtobaccothroughthetpd 37 (Greeretal.,2014). In regards to the taxation of alcohol, there is an enormous gap between prices of alcohol across Member States (Eurostat, 19/06/2015). However, the EU does have legislation for excise duties on alcoholbutopposedtotobacco,theseexcisedutieshavenotbeenappliedtoestablishahighminimum level of excise duty and thus a stable price throughout the EU. As many Member States in the EU produce alcohol as opposed to tobacco and a unanimous agreement in the Council is required to establish such a level of excise duty, it is difficult to legislate on such a matter (European Council, 31/10/1992a;31/10/1992b;Greeretal.,2014).Thesameisdescriptivefortherulesforadvertisingand labellingofalcoholateulevel.duetotheinherentlydifferentviewstowardsthehealthrisksofalcohol asopposedtotobaccoacrosseumemberstates,advertisingandlabellingisleftlargelyinthehandsof nationalgovernmentstodecide. Similarly to tobacco, the development of EU legislation or lack thereof, seems to be derived directly frommemberstatepreferencesofespeciallylargealcoholproducingcountries(peetersetal.,2015). However, Member States have in recent years increasingly called for more EU regulation of alcohol (LatvianEUPresidency,20/04/2015;EuropeanCouncil,18/06/2015;12/12/2009;01/12/2011),aswell astheeucommissionerforhealth,ytenisandriukaitis,whohaverecentlystatedthathewouldliketo discussthepossibilitytochangetheeuropeanuniontreatiesinthefuturetoenshrinealargerrolefor 37 ExamplesincludecountriessuchasSwedenandFinlandthathavecompletelymonopolizedtheavailabilityof alcohol.alcoholcanthusonlybepurchasedatgovernmentdrivenstores,claimingthatitistothebenefitoftheir population shealthtolimitwherealcoholcanbeobtained(greeretal.,2014). 96

97 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco the EU towards health policy (Politico, 02/07/2015). In turn, this could emphasise its potential for certainimminentsupranationallegislativemeasureswithinalcohol Conclusion( Itremainsclearthatmuchefforthasbeenundertakentoreachahighdegreeofeconomicintegrationin anattempttomaketheeuamorecompetitiveandeconomicallyprosperousregionwithhighlevelsof job creation and a wellfunctioning internal market with free flow of capital and human capital. However, there remains some degree of ambiguity as to what has actually been done to foster the protectionofhealthintheeu. Ultimately,scholars(Greeretal.,2014;McKee,2015)havesuggestedthatdespiteeffortstoincrease legislationoftobacco,whichwouldseemtobebeneficialtothehealthofeucitizens,theyareinfact drivenbyeconomicincentives.thisdatesbacktotheveryfirsteffortsoftobaccoregulationintheeu,in early 1970s when the primary objective of the regulation was to harmonise prices through a set of uniform excise rates for tobacco in the Union (European Parliament, 04/2014; EU, 05/07/2011). AccordingtoGreeretal.(2014),thegoaloftheTPDwasprimarilytoensurethewellfunctioningofthe internalmarketintheeubyprovidingaharmonisedapproachtotheingredientsoftobaccoproducts, although disguised to be primarily for the protection of EU citizens. This raises the question of how muchinfluenceindustryinterestgroupsholdinthediscussionofsuchmatters,giventhatindustryisa vital part of the wellfunctioning of the internal market. In turn, this can serve as explanation of the tobacco industry s success in lobbying the revision of the TPD. It further supports the argument that muchofhealthpoliciesintheeuarenegotiatedandlegislatedatnationallevelorwithspecificmember Stateinterestsinmind. Thematterofalcoholisclearlynotasstraightforwardastobacco,anditisevenclearerinthiscasethat legislativepowerislargelyheldatnationallevel,despitesimilargovernanceframeworksfortobaccoand alcoholateulevel.giventheapproachtotobaccoandtheimportanceofthewellfunctioningofthe internal market, it is highly relevant to question whether the EU has refrained from attempting to regulatealcohol,duetoanassessmentofitsimpactoneconomicgrowthoftheunionandtheinternal market. Ultimately, it can be concluded that legislation of health policies within the EU is a complex issue, with overlapping competencies and consequentially numerous actors seeking to influence the policyareas. 97

98 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco However, certain trends point towards a coherent call across coalitions within alcohol for additional legislationateulevel.assuch,thefuturecouldholdmorelegislationofalcoholasadeterminantfor healthatsupranationallevel,similartowhathasalreadytakenplacefortobacco.thispotentialwillbe furtherassessedinthenextchapter. 98

99 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!5! AlcoholandtobaccolegislationintheEU alooktothefuture E E? A I? C? C? I?? A? C? A C F C? F? F?????CE A? F??. C 8 1, 5 99

100 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 5. Alcohol(and(tobacco(legislation(in(the(EU( (a(look(to(the(future( Withthemultiple,mutuallyinflictinglayersoflegislativeprowessintheEU,andrecentyears emphasis on economic stabilisation in the aftermath of a global financial crisis, which has severely impacted politicaldecisions,itisinterestingtoassessthepotentialforlegislationofalcoholandtobaccointheeu inthecomingdecades. Astheprevious chapter explained,theeu competencies within health, and thus within regulationof alcoholandtobaccoarelimitedtoregulationofcrossbordermeasures.whereasthiscompetencyhas beenleveragedwithintobacco,evidencedinthetobaccoproductsdirective,itremainstobeseenfor alcohol. However, alcohol could in the coming decades increasingly resemble tobacco in terms of legislation at EUlevel. Starting from the broadest perspective on health, Greer et al. (2014) has proposedthat there%is%clearly%no%future%for%europe%in%trying%to%become%a%cheap,%low>wage%economy;% Europe s%future%lies%in%adding%value%through%expertise%and%specialization.%to%do%this%with%the%relatively% smaller,%older>working>age%population%that%europe%will%have%in%the%coming%decades%depends%on%people% investing% in% their% skills% and% staying% in% work;% that% in% turn% depends% crucially% on% them% staying% healthy% (Suhrcke%et%al.,%2006).%So%far%from%being%a%burden,%as%sometimes%portrayed,%Europe s%health%systems%are% essential%for%europe s%future%and%its%ability%to%sustain%its%way%of%life%more%generally.%moreover,%the%health% sector% itself% is% one% of% the% strongest% economic% performers% within% the% European% economy.% Research% in% Germany%identified%that%the%health%economy%added%more%value%to%the%German%economy%than%the%entire% mighty%german%car%industry,%and%it%employed%every%seventh%person%in%work.%( )%The%impact%of%the%EU%on% health%is%substantial% % it% could% hardly% be% otherwise,% given% how% important% both% health% and% the% EU% are% within%the%economies%and%societies%of%eu%countries% %and%is%only%likely%to%increase. To this end, WHOEurope has also recommended for EU Member States to achieve stewardship, in which the% stewardship>guided% state% recognizes% that% a% primary% asset% of% a% nation% is% its% health:% higher% levels%of%health%are%associated%with%greater%overall%well>being%and%productivity %(WHOEurope,2009). ThisimpliesthathealthshouldbeattheforefrontoflegislativemeasuresforagivenEUMemberState concernedwithprotectinganddevelopingitsassets.inthisregard,itbuildsongreeretal. snotionthat Europe sfutureliesinaddingvaluethroughexpertiseandspecialisationstemmingfrominvestmentsin people sskillsandhealth(2014).thus,economicinterestsandhealthprioritisationdoesnotnecessitate preferentialism,butrathercanbetreatedasanentitytoachievethecommongoalofsocietalprosperity intheeuropeanunionintheyearstocome.however,thisnecessitatesaproliferationofhealthasa priority in EU and Member State legislation, rather than succumbing to the terms of traditional 100

101 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco economicinterests.thisprioritisationofhealthovertobaccohasalreadytovaryingdegreestakenplace acrosseurope,butthequestionremains,whetherthesamewillhappenforalcohol. This will arguably rely on the development of EU competencies in the coming years, as the current frameworkdoesnotallowformuchcrossborderpolicymeasurestobeimplementedbytheeu.taking into account three purported crossborder measures within alcohol, namely physical availability, economicavailabilityandadvertisingandlabelling,unliketobacco,eulegislationhasnotbeenusedto setahighminimumlevelofexcisedutyandpriceforalcoholthroughouteurope.thereasonforthishas beensuggestedtoberesultoftherelativelylimitedproductionandthusconcentrationintheeufor tobacco (ECLemployee interview, 11/06/2015), whereas alcohol production is spread widely throughout the EU, to which the necessary unanimous agreement at EUlevel for taxation legislation becomesdifficult 38 (Greeretal.,2014).Similartoadvertisingandlabelling,thelegalcapacityisapparent fortheeu,asevidencedwiththetpdrevisionsanditslimitationsonadvertisingandlabellingoftobacco products.yet,thedemocraticagreementinthelegislativebodiesoftheeuseemstobelacking,dueto differences in cultural perception and advocacy coalition influence, which in turn highlights the difficultiesonreachingagreementonmorerestrictivelegislationwithinalcohol. Despitethispreconception,numerousdevelopmentswithinthelastyearssuggestthatalcoholwillin the coming decades experience increasing crossborder regulation at EUlevel. These will be outlined below Alcohol(to(follow(in(the(footsteps(of(tobacco( DespitehistoricalprecedencewithinalcoholatEUlevel,theargumentofthisthesisisthatalcoholwill experienceincreasedregulationofcrossborderissueswithinitscurrentmandateinthecomingyears. Multiplefactorsmotivatethispresumption. First and foremost, there have been extensive calls for more regulatory action at EUlevel from key institutions and stakeholders in the last couple of years, which will eventually manifest in the more concretelegislativeproposalsbythecommission.recently,aukhouseoflordsreportwasdraftedon theeualcoholstrategyfollowingconsultationwithrelevanteustakeholderswithinalcohol(ukhouse 38 AnexampleincludesaCommissionproposaltoupgradethecurrentminimumlevelsofexcisedutyonalcohol. However,thisfailedtomakeprogressintheCouncilandwasrejectedoutrightbytheEuropeanParliament(Greer etal.,2014). 101

102 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco of Lords, 06/03/2015). It recommended that, based on the limited EU competence within this field, there%are%areas%where%the%eu%can%usefully%coordinate%the%activities%of%member%states,%but%only%a%few% topics%where%it%can%act,%and%where%its%actions%can%make%a%difference.%the%strategy%failed%to%differentiate% between%them.%a%new%eu%alcohol%strategy,%which%is%simply%a%continuation%of%the%previous%one,%would% only%perpetuate%its%deficiencies.%future%action%at%eu%level%should%concentrate%on%the%initiatives%which%the% EU% can% take% and% which% would% make% a% difference,% in% particular% by% taking% a% health% in% all% policies % approach%to%its%own%policies%in%the%areas%of%taxation,%labelling%and%marketing.althoughthecommission hasfailedtosubmitaneweualcoholstrategy,butratherwillincludeitwithinabroaderframeworkon chronicdiseases(euractiv,22/05/2015),callsbyeumemberstates(latvianeupresidency,20/04/2015; European Council, 18/06/2015; 12/12/2009; 01/12/2011), the Parliament (European Parliament, 22/04/2015; Eurocare, 29/04/2015) and the public health community (Eurocareemployee interview, 09/04/2015; WHOemployee interview, 14/04/2015) all suggest for more to be done at EUlevel to addresstheburdenofalcoholrelatedharm.furthercallsintheshapeofjointcouncilconclusionsby the EU Member States towards the Commission and a new EU alcohol strategy are currently being preparedinaccordancewiththeluxembourgishpresidencyofthecounciloftheeuforthesecondhalf of2015(europeancouncil,10/07/2015). Secondly,itisimportanttoperpetuatethehistoricalevolutionoftobacco,whichhasbeenaccentuated overthecourseofthelasthalfdecade.%itmustberecognisedthattheprocessofachievingfirmtobacco legislation was commenced more than 50 years ago, at a time where the risks of high alcohol consumptionwererelativelyunquestioned.theworktolegislateontobaccoandadvocacyforconcrete legislationmeasurestobeimplementedcanbetracedbacktothe1960s.astheukroyalcollegeof Physicians(2012)denotedin2012, the%1962%report%of%the%royal%college%of%physicians%(rcp)%was%the% seminal%event%that%finally%established%in%the%public%mind%the%extent%of%the%impact%of%smoking%on%health. This perception is further underlined by an employee of the WHO (interview, 14/04/2015). Instead, alcohol,perhapsduetothedifferencesestablishedearlierinthepaper,hasnotseensamelegislative measures.thus,applyingasimilartimehorizonforalcohollegislation,proposingthatalcoholhasonly seenattentionsimilartothatoftobaccoforlessthanadecade,shouldwieldsomeresponseastothe legislative response for what can be deemed a comparable risk factor. As a Eurocareemployee (interview,09/04/2015)hassuggested, when%it%comes%to%public%health%ngos,%i%think%that%alcohol%was% very% low% on% the% agenda% ( )% slowly% over% the% years,% it% has% increased,% and% we% have% seen% a% positive% development.%people%have%become%more%aware%of%alcohol%as%an%issue,%and%more%organisations%are%taking% 102

103 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco it%on%board%and%following%it%up%( )%what%happens%now,%is%that%the%work%on%tobacco%is%almost%done.%thus,% people% need% new% funding% opportunities,% which% increase% the% engagement% on% alcohol. The notion of increased emphasis on alcohol in the public health community is supported by an employee of SpiritsEUROPE(interview,09/04/2015),whohaspositedthat,duetotobaccohavinggonerelativelyfar intermsofeuregulation,theadvocatesarguingforincreasedtobaccocontrolhavenowmovedtonew jobswithinalcohol. Despite these proclamations, which back the informed assumption that alcohol will see increasing regulationateulevelinthecomingdecades,itisimportanttounderstandthattheprogressoftobacco legislationcouldcreateapatternofpathdeviationratherthandependency.incontinuanceoftherising euroscepticismdueinparttoexternaleconomicfluctuations(torreblanca&leonard,2013),socalled EU micromanagement of a policy area, which many European citizens feel passionately about and against, can be increasingly hard to promote. The euroscepticism further intrigues the underlying discussion of subsidiarity, which has already been argued for by some advocacy coalitions (House of Lords,2014).Coiningthetermpathdeviationalludestoanoppositiontothecommonlyusedtermof path dependency within neofunctionalist integration theory, and should be taken seriously, as exemplified,albeitonamoregrandeurscale,intheparliamentelectionsin2014,withrightwing,eu scepticpartiesgainingmomentum(huffingtonpost,19/06/2014),inthegreeknationalelectionsand subsequent redirection of economic policy (BBC, 16/01/2015) and the upcoming referendum in the UnitedKingdomonitsmembershipoftheEU(UKParliament,2015).Forthismatter,theincreasingly progressive tobacco legislation in the EU can actually become a hindrance rather than support for furtherlegislativemeasureswithinalcohol.additionally,ashavebeensuggested,alcoholdoesnothave theadvantageoforiginality,whichmeansthatindustryandpowerfulstateinterestsareacutelyaware of interests in European and international lawmaking and thus ready to rigorously oppose supranational regulation (Taylor & Dhillon, 13/04/2012). Thus, path deviation can instead become descriptive of EU alcohol legislation, or lack of the same, in the aftermath of the Tobacco Products DirectiveandtobaccolegislationintheEU.However,duetofurthertrendsacrosstheEU,thepaperwill remain assertive to the belief that alcohol will be increasingly regulated at EUlevel in the coming decades. Thirdly,relatingtoGreeretal. spresumption(2014)thatattainmentofhealthacrosseuropeisoneof theultimateaimsoftheeuframework,healthhasbeenarguedtohavebecomeincreasinglyimportant foreu scitizens.asapublicaffairsagencyemployeeproposes(30/03/2015), we,%as%a%society,%seem%to% 103

104 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco be%moving%into%a%more%conscious%and%healthy%approach%to%lifestyle,%empowering%ourselves%on%the%choices% we%make%that%may%impact%our%health.%as%such,%( )%we%will%probably%see%more%and%more%legislation%on% excessive%alcohol%consumption,althoughaspecificfctcforalcoholseemsunlikely.echoingthisstance, FionaGodfrey(2015)oftheEuropeanNGO,EASL,hasrecommendedthat we%could%take%a%leaf%out%of% the%tobacco%control%playbook%and%there%is%no%reason%why%we%cannot%implement%the%same%kind%of%policies% which%we%have%seen%have%been%effective%in%bringing%down%tobacco%consumption%at%eu%level%and%in%the% Member% States. These crossborder, populationbased measures has further been argued to be the mostcostefficientincurtailingthecostandburdenofalcoholrelatedharmtoeuropeansocietiesby bothoecd(2015a)andwho(2013a;2014a). Fourthly,theincreasingfocusonchronicdiseasesandtheirriskfactors(WHO,2013),evidencedinthe recentarticulationfromthecommissionforembeddingitsalcoholmeasuresunderabroaderchronic disease strategy (EurActiv, 22/05/2015), yields further comparison and resemblance between alcohol and tobacco. In turn, this permits additional questions on the dissimilarity in approach by the EU institutions towards the two substances, as evidenced by this thesis. Accepting the neofunctionalist argumentation that the EU integration process is inevitable and follows spillover effects from other, interrelatedpolicyareasfurthersupportsthepredictionofalcohollegislationgraduallyresemblingthe equivalentfortobaccointhefuture.additionally,adistinctivedifferenceintheperceptionofalcohol and tobacco has in recent years increasingly been rejected by the WHO. As a WHOemployee has posited(interview,14/04/2015), we%have%better%and%better%evidence%to%support%this.%the%old%studies% showing%the%j>shaped%curve%(which%argue%that%small%levels%of%alcohol%consumption%are%beneficial%for%you)% have% been% questioned% a% lot,% among% others% recently% in% the% British% Medical% Journal,% which% has% been% opposed%by%the%industry,%although%the%argumentation%in%the%british%medical%journal%is%very%strong.%i%think% that%for%the%j>shaped%curve%argument,%the%group%of%abstainers%are%heavily%confounded,%which%you%cannot% control% for. In turn, it supports the claim that the toxicity of the two substances is similar, and that alcohollegislationateulevelwillbecomeincreasinglystringentinthefuture. Finally,recentdevelopmentintermsoftheBrewersofEuropevoluntarilyincludingnutritionallabelling ontheirbeveragesisafurthersignofthingstocomewithinalcohol.althoughthiscanbeseenasapush for voluntary measures and increased selfregulation by the industry, it is a leap forward in terms of alcohol regulation acknowledged by the public health community (Eurocareemployee interview, 09/04/2015), as the nutritional labelling of alcoholic beverages of more than 1.2% AB (alcohol by volume) has previously been exempt from EU legislation (Brewers of Europe, 26/03/2015). For this 104

105 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco matter,avividanalogyhasbeenofferedtodescribetheprogressoftobaccolegislationandthereason for its evolution; like% surfers,% legislators% and% corporate% officials% who% wish% to% change% everyday% social% norms%must%wait%for%signs%of%a%rising%wave%of%cultural%support,%catching%it%at%just%the%right%time (Feldman &Bayer,2004).PerhapstheWHOFrameworkConventiononTobaccoControl(FCTC)andchangesto public perception was part of the surfer s wave for tobacco legislation, and to continue the analogy, althoughthewavewithinalcoholhasgainedmomentum 39,itstillneedstimetoaccumulatestrength. However, evidence of the continued disparity in approach to reduce alcohol consumption versus tobaccoisnotonlycontainedtoeulevel.despiteargumentsforincreasedemphasisonalcohol(who employee interview, 14/04/2015), the WHO Global Action Plan for the Prevention and Control of noncommunicable diseases (WHO, 2013) highlights a set of targets to be achieved by its MemberStatesin2025.Here,harmfuluseofalcoholmustbereducedbyatleast10%,whiletobacco use instead shall be reduced by 30%. This discrepancy is important to highlight, and underlines the sustained emphasis on reducing harm from tobacco relative to alcohol, even by the public health institutions. In turn, if alcohol is to experience similar legislation to tobacco in the next decades, a concertedandalignedpushacrossthepublichealthcommunityandadvocacycoalitionmustbebuilt andenforced. Despiteevenaconcertedpushbythepublichealthcommunity,alcohol,intermsofglobalregulation, willhoweverlikelynotfollowalinearlysupplementarypathtothatoftobacco,asanfctcforalcohol will be difficult to establish and subsequently enforce (WHOemployee interview, 14/04/2015; Public AffairsAgencyemployeeinterview,30/03/2015;Taylor&Dhillon,2012).Instead,suggestionsfornon bindingcodesofpractice(taylor&dhillon,2012),preliminaryconventionssolelyonalcoholmarketing (WHOemployeeinterview,14/04/2015)orinclusionofalcoholwithinalreadyexistingconventions,such asthe1971internationaldrugconvention(room,2006),asastartingpointtowardsaninternational strategyhavebeenvoiced,althoughthefinerdetailsaredifficulttopredict.indeed,oonetal.(2015) has suggested that the WHO Global Strategy to Reduce the Harmful Use of Alcohol (WHO, 2010), adoptedbytheworldhealthassemblyinmay2010,providespolicyoptionsandstandards,which,asa 39 Asevidencedbytheincreasedfocusonlegislationwithinalcoholatbothsupranationallevel(i.e.theEUAlcohol Strategy,WHOGlobalAlcoholStrategy)andnationallevels(i.e.theLatvianCouncilPresidency sfocusonalcohol). ForEUMemberStates,ithasspecificallybeeniteratedthat 16%EU%Member%States%have%created%or%updated%their% national%alcohol%strategies%between%2006%and%2010.%in%line%with%eu%recommendations,%by%2010,%all%but%two% Member%States%have%established%maximum%blood%alcohol%concentration%(BAC)%of%0.5%mg/ml%or%less,%( )%and%21% Member%States%have%reported%that%they%strengthened%these%measures%or%their%enforcement%between%2006%and% 2010 %(EurActiv,30/03/2015). 105

106 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco consequence of responding to the growing noncommunicable disease epidemic, can become a tool similartothewhofctctodirectpolicymakers,courtsandcivilsocietyindefiningastate sobligations undertherighttohealth.already,thewhoisvocalonasimilarstancetowardsthealcoholindustry,as towardsthetobaccoindustryinthefctcandspecificallyitsarticle5.3.asmargaretchan,thedirector GeneralofWHO,hasstated, all%the%necessary%measures%should%be%taken%to%protect%the%formulation%of% health%policies%from%distortion%by%commercial%or%vested%interests,%and,%in%the%view%of%who,%the%alcohol% industry%has%no%role%in%the%formulation%of%alcohol%policies (WHO,2014a). Fortheabovereasonsandtrends,andinterviewsconductedwithexpertswithinthefield,thispaper projectsthatalcoholwillbeincreasinglylegislatedateulevelinthecomingyears.thecompetencies withintheeutowardshealthhavealreadyachievedsignificantprogress(greeretal.,2014),andallows forcrossbordermeasures,evidencedbytheextensiverelativeregulationoftobacco.despitecultural andperception differencesandevidentinconsistencyinperceptionofalcoholacrossmemberstates, the willingness to engage in Council Conclusions and recommendations for a new EU framework on alcohol(latvianeupresidency,20/04/2015;europeancouncil,18/06/2015;12/12/2009;01/12/2011; 10/07/2015), the CNAPA committee s calls for the adoption of crossborder measures (CNAPA, 10/12/2014),andtheParliament sadoptionofaresolutionforaneweualcoholstrategy(22/04/2015), whichconsiderssuchmeasures,delineates amemberstate push at various levels towards increased regulationateulevel.trailingthepathdelineatedbyneofunctionalismalsoyieldfurtheremphasison increased integration, due to spillover effects from tobacco, which would accommodate increased regulationofalcoholinthecomingdecades Further(regulation(of(tobacco(in(the(future( DespitetobaccoalreadyhavingexperiencedextensivelegislativemeasuresatEUlevel,evidencedbythe Tobacco Products Directive, relative to alcohol, several sections of further EU legislation can be postulated to take place in the coming decades. These can happen as result of spillover effects, concertedeffortsbythepublichealthcommunityandthedeteriorationofthetobaccoindustry sroleas influenceronpolicymaking. ThereasonforpotentialfurtherregulationisthecontinuedprevalenceofsmokingacrossEUMember States,albeitdeclining.TheUKRoyalCollegeofPhysicians(2012),whowaspartofinitiatingthetobacco controlcampaignfiftyyearsago,hasinferredsuch,bystatingthat smoking%prevalence%has%halved,%and% the%epidemic%of%deaths%caused%by%smoking,%which%lags%about%20%years%behind%smoking%prevalence,%is%now% 106

107 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco also%in%decline.%yet%smoking%is%still%the%largest%avoidable%cause%of%premature%death%and%disability%in%the% UK,%where%there%are%still%around%10%million%smokers,%of%whom%half%will%die%prematurely%as%a%result%of%their% smoking,% unless% they% quit.% Smoking% prevention% has% been% most% successful% among% the% more% skilled,% educated% and% affluent% socioeconomic% groups,% with% the% result% that% smoking% is% now% also% the% largest% avoidable% cause% of% social% health% inequalities% in% the% UK.% Smoking% also% remains% a% massive% drain% on% economic%resources,%costing%the%nhs%alone%around% 5%billion,%and%wider%society%an%estimated% 14%billion.% There% is% still% a% great% deal% to% do. The WHO and its Member States have already acknowledged this continuedimpactandagreedonafurtherreductionoftobaccoprevalenceintheadultpopulationof 30%by2025(WHO,2013). One of the main areas of potential further regulation in the next years is ecigarettes, which was introducedinthetobaccoproductsdirectiverevision.asanemployeeatamajorbrusselsbasedpublic AffairsAgencyhassuggested(interview,30/03/2015), e>cigarettes%is%a%new%territory%that%could%open%up% for% alternative% industry% and% economic% interests,% and% push% back% the% debate,% as% these% would% also% need% fundamental%regulation.similarly,theemergenceofothersmokingalternatives,includingforexample moistsnuffandsnusasasmokingsubstituteinsweden,willpotentiallydemandadditionalregulation andderegulationateulevel.thesealternativeshavebysomebeenarguedtobeeffectivealternatives tosmoking,someofwhichareillegalundereulawcurrently,inturnresultinginpersonalandpublic healthbenefit(royalcollegeofphysicians,2012;americancancersociety,2015). AnotherareaofincreasedEUregulationhasbeenproposedtobecomethecircumventionofexposure to secondhand tobacco smoke (Greer et al., 2014). This perception is already acknowledged by the Commission (14/03/2013), which suggests that while Member States have taken steps to decrease exposuretosecondhandsmoke,theadvancementsacrossmemberstatesareincomplete.thisareais furtherencompassedinexistingtreaties,providingtheeuwithlegalpowerstoact,especiallywithinthe contextofworkplaces,throughhealthandsafetyatworkprovisionsalreadyleveragedforlegislationon tobacco,aswellasmoreexpansivelyviaenvironmentprovisions,giventheevidenceofhealthbenefits stemming from smokefree environments (Greer et al., 2014).These measures will further include healthasanobjectivetoavoidcomplicationsoftheinternalmarket.however,similarlytoalcohol,the dissimilarityinactionswithinthisfieldacrossmemberstatesreflectsthesensitivityoftheissue,which couldinturnresultindifficultytobuildasufficientmajorityintheparliamentandcouncil. 107

108 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco CrossbordermeasuresandapopulationbasedapproachtoEUregulationisalsocontinuouslyargued forbythepublichealthcommunity(royalcollegeofphysicians,2012;smokefreepartnership,2015a; ECLemployeeinterview,11/06/2015),includingmeasuressuchastaxation,reducingtheaffordabilityof cigarettesandpreventingadvertisingandpromotion.asthefinaloutcomeofthetpdrevisiondoesnot reflectcompletelythepositionofthepublichealthcoalitioneither,thepublichealthcommunitywill unarguablypushforfurthermeasurestobeadoptedateulevelinthefuture.theconcertedactionof the public health community within tobacco has already shown significant prowess in ensuring supranationalregulation,andseveraladdedmeasurescouldfollowinthecomingyears.! 108

109 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!6! Conclusion F I?C?? EC C?I C C E C HA CC F I?? F A C? HA??? C? 109 CE C? C F

110 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 6. Conclusion( ThispaperhassoughttodelineatethedifferencesinlegislationoftobaccoandalcoholatEUlevel,and propose the underlying context of this variation through an advocacy analysis. The differences in regulation of tobacco and alcohol at EUlevel are significant. Whereas several hard law measures, including the Tobacco Products Directive and its revision, have been characteristic for the EU s treatmentoftobaccointhelastdecade,alcoholhasonlybeensubjectedtoonesoftlawstrategywithin thesametimespan,namelytheeualcoholstrategy. The reason for the different approach have in this paper been analysed on the basis of both a perceptionandadvocacyvarianceofthetwosubstances.perceptionofalcoholisgreatlydifferentinan EUcontext compared to tobacco, due to factors including the arguable health benefits of moderate alcoholconsumption,theculturalanddietarysignificanceofalcoholincertaineuropeanmemberstates andthedifferentaddictionprofiles.however,theeffectsoftheeu sexcessivealcoholconsumptionin the form of severe social and economic costs to European societies, has led institutions and public health communities including the WHO, the OECD and the Parliament, in recent years to argue for increasedmeasuresateuleveltocircumventtheburdenofalcoholrelatedharmthroughsupranational direction. Fortheadvocacyanalysisanddiscussion,thescholarlynotionofadvocacycoalitionsbeingtheprimary interlocutor rather than individual interest groups for influencing legislation and decisionmakers, as introducedbysabatier&jenkinssmith(1988)andklüver(2011,2013),hasbeenassessed.thethesis suggests that there are two distinct advocacy coalitions within both alcohol and tobacco, namely an industrycoalitionandapublichealthcoalition.theadvocacycoalitionswithinalcoholandtobaccoat EUlevelsharemanysimilaritiesintermsoflobbyingtools,accesspointsandpolicymessages.Whilethe industrycoalitionsbroadlyarguefortheeconomicinterestsandtheeffectofincreasedregulationon such, the public health communities within the two areas both promote more populationbased measurestodecreaseconsumption.despitethesesimilaritiesinmessages,however,thecoalitionsdo notworkofficiallyincollaborationacrosssectors. The advocacy coalitions within alcohol and tobacco thus share many similarities, but also differ expressivelyoncertainvitalparameters,whichcanexplainthedifferenceinlegislationofthesubstances ateulevel.thedissimilaritiesidentifiedincludethevarianceinpower,politicallegitimacyandpresence acrossmemberstates at the advantage of the alcohol industry compared to tobacco. Moreover, the 110

111 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco strengthandcoherenceofthepublichealthcoalitionwithintobaccoanditspolicymessages,compared tothepublichealthcommunitywithinalcoholalsoyielddiscrepancyacrossthetwoareas.thedegreeof technicality for alcohol and the higher public salience for tobacco is presented as further aspects capableofdescribingthedifferenceinlegislativepathsforalcoholandtobaccoateulevel. However,itisimportanttoacknowledgethatthedifferencesinadvocacycoalitionscanonlygosofarin explainingthedifferentlegislativepathsforalcoholandtobacco.partoftheexplanationmustalsobe accredited to the aforementioned perception differences of the two substances. Despite these differences,thispapergoesfurtherwiththeargumentthatthefuturewilllikelyholdmorelegislationof alcohol,levellingittotobacco.thiswillrequirethatpoliticianssetasideshorttermeconomicgainsfor moregrandeur,longertermpublichealthconsiderations.despitemanypoliticalinterventionstowards bothtobaccoandalcoholcanarguablybeseenascosteffective,thepredominantremainingquestion willbewhetherpoliticiansateuandnationallevelswillpromotehealthandgranttheeumorepowerto manoeuvreinthisfieldattheexpenseofnationalsovereignty,economicinterestsandthelibertiesof theinternalmarket. Itisnotimpossible,ashavebeenseeninthecaseoftobaccowiththeTobaccoProductsDirective,but eventhoughthisisbymanyseenasapredecessortopotentialfuturealcohollegislationateulevel,this thesis has proposed that the opposite can become a consequence. As public perception of the two substances differ significantly, and as the industry is increasingly proactive, politically legitimised and observantofdevelopmentsintheaftermathofthetobaccolegislation,thetpdcaninfactbecomea barriertomoreeuscrutinyandlegislationwithinalcohol,despiteasetofobviouslysimilarproperties whichthesetworiskfactorsshare. However, on the basis of neofunctionalist inferences, as well as interviews conducted with experts withinthefield,thispaperproposesthatalcoholinthecomingdecadeswillincreasinglybelegislated andgovernedateulevel.eumemberstates,theeuropeanparliament,thepublichealthcommunity and the industry have all called for more action at EUlevel to address the burden of alcoholrelated harm.despitedifferentperspectivesonthemeasurestointroduceforthismatter,thepushfromkey stakeholdersandinstitutionsbearresemblancetowhatwasseenfortobaccoleadinguptothewho FCTC and the Tobacco Products Directive. As such, albeit difficult to project in the context of critical realism, it is proposed that alcohol will see increased legislation in the coming years, and eventually alignwiththelegislativemeasuresintroducedfortobaccoateulevel. 111

112 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Chapter!7! Perspectivation (E? IC C??? CA? E?? A C C A?C F A F CC CC??? C???? F I A CC. C E? C E? EA?? E E C E 8 2 8A

113 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 7. Perspectivation( ThisthesishasbeenfocusedspecificallyonalcoholandtobaccoandlegislationofsuchatEUlevel,in turnanalysinganddiscussingitfromanadvocacyperspectivetoexplainitsdevelopment.inorderto delineateandframethethesiscoherently,ithasthusbeennecessarytoleaveoutpotentiallyrelevant areasoffurtheranalysis,whichcouldhavebeeninterestingtogaugeforthethesis.withinthescopeof this thesis, it has been impossible to include below areas of analysis, which thus remain potentially rewardingforimminentscholarlyresearchtoassess. Duringthewritingprocessofthispaper,ithasbecomeevidentthatforlobbyingaworthwhileelement toanalyseevenfurther is the concept of revolving doors. Examples ofrevolving doors whereformer politiciansorgovernmentofficialseithersimultaneouslyoraftertheirpubliccareerbegintoworkfor privateactorsandcompaniesareplentifulwithineuinstitutionsandmemberstates 40.Asalludedtoin thispaper,thestrategyhasbeenleveragedbyboththealcoholandtobaccoindustry.however,onlyfew MemberStateshavelawsthatinvokequarantinebetweenshiftingfromthepublictoprivatesector,and there are none in place at EUlevel, despite calls for more robust review processes by the European Ombudsman 41 (23/09/2014). Anotherprospectiveareaoffurtheranalysisistheinternationalsphere,includingillicittradeandthird worldimpactoftheeuregulationoftobaccoandalcohol.especiallytheillicittradeoftobaccointhe aftermath of the Tobacco Products Directive has been proposed as a key item to be focused on and legislated further internationally and within the EU (ECLemployee interview, 11/06/2015). In turn, it would also be valuable to conduct a more comprehensive comparative assessment of national legislationofthesubstances.forthispurpose,thenationaladvocacyimpactacrosseumemberstates andtheaccessoflobbyismtotheseregulatoryframeworkscouldberewardingtoembarkupon. Outsideoftobaccoandalcohol,futureresearchonregulationandadvocacystrategiesrelatedtosimilar chronic disease risk factors of more dietary nature as defined by WHO (2013a), such as sugar orfat, couldbefascinatingtoundertake,andfurtherstrengthenthecomparativeanalysisofriskfactorsfor chronicdiseases,andtheirdifferentadvocacycontexts. 40 RecentexamplesincludeJohnManzoni,KarenHækkerupandLeneEspersen. 41 TheEuropeanOmbudsmanhasspecificallypositedthatrevolvingdoors can%at%times%potentially%have%a% corrupting%influence%on%senior%staff,%which%damages%public%trust%immensely (23/09/2014) 113

114 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Asasourceoffurtheranalysisanddiscussion,itcouldberewardingtoassesstheoverallsituationof lobbyingintheeuandbothquantitativelyandqualitatively,suchasbyleveragingtheperspectivesof cultural theory 42 to assess public perception and the process of policy core belief identification. This wouldfurtherstrengthentheanalysisofpolicycorebeliefsandtheaffirmationofsuchasbackground forestablishmentofadvocacycoalitions.additionally,ananalysisofthepoliticalperceptiontolobbying influenceacrosspoliticalgroupsintheparliamentcoulduncovertheapproachabilityofthesegroupsin termsofputtingforwardlobbymessagesofaninterestgrouporadvocacycoalition. Lastly,itcouldhavebeeninterestingtobroadenthescopetolobbyingofalcoholandtobaccooutsideof Europe,asinferenceshasbeenmadetowardsadifferentframeworkandthusapproachtolobbyismin otherpartsoftheworld,suchastheunitedstates,amongothers(woll,2012;euractiv,01/03/2005; Reuters,18/03/2011).Thisanalysiscouldpositionpublicdebatetowardstheinfluenceoflobbyismand advocacycoalitionsspecificallyinlightoftheongoingtransatlantictradeandinvestmentpartnership (TTIP) discussions between the United States and the EU, which have already been suggested to be impactedtowardsparticularalcoholinterests(euractiv,09/07/2014). 42 Culturaltheoryproposesthatsocialorganizationstructuresbestowindividualswithcertainideasand perceptions,whichinturnreinforcethosesamestructuresincompetitionwithdifferentones(jenkinssmithetal., 2014). 114

115 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Bibliography! 115

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133 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco 133 he_commission:_flooding_consultation_processes_and_targeting_non health_commissioners_and_their_officials[accessed9july2015] Torreblanca,J.I.&Leonard,M.,2013,TheContinentWideRiseofEuroscepticism,EuropeanCouncil onforeignrelations, [accessed7july2015] Treisman,D.,2000,Thecausesofcorruption:acrossnationalstudy,JournalofPublicEconomics, vol.76,issue3,pp , [accessed14june2015] UKDepartmentofHealth,1998,Smokingkills.AWhitePaperontobacco.London:TSO UKHouseofLords,2014,AnewEUAlcoholStrategy? Evidenceolume,EuropeanUnion Committee,HomeAffairs,HealthandEducationSubcommittee, strategy/alcoholstrategyevidenceolumefinal.pdf[accessed9july2015] UKHouseofLords,06/03/2015,AnewEUAlcoholStrategy?, July2015] UKParliament,2015,EuropeanUnionReferendumBill, _en_2.htm#pb1l1g5[accessed28May2015] UniversityofCalifornia,SanFrancisco(USCF),2015,LegacyTobacco DocumentsLibrary, oon,t.,mitchell,a.d.&liberman,j.,2015,regulatingtobacco,alcoholandunhealthyfoods:the LegalIssues,Routledge Weatherill,S.,2011,TheLimitsofLegislativeHarmonizationTenYearsafterTobaccoAdvertising: HowtheCourt scaselawhasbecomea DraftingGuide,GermanLawJournal,vol.12,no.3, 864_Articles_Weatherill.pdf[accessed14July2015] Weible,C.M.,2006,AnAdvocacyCoalitionFrameworkApproachtoStakeholderAnalysis: UnderstandingthePoliticalContextofCaliforniaMarineProtectedAreaPolicy,JPART17:95117, OxfordUniversityPress, _07.pdf[accessed13July2015] Weible,C.M.,Sabatier,P.A.&McQueen,K.,2009,Themesandariations:TakingStockofthe AdvocacyCoalitionFramework,ThePolicyStudiesJournal,vol.37,no.1, batier,%20mcqueen%20psj%202009%20acf%20review.pdf Weible,C.M.,Sabatier,P.A.,JenkinsSmith,H.C.,Nohrstedt,D.,Henry,A.D.&deLeon,P.,2011,A QuarterCenturyoftheAdvocacyCoalitionFramework:AnIntroductiontotheSpecialIssue,The PolicyStudiesJournal,vol.39,no.3, %20al%20PSJ% pdf

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135 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco WHOEurope,2012b,Europeanactionplantoreducetheharmfuluseofalcohol , data/assets/pdf_file/0008/178163/e96726.pdf?ua=1[accessed12june 2015] WHOEurope,2013,Statusreportonalcoholandhealthin35Europeancountries2013, data/assets/pdf_file/0017/190430/statusreportonalcoholand Healthin35EuropeanCountries.pdf[accessed17June2015] WHOEurope,2015a,EuropeanCodeagainstCancer, topics/noncommunicablediseases/cancer/publications/2014/europeancodeagainstcancer [accessed8july2015] WHOEurope,2015b,TechnicalconsultationonroadmapofactionstofullycomplywiththeWHO FrameworkConventiononTobaccoControl, , centre/events/events/2015/02/technicalconsultationonroadmapofactionstofullycomply withthewhoframeworkconventionontobaccocontrol, [accessed7july2015] WHOEurope,2015c,Plaintobaccopackagingencouragesmorepeopletostopsmokingandfewer tostart, prevention/tobacco/news/news/2015/01/plaintobaccopackagingencouragesmorepeopleto stopsmokingandfewertostart[accessed6july2015] Woll,C.,2012,Thebrashandthesoftspoken:Lobbyingstylesinatransatlanticcomparison,In: InterestGroups&Advocacy,1(2),pp ,PalgraveMacmillan, WorldFederationofAdvertisers,16/04/2012,Leadingalcoholbeverageproducersagreetoextend commonmarketingstandardsandreinforceselfregulationacrosstheeu, commonmarketingstandardsandreinforceselfregulationacrosstheeu[accessed9july2015] 135

136 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Appendices! 136

137 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription! Interviewwithemployee,PublicAffairsAgency! 137

138 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Appendices( Transcription(of(interview(with(employee,(Public(Affairs(Agency(( FollowingisatranscriptionofaninterviewconductedwithanemployeeatamajorBrusselsbased PublicAffairsagencyon30March2015.Theemployeehasbeenaconsultantforseveralpharmaceutical companiesandbeeninvolvedintobaccoandalcohollegislationateulevel.theindividual sidentityand position,aswellasthespecificcompaniesareknowntotheauthors,butwillremainunidentifiedinthis paper,asitisirrelevantforthesubjectmatter. Comments,whichhavenothingtodowiththetopicofthepaperhavenotbeenincluded,hencethe transcriptionbeginsandendsabruptly. SRBstandsforSimonRedderBerthelsen. EPAAstandsforEmployeeatPublicAffairsAgency. ***** SRB:HowhaveyoubeeninvolvedintobaccoandalcohollegislationandlobbyingatEUlevel? EPAA:IwasinvolvedintherevisionoftheTPD(TobaccoProductsDirective)asaconsultanttoamajor pharmaceuticalcompany,whichhasacommercialinterestintobaccocontrol,astheymakecessation treatment. SRB:Ok.Iknowthatyouhavealsobeeninvolvedinalcohollegislationtosomeextent,isthatfroma similarcapacity? EPAA:Yes.Ihaveworkedonalcoholasaconsultanttoanotherpharmaceuticalcompanyfocusedon researchanddevelopmentinbraindiseasesincludingalcoholdependence. SRB:Ok,thankyou.Asyouknow,thesubjectofourthesisistobaccolegislationintheEU,andinthis regard,wewouldliketohearyourperspectiveonwhatstartedtheprocessoftobaccolegislationin general? EPAA:Ithinkthehistoryoftobaccocontrolhasbeenquitesuccessful,butithasbeenlong.Yousee serieslike MadMen inthe1960s,wherepeoplewouldsmokeeverywhereandistillrememberin Portugal,wherepeoplewouldsmokeonthemetroandindoors,soitisstillnotthatlongago.Itistrue thattobaccolegislationintheeuhasbeeninplacefor1015years,andithinkthisstartedwiththe generalknowledgeandevidencethattobaccoisharmfulasaproduct,thattherearenosafelevelof smokingandthatitjustcausesalotmoreharmthaninitiallythought.ifregulatorsandthepublicknew backthenwhatweknownow,cigarettesandothertobaccoproductswouldhaveneverbeenallowed ontothemarket.unfortunatelyhowever,lotoftheresearchandevidenceontheharmfuleffectsonthe 138

139 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco individualsmokerbutalsoonthosesurroundinghim/her,onlycameouttoolate,aftertobaccowas approvedasa normal product.irememberrecentlycheckingavideofromtheprmuseum(which apparentlyexistsinnyc)fromthefounderofacompetitoragency.inthatvideothispersonspokeof howtheagencywentabout institutionalising theideaandneedforarobustbreakfastinthemorning, eatingbaconandeggsatatimeofrecession.howeverwhatcaughtmyeyewasthatinthetext accompanyingthevideo,itwasmentionedthatthismanandhisagencyworkedforthetobacco industrytoallurewomenintosmoking(aspartoftheemancipationmovement).itturnsoutthathis wifestartedsmokinganddiedoflungcancer.itcanbereadthat thisistheonlyproject[thefounder] everregrettedworkingon.butthisistosaythat,inadditiontopotentialmarketdistortions,we eventuallystartedtounderstandwhattheproductwasallabout.andthat swhen,ibelieve,legislation, alsoconsideringthehealthaspects,startedtoappear. TheTobaccoProductsDirectivestartedin2001,andIbelievethattherewasalreadysomelegislationin placebeforethis.legislationfromtheeuwithintobaccocoversadvertising,includingbanningofcross borderadvertising,alittlebitontaxation,giventhecompetenceofeumemberstates,thetobacco ProductsDirectiveandthenintermsof softlegislation,wehavehadthesmokefreeenvironments, whichwasfrom2009andtobaccohasbeenconstantlypresentineverythingthathastodowithco morbiditiessuchascardiovasculardisease,cancer,diabetesandcopd. IntermsoftheWHO,theFCTC(FrameworkConventiononTobaccoControl),whichwassignedfor ratificationin2005,helpedgivemoreglobalandofficialrecognitiontotheharmfuleffectsoftobacco, andthatwasactuallyposttpd.thereishoweverstillalotoflifestyleassociatedwithtobaccoforgood andforbad,andtreatmentfortobaccodependenceisnotreallyrecognisedasanecessitybecause manyseeitasalifestyledisease,whichisnotthecase.ofcoursetherehasalsobeenalotofevidence andithinkthatwearedefinitelystartinganeraof denormalisation oftobaccoandsmoking,andthat helpswiththe softlegislation mentionedearlierandtomarginalisetheactofsmoking,becauseitlimits theoptionsastowhereyoucansmokeandrightfullysoforthesakeofotherpeople. SRB:Ok.GoingintoabitmoredetailontobaccolegislationandtheTPD,howwouldyoudescribethat processofrevisingthetpd,anareawithsignificantlydifferentinterests? EPAA:ThefirstwordthatcomestomindwhenthinkingoftheTPDrevisionis controversial.you mentionthatthereareseveralconflictinginterests,butattheendoftheday,thereisnotreally;you havethetobaccoadvocates/industryandthehealthcarecommunity,andthenyouhavetheecigarettes industry,whichcanbesaidtobesomewhereinbetween,assomemayseeecigarettesasameansto reducingsmokingoreventostopsmokingeventually,asanindependentproductandproducertothe tobaccoindustry,ornot. IguessbecauseoftheinclusionofecigarettesintheTPDrevision,itbecameamuchmoreheated debateevenamongmepsandespeciallythosemeps,whoyouwould traditionallythinktobehealth advocates (itshouldbenotedthatipersonallyconsiderecigsmoreonthetobaccoproductsidevs.a harmreduction/cessationsupport,hencetheuseofquotationmarks).ithink,itisbasedonthe discussionofwhetherecigarettescouldbeconsideredameanstoreducesmokingortoinitiate,butin 139

140 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco thissenseitwasreallycontroversialbecauseittheoriginalproposalofthetpdrevisiondidnotintend tofocusonthatarea,butthengiventhegrowthofthemarket,itjusthadto. Also,aroundtheissueofecigarettes,fromaregulatorypointofview,itwasinterestingtoseetherole ofdigitalandsocialmediaintherevisionoftpd.inmanyofthetriloguemeetingsbetweenthe Parliament,theCommissionandtheCouncil normallythesemeetingsareverysecret yousawmeps tweetingaboutitanddocumentsleakedontotwitteralmosteveryday.iwasworkingverymuchonthe sidelineofthetpdrevision,becausetheinitialproposalwasratherfavourableintermsofmyclient s keypolicyasks,butikeptmyeyeontheprogressoftherevisionanditistruethatifeltthetension whenitcametoecigarettes(morethananyotherprovision).andthefactthatalmosteverythingwas accessibleonlineeventhoughtheprocesswasongoing,wascontributingtotheheateddebate.the positionofthememberstatesnotsomuchofasurprise(asyoukindofknowwhoismoreprotobacco industry/growthandwhoismoreprotobaccocontrol),butinthegrandschemeofthingsitwas interestingtosee(andsometimessad)thatitallreallyboilsdowntoaneconomicoverahealthaspect. SRB:Yes,sooverallitisprotobaccoversusantitobacco? EPAA:Yes,withecigarettesinthemiddle. SRB:Ok,sonowyoutoucheduponmynextquestion,whichisaroundtheinvolvedstakeholdersinthe TPDrevision.Yousaythatyouhavethetobaccoindustryononeside butthepharmaceuticalindustry theywerethenonthepublichealthside? EPAA:Yes,intobaccocontrol,thepharmaceuticalindustrytendstoalignverycloselywiththepublic healthngosandpatientgroups.iwouldnotnecessarilysay100%alignment,astheremightbesome issuesregardingplainpackaging,ipissuesandsoon,butintermsofwheretheystand,pharmaceutical companies,notjustmyclient,tendtoalignwiththetobaccocontrolcommunityandhealthadvocates.i dothinkhoweverthat,especiallyforanindustry,whichtendstobenegativelyperceived,the pharmaceuticalindustryplayedarathersmall/backburnerrole,mostlyfollowingthediscussionsand meetingpeoplewhennecessary.atleastfrommyclient sperspectivewestuckverymuchwith monitoringandintelligencegathering.idon tthinkanyplayerwasasactiveasthetobaccoindustrywho hiredthousandsoflobbyiststofollow,influenceandthetpdrevision.asflorenceberteletti,directorof SmokeFreePartnership(aBrusselsbasedpublichealthNGOfocusedontobaccocontroladvocacyand research),says,thefactthatthetobaccoindustrywassoscaredmeansthatitwasastrongproposaland averyfiercediscussionandrevision. SRB:Doyouseethisprocessbeingmarkedlydifferentfromotherpolicyareasintermsoflobbyism? EPAA:Idonotknow,asIamnotinvolvedinmanyother hardcorelegislations duetoitbeinga competenceofmemberstatesintermsofhealth.tobaccoindustrylobbyingisdefinitelyveryheavyand aggressiveincomparisontotheusualareas,suchasclinicaltrialsforexamplewhereyouhave pharmaceuticalcompanieswhoareveryactive,buttothepointofaggressiveness/nastiness,theydo notshownearlythesameextent.eryfewpeoplewanttobeassociatedwiththetobaccoindustry,this howeverdoesnotmeanthattheywillnotactontheirbehalf/accommodatetheirasks. 140

141 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Thisalsoleadsmetothearticle5.3oftheFCTC(ontobaccoindustryinvolvement),sowestart wonderinghowmuchthetobaccoindustryshouldbeallowedtobeinvolvedandtheirconflictof interestwithregardstospecificcommercialinterestsversushealth.therefore,iwoulddefinitelysayyes toyourquestion;tobaccolegislationismuchdifferentfromotherhealthcareareas,asitincludessuch heavyeconomicplayersasthetobaccoindustry,andeventhoughmostpeoplewouldnotwanttobe associatedwithtobaccoindustryofficiallyor inthebooks,alotofpeoplestillare. SRB:Movingbacktowhatyousaidearlier,yourclientwasquitehappywiththefirstdraftoftheTPD revision,whichwasveryprogressive,ifyouwill.comparedtotheoutcomeoftheactualrevision,which somesuggesthavebeen watereddown tosomeextent,howdoyouseetheoutcomefromyour personalperspectiveandthatofyourclient? EPAA:Frommyclient sperspective,itwasfairlyok.therewassomewateringdownforexamplein termsofthesizeofthehealthwarnings.here,thewhogoldstandardis80%,anditwasfixedat65% comparedtothe75%,whichwasoriginallyproposed.thus,therewassomewateringdowninarea,but itwasstillbetterthan50%andfrommyclient sperspective,thiswasthemajorloss,ifyoucanevencall itthat. Frommypersonalperspective,knowingtobaccocontrolandthemeasures,forexamplealso understandingwhatthetobaccocontrolcommunitywouldhavelikedtosee,themajorlosseswerethe transitionperiodsformentholcigarettesandslimcigarettesforexample,andifiremembercorrectly, theslimcigarettesarestillallowed.thisiscertainlysomethingthatisstillveryappealingtochildren,and tomyknowledge,itwasstronglobbyingfrompolandthatensuredthisallowance.anotheraspectwas thecrossbordersaleoftobaccoandpointofsaleadvertising,whichwasalsowatereddownfromthe originaldraft. Intermsoftheecigarettes,Idonotreallyhaveaposition.Idonotwanttobebiased,butIdothinkthat theyoughttoberegulatedaspharmaceuticalproducts,becausetheyunofficiallyclaimtobecessation orreductiontherapieswithouthavingtogothroughclinicaltrialstoproveit.iamjustafraidthatwe havecomethisfartodenormalisecigarettesandtheactofsmoking,andweseriouslyriskthate cigarettesandtheactofvapingwillundowhatwehaveworkedforsomanyyearsintobaccocontrol advocacy.whetherpeoplewillactuallycraveastrongernicotinedosageorwhetherecigaretteswill leadtostopcigaretteuse,iamnotsure,butfromthispointofviewitisputtingtheactofsmokingback tonormality,thusundoingtheworkofdecadesoflegislation. Thereareofcoursecertainareas,whichIhavenottouchedupon,suchastrackandtracing, positive/negativeingredientlistsforapprovaloftobaccoproductsandthesekindsofthings,butithink thatthekeyareasaredefinitelyflavouring,slimcigarettesandtheregulationofecigarettes,aswellas crossbordersalesandthetobaccodisplayban. SRB:Ok.Iagreethatespeciallyforthecrossborderissues,itisspecificallyconnotesthetradeoffinthe EuropeanUnionbetweenthesinglemarketandeconomicinterestsversusthepublichealthaspect.Of course,theeucompetencewithinhealthissmallduetothesubsidiarityprinciple 141

142 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EPAA:Yes.IthinkthatMemberStatescanactuallybanonlinesales,butwhatisthepointofIreland,UK andfinlandbanningit,ifyoucanstillbuyitonfrenchwebsites.itisalwaysthatfinelinebetween everyonehavingtoincludeapictorialwarningontheirpacks,buttherearestillmemberstatesthatcan gowithplainpackaging.wheredoesthatleavememberstatesthatdonotimplementplainpackaging, likewhenromaniastartedadoptingthepictorialwarningsalongwiththeukandbelgium,withoutany othercountriesdoingthesame?youalwaysfeellikethereisacertainpointyouarecatchingup,buti thinkpeopleunderstandthatweneedtobeprogressiveandgetthemassesusedtoacertainthing,and thenmoveontomorestringentprovisions.itisalwaysdifficultbecausewearetalkingaboutthe tobaccoindustry,whichisverypowerfulandresourceful. SRB:Alright,thankyou.Movingon,Iwouldliketoassessthelinkbetweentobaccoandalcohol,asthese canbearguedtobesimilarriskfactorsandusuallypooledtogetherwhentalkingaboutprimaryrisksfor chronicdiseasesamongothers.iknowthatyouhaveworkedwithinalcoholforanotherclient,andthus inyouropinion,canthesetworiskfactorsbelinkedtogether?anddothecoalitionsandinterestsdiffer withinalcoholandwithintobacco? EPAA:Steppingbackalittlebit,Iwouldmakethedifferentiationbetweenalcoholandtobacco.Iagree thattheyarebothmainriskfactorsforchronicdiseases,andsometimestheyevengohandinhand. However,fundamentallyIthinkthatthereisadifferencebetweenalcoholandtobacco.Thisismyvery noninformedopinion,butidonotconsiderthatthereisasafelevelofsmoking,sonomatterhow muchorhowoftenyousmoke,youcanexperiencewithdrawalsymptomsonceyoudonotsmoke becausenicotineissuchanaddictivesubstance.withalcoholyoucanhaveasafelevelofconsumption, ofcourseleavingouttheexamplesofalcoholdependencyandaddiction.asnormal,healthyindividuals youcanhaveanormal(oroccasionalexcessive)levelofconsumptionwithalcoholwithoutassuming dependency,whichisnotthecasefortobacco.forme,thisisthekeydifferentiationintermsof products,andthisyoucanalsoseefrombothpolicyandcoalitionside. Intermsofcoalitionswiththehealthcarecommunity,ontobaccocontrolIseethatweareallonthe samepage,agreeingthatthereisacomprehensiveapproachtotacklingtobacco(thatincludeslabelling, taxation,treatment,educationetc.).withalcohol,workingwithmyclient,youhavepeopleevenwithin anorganisation/ngothatareeithertotallyabstinencefocusedoragreetoacertainsafelevelof consumption.inadditiontothis abstinenceversussafelevel,thealcoholcontrol/healthcommunity furtherdividesitselfamongthosethatrecognisetheneedforanintegratedapproachtoalcoholpolicies coveringalcoholexcessiveconsumptionanddependency,andthosewhoonlyfocusontaxation, labelling/nutritionandexcludethedisease/treatmentaspect.thatisalsoadifferenceinoticewhile workingwithbothproducts:myclientworkingontobaccocontrolwillacknowledgetheneedfora comprehensiveapproachandwillequallycallformeasureswithintaxation,educationandforexample smokefreeenvironments,whereasmyclientfocusingonalcoholdependencemaynotnecessarilygo asbroadandallencompassingandtendstofocusmoreononepolicyaspectoftheintegrated approach. Hence,althoughtheproductsattheendofthedaymaybeverysimilartotheharmtheycaninflictupon anindividual,idothinkthattheydifferinthatthereisanestablishedsafelevelofconsumptionfor 142

143 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco alcohol,whichisnotthecasefortobacco.also,althoughthealcoholindustrymaybeaspowerfulasthe tobaccoindustryintermsofresources,itdefinitelydoesnothavetothenotoriousconnotationthe tobaccoindustryhas.youhavehealthmepsfrommajoreucountries(e.g.,france,anditaly)thatwill callforallthemeasurespossibleagainsttobaccobutwilltakeamoremoderateapproachtoalcohol (andonlyfocusonexcessiveconsumptionsvs.theproductasawhole). SRB:Alright,soyouseethisastheprimaryreasonforwhywehavenotseenalcohollegislationtothe sameextentastobaccolegislationintheeu? EPAA:Ibelieveso,yes.However,we,asasociety,seemtobemovingintoamoreconsciousandhealthy approachtolifestyle,empoweringourselvesonthechoiceswemakethatmayimpactourhealth.as such,althoughwewillprobablyseemoreandmorelegislationonexcessivealcoholconsumption,ido notthinkthatwewillexperiencethesamelevelofrestrictivenessandcomprehensivenessaswehave withtobacco(includinganarticlespecificallycallingongovernmentsnottodealwiththeindustryon healthmatters,asitisthecasewithart5.3ofthefctc). SRB:SoyoudonotexpectaWHOframeworkconventiononalcohol? EPAA:Icouldseeitcoming,butIamhesitanttosaythatitwouldbeacopypasteoftheFCTC.WHO alreadyhasactionplansandstrategiesforharmfuluseofalcohol,andcouldbemovingclosertoa framework/healthtreatyonalcohol.however,idonotthinkthatitwouldbeasstringentand health/onesided asthefctc.themediterraneandietrecommendsaglassofwineeverynowand then,soimmediatelythereyouhavealongwaytogotogettothatstage,ifyoueverwill(whichi doubt). SRB:Ok,thankyouforthatperspective.Ijusthaveonefinalquestiononthetobaccoindustryas comparedtothealcoholindustry.yousaidbeforethattheyseemsimilarinstrengthandresources,but hasthetobaccoindustrymadeanymistakes,hencewhywehaveseentheextentoflegislationfor tobaccoasopposedtoalcoholwithinthelast1015years? EPAA:Thetobaccoindustryhasfailedtoaccountfor,oratleastunderestimatedseverely,thepowerof healthadvocatesincludingpatientgroupsandngos.ithinkthatthealcoholindustryhaslearnedfrom thatmistakeinthesensethattheyareratherattentiveandunderstandthepowera simple health advocatecanhave.however,inthatperspective,ialsothinkthatthealcoholindustrytakesadvantage ofalessunifiedhealthcarecommunity,becauseasmentionedearlier,withinthetobaccocontrol discussion,thehealthcarecommunityisverystrongandunited,eventhoughyouhavesectionsofthat communitythatwillbeproharmreduction,sofavouringecigarettesandaddictiontonicotinebutnot smoking.thistosay:eventhoughyouhaveexceptionstotherulewithinthiscommunityaswell,itisa verystrongandunifiedcommunity,nomatterwhetheryougotofrance,ukorbrussels.consequently,i thinkthatthealcoholindustryhaslearnedtoplaywiththe cracks inthehealthcarecommunityon alcoholabuse.finally,asoneseesmoreandmore,thealcoholindustryisprofilingitselfasasolution orientedstakeholderandcontributingtothehealthdebatewith selfdriven initiatives,wellreceived bysomestakeholders.thealcoholindustryisnotas bad asthetobaccoone,itsproductsisnotas 143

144 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco harmfulandyetitisstillpositioningitselfinamatterthatthelegislatorsandthecommunitycannot reproachthem(bytakingon responsible initiatives). 144

145 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription! Interviewwithemployee,WorldHealthOrganization(WHO) 145

146 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription(of(interview(with(employee,(World(Health(Organization((WHO)( FollowingisatranscriptionofaninterviewconductedwithanemployeeattheWorldHealth Organization(WHO)on14April2015.Theidentityandpositionoftheindividualisknowntothe authors. Comments,whichhavenothingtodowiththetopicofthepaperhavenotbeenincluded,hencethe transcriptionbeginsandendsabruptly. SRBstandsforSimonRedderBerthelsen. EWHOstandsforEmployeeattheWorldHealthOrganization. ***** SRB:CanyoubrieflyintroduceyourselfandyourworkatWHOEurope? EWHO:IamtheProgrammeManagerfortheAlcoholandIllicitDrugsunitoftheWHOEurope,aswell asprogrammemanagerforaprogrammeonprisonhealth.theseprogrammesareplacedwithinthe divisionofnoncommunicablediseases.ihavebeenwithwhosince2001,andbeforethen,iwas workingforthenationalboardofhealthandforcopenhagenuniversity.iamaphysicianwitha postgraduatespecialisationinpublichealthmedicine,andiholdadoctor sdegreeindisease prevention. SRB:WhatisWHOEurope srolewhenitcomestopreventingalcoholrelatedharm? EWHO:WHOisdividedintosixregionsandWHOEuroperepresentstheEuropeanregioncovering53 MemberStates.WehaveofcoursethesamemandateandroleoftheWHOingeneral,butonalcohol wespecificallygiveguidancetomemberstates.atthemoment,wefocusonimplementingboththe globalstrategytoreducetheharmfuluseofalcohol,butalsotheeuropeanactionplanfrom Wealsohaveonalcoholaroleinmonitoringalcoholconsumptionandharm,aswellasthepolicy responsesinourmemberstates.assuch,wehavecollectionofdata,makingreportsandcollectingand publishingevidence,andalsoprovidespecificguidancetomemberstatesmainlywhenrequested. SRB:SoitisrecommendationstoMemberStates,whichtheycanthenchoosetofollow? EWHO:Yes,becauseourresolutiondoesnothavea treatystatus,soitcanonlybeusedasguidance, eventhoughithastogothroughanadoptionprocessetcetera. SRB:Ok.Canyoubrieflysumupwhatyourmainasksarewhenitcomestoalcohol?WhatdoesWHO Europebelievearethebestbuys? 146

147 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EWHO:Inouractionplan,wehavethesameactionareasasintheglobalstrategy.Theseareleadership andawareness,whichmeansthateventhoughwho sonlycontactinthememberstateisthenational ministryofhealth,wedonotbelievethattheministryofhealthcanworkonalcoholalone.ithastobea multisectorialaction,sodifferentstakeholdersmustbeinvolvedatnationallevel,inordertomake effectivepolicies.thiscouldbetheministerofeducation,taxation,agriculture,justiceandsoon. WhatwedoinMemberStatesisthatwehelpthemsetupcommitteesanddraftinggroupsformaking nationalpolicies,helpthemandprovideadvicewhentheyhaveadraftpolicy.sometimeswestartthe processbyorganisingroundtables,smallconferencesormakenationalreportsonthesituation, comparethecountrywiththeirneighbours,andthatusuallyconvincesthemthatsomethingneedstobe done. SRB:DoyoualsoworkactivelyasWHOEuropewithEUinstitutions,suchastheEuropeanParliamentor theeuropeancommission? EWHO:Yes.WeworkverycloselywiththeEuropeanCommission,andthatisespeciallyinregardsto monitoring.before2006thereweredifferentmonitoringsystemsinplace.evenatwhoeurope,we hadoneatheadquartersandoneinthecommission,andyoucouldforthesameindicatorsometimes evenfinddifferentdatafromthesamecountry.hence,wedecidedtomakeone,unifiedsystem,andwe (WHOEurope)nowcollectthesedataforEuropewiththeCommissioncofinancingthiswork.Atleast, theyhavedonesountiltheendoflastyear,andnowwearenegotiatingwiththemanewcontractso wecancontinuethiswork.forthismatter,theyareveryeagertoincludemonitoringandevaluationof thenewactionplanonyouthandbingedrinking. SRB:Goingintothealcohol,weseedifferent players oractorsinvolvedwithinalcoholateuropean level,includingthepublichealthcommunity,patientorganisationsandindustry.whichactorswould youarguetoberelevantateulevel,andwhodoeswhoeuropeworkwith?doyouworkwith everyone? EWHO:No,wedonotworkwitheveryone.OurmainactorsherearetheMemberStates,sothe representativesandexpertsfrommemberstatesaretheonesweworkclosestwith.ofcoursewetryto alsoincludeotheractors,suchasthengonetwork,whomweworkcloselywith.theyarevery importantactors,butwedonotworkwiththealcoholindustry.wedonotbelievethattheindustry shouldbeinvolvedwhatsoeverinpolicymaking.thatisabasicruleofwhothatnoteventhe pharmaceuticalindustryshouldbeinvolved.however,atheadquarterlevel(who)theyareobligedto haveanexchangewith economicoperators,whichtheyhaveonceayear,wheretheymeetand discuss,butalsotheindustryisveryhelpfulinprovidingsomedataonconsumptionespeciallyin countrieswhereothersourcesofreliabledataareminimal.though,wedonotdiscusspolicyor implementationwiththeindustry. SRB:Ok,rathersimilartotobaccoandtheFCTC EWHO:Yes,althoughtobaccoisthestrictest. 147

148 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco SRB:Soitisnotasstrictforalcoholasfortobacco? EWHO:No,butthereareongoingdiscussionsatheadquarterlevelofWHOonhowtoactwiththe privatesector,andthesediscussionsarenotfinalisedyet.itcanbethattherewillbesomeguidancefor alcoholinthefuture,butatthemomentwheneverwereceiveinvitations,whichweoftengetfromthe industry,weverykindlydecline.wecannotriskthatwearenotseenasanindependentorganisationon this. SRB:Ofcourse.Buildingonthis,doyouthenexperiencelobbyism? EWHO:Idonotexperiencethatmuchlobbyismagainstme.Ofcourse,ifIacceptedthese aforementionedinvitations,sayifcarlsberginvitesmetotheirpremises,iwouldpresumethaticould comeinasituationwhereifeltthatihadtopaysomethingback,andidonotwanttobeinthat position. Theindustryitselfofcourselobbiesextensively,especiallyattheEUlevel,suchasintheEuropean ParliamentandintheCommission.Iknowthattheyarealsolobbyingheavilyatcountrylevel,so wheneverweproduceanactionplanorthelike,theindustryalwayshavethedraftandprovide commentstomemberstatesintrackchangesonhowtheyreacttoourdrafts.inthissense,theyare indeedveryactive. SRB:Doyouseeobviouspoints,whereyouhaveopposinginterests? EWHO:Yes.Ifyougototheindustrywebsites,youwillseethattheyalsothinkthatthereshouldbe regulationandalcoholpolicies.however,theyonlyfocusonhighriskgroups,socontrollingdrink driving,controlthosewhodrinktoomuch,givegoodtreatmenttoheavyabusersetcetera.they supporttheseactivities,buttheydonotsupportpopulationbasedapproaches,whicharethe best buys,suchasmarketingissues,availabilityissuesandpricingissues.theseareasarewhereweactually canhavethegreatestimpactonalcoholconsumptionandharm.weknowthis,aswehaveverygood evidencetosupportit.wearenotarguingthatweonlyneedthis;wehaveabroadrangeofpolicy options,butthebestbuysareclearlywithinthesethreegroups. SRB:Ok,sothereasonissimplythatthesemeasuresintheendwoulddecreasetheirprofits EWHO:Yes,Iwouldguessso.Wearealsodifferentinthesensethatwedonotagreethatthereisany healthyalcoholconsumptionora safelevel ofconsumption.oursloganhasalwaysbeen, lessis better,sowedonothavesafedrinkinglevelsandwedonotacknowledgeathresholdandabeneficial levelofalcoholconsumption.thatisalsooneofthethings,whichwewouldliketoinformthepublic about;thatthereisariskwhendrinking,evenatmoderatelevels,althoughexcessiveandbingedrinking istheworst. SRB:Thatisveryinteresting.Ireadalsoonyourwebsite,thatnotevenonedrinkortwoisgoodfor you 148

149 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EWHO:Wehavebetterandbetterevidencetosupportthis.TheoldstudiesshowingtheJshapedcurve (whicharguethatsmalllevelsofalcoholconsumptionarebeneficialforyou)havebeenquestionedalot, amongothersrecentlyinthebritishmedicaljournal,whichhasbeenopposedbytheindustry,although theargumentationinthebritishmedicaljournalisverystrong.ithinkthatforthejshapedcurve argument,thegroupofabstainersareheavilyconfounded,whichyoucannotcontrolfor.itisagroup whereselectedpeoplecouldbethosewhoalreadyfeelsickwithouttheirdoctorsbeingabletoseeit;it couldbethosethathavehadaheavyalcoholconsumptionpatterninthepast.itisthusverydifficultto lookinto,andtoreallycontrolforthatgroup. SRB:SoWHO soverallstanceisthatnodrinkingisbestforyou? EWHO:Yes,ifyouwanttodowhatisbestforyourhealth.However,thereisofcoursealotofculture involved,sowedonotliketopromoteabstentionofalcohol,whichwedowithtobacco,wherewe arguefora smokefreeeurope. SRB:Itjustseems,whenspeakingwithotherstakeholders,thatoneofthekeydifferentiatorsbetween alcoholandtobaccoisthefactthatalcoholinsmalldoses,suchasaglassofwineeveryday,isactually beneficialforyourhealth. EWHO:WHOdoesnotsaythat,because,asIsay,thereisnoevidenceforthis,andcancerratesstarts alreadyfromseroanditisadoserelationship,soeventhoughriskisverysmallatlowlevels,italready hasanimpactfromzeroconsumption. SRB:Iappreciatethatyourareaofexpertiselieswithinalcohol,butlookingalittlebitattobacco,asitis sometimescompared,doyouseesimilaritiesbetweenthesetwosubstances? EWHO:Yes,therearemanysimilaritiesandthepolicymeasuresareverysimilarfortobaccoandfor alcohol,suchasavailability,marketingandpricing.thebestbuysarethusthesame.ithinkthereason forwhytobaccohasseenextensivelegislation,isbecausetherehasbeenmuchmorefocusonpassive smokingalreadystarting2030yearsago.thathasnotbeenthesamewithalcohol,althoughwealso havefiguresnow,whichshowsthatroughly34%ofallalcoholrelateddeathsineuropeisduetoharm toothers.thisincludesadrunkdriverkillinganinnocent,nondrinker,domesticviolenceandsoon.i wouldguess Ihavenotdonethecalculations thatthisisverysimilartotheeffectsofpassive smoking. However,Idonotthinkthatitiseasytogetattentiontothis,andwehavenotyetfoundagoodword forpassivedrinking. SRB:Soyouwouldarguethatalcoholandtobaccoshouldbetreatedmoresimilarly? EWHO:Yes,wellinDenmark,whydowehaveapolicythatbanstobaccoforyoungpeopleunder18 years,whereasforalcoholitisonly16years?becausethisissuchagoodsignalforparentsthatyoudo notwanttoacceptsmokinganddrinkingbeforethisage.itisknownthatifyoucanactuallypostpone smokinguntilafter18years,youlimittogreatextenttheriskofbecomingaddictedtosmoking,asmost smokersstartearlier.ibelievethesametobethecaseforalcohol,soifyoucanpostponethisonsetand 149

150 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco alcoholuse,wecouldsavealotoflives.inaddition,braindevelopmentisabigissueandthebrainisnot developeduntilthe20s,soalcohol,whichaffectsthebrain,canhavesignificantimpact.therefore, therearegoodargumentstoatleasttrytopostponeitasmuchaspossible. SRB:Whydoyouthenthinkthattheyhavebeentreatedsodifferently? EWHO:Fortobacco,wehadmoreevidenceearlierabouttheharmfuleffectsofevenmoderatesmoking levels.wehavenothadthatonalcoholuntilrecentyears,wheretheiarc(internationalagencyfor ResearchonCancer)haveobtainedevidencetosupportthecausallinkbetweensixtypesofcancerand alcohol.assuch,wehavemuchbetterevidencenow. Ithinkthattobaccowasbeforealcohol,becausetherelativeriskishigherthanforalcohol.Assuch,it waseasiertoidentifytheriskfortobacco. SRB:Soyouthinkthatalcoholwilleventuallyexperiencethesamedevelopmentastobacco? EWHO:Itishardtoanswer,becausetheeconomicinterestsfromcountriesandtheindustryarehuge onalcohol.itwasalsofortobacco,butithinkthatitisevengreateronalcohol.therefore,ithinkthatit willbeatoughbattle,andaframeworkconventiononalcohol(similartothefctc)ingeneralwillbe difficulttoachieve.whatcouldpotentiallyhappenistohaveaframeworkconventiononlyonmarketing ofalcohol,whichwouldbesignificantinitself.ithinkthatthiswouldchangealot. SRB:Ok,thatwasactuallyalsooneofmyfinalquestions,becausewehaveseentheFCTContobacco butnothingonalcohol.iunderstandthatyouwouldnotforeseethat EWHO:No.WehaveanumberofMemberStatesaskingforthisoption,butofcourseithastocome frommemberstates,sotheycouldatourregionalcommitteesorworldhealthassemblycomeupwith thisresolution.then,whoeuropewouldbedelightedtolookintoit,butitisnotsomethingthatcan comefromus. WHOEuropehasalsosupportedanewEUAlcoholStrategy,especiallyemphasisingcrossborderissues, likemarketing,pricingandtosomeextent,availability.thiscouldbeanarea,wheretheeucould strengthentheircontrolandlegislation. SRB:SoyousaythatyousupportanewEUAlcoholStrategy.Whydoyouthinkthatitranoutin2012? EWHO:Theysaythatitisstillvalid,becausetherehavebeennonewone.Idonotknowwhyitranout. TheEUjustsaysthatitneedstolookattheevaluation,whichwasdelayedandthentheCommission waschangedafterthe2014elections,soithasbeenpostponed. ItlooksasifthenewCommissionisnotinterestedintakingmanynewtopicsontheagenda,andthusI donotknow,iftheywillrenewtheeualcoholstrategy.thelatvianeupresidency(firsthalfof2015) hasameetingon2021april2015,wherealcoholisontheagenda.latviahasinthisregardproduceda nonpaper onalcoholandtheyverystronglysupportthedevelopmentanddraftingofaneweu AlcoholStrategy.WHOEuropewillalsoberepresentedatthismeeting,andwearesupportingthat. 150

151 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco SRB:Lookinginthecrystalball,whatwouldbetheidealscenarioforWHOEuropeforalcoholintheEU withinthenextdecade? EWHO:WeveryoftenseetheneighbouringcountriestotheEUadoptinglawsverysimilartotheEU,so eventhoughtheeuonlycomprises29countries,itwillpotentiallycovermanymorecountries. Minimumtaxationonalcohol,whichshouldbeadjustedforinflation,becauseitwasnotadjustedsince itwasadoptedforbeerandspiritsin1992,shouldbemuchhigher,sowecouldatleasthavemuchless crossbordersales.thatisabigproblemforcountries,asyouarenotabletoincreaseyourpricesvery much,becausepeoplewillthengotoneighbouringcountries.itisinthisregardalwaysanindustry argument,thatforexampleindenmark,webuysomuchingermanyduetothecheaperalcohol,and theonlyresultingresponsefromgovernmentsistodecreasetaxation.itwouldbeveryusefultohave minimumtaxationalsoincludingwine,aswellassharedmarketingrulesonalcoholproducts.marketing doesnotrespectborders. SRB:AndthedriverforthatcouldbetheEUAlcoholStrategy? EWHO:Yes,thatwouldbefantastic,asWHOEuropecannotdothatandtheEUhasmuchmoredirect contactwithdifferentnationalministries,whereasweonlyhavewiththeministriesofhealth.thus,i thinkthattheeuwouldbeinabetterpositiontoimplementnewlaws,regulationordirectivesonthat. SRB:Ok.IntermsofEU,yousaidthatyouworktogetherwiththeCommissionespecially.Areyou involvedinanyofthealcoholforumsateulevel,suchastheeuropeanalcoholandhealthforum (EAHF)ordoyoucontributetotheCNAPA? EWHO:Yes,IhaveanobserverstatusattheCNAPA,soIamalwaysinvitedandparticipatingintheir meetings.inmostmeetingsiamalsoinvitedtopresent.idonotattendtheeahfmeetings,asidonot seetheinteresthere.sometimesourbrusselsofficeattendsthesemeetings,butwedonotreallysee anyvalueinit.thenofcourseweareengagedinthealcoholpolicynetwork(apn)andiaminvitedto manyconferencesorganisedbyngonetworks,suchaseurocare. SRB:Myfinalquestionrelatestothepublichealthcommunity.Speakingtootherstakeholders,apicture emergesofthecommunitywithintobaccohavingbeenveryconsistentandcoherentinitssupportfor anintegratedapproach.howdoyouseethepublichealthcommunitywithinalcohol?youmentioned thatthealcoholindustryispotentiallyevenlargerandmoreresourcefulthanthetobaccoindustry,so doyouseethepublichealthcommunitywithinalcoholasstrongandcoherentenoughtotakethis battle? EWHO:No.Itdiffersalotfromcountrytocountry,whereweinsomecountriesseeitasveryusefuland inotherslessusefulanddeveloped.idothinkthatthepublichealthcommunityplayanimportantrole bothinpolicymakingbutalsointermsofsupportingpatients.wearehappytoengagewiththepublic healthcommunity,althoughwedonotpromoteabstinence,assomeoftheseorganisationsdo.thisof coursereliesontheassumptionthattheyareindependentfromthealcoholindustry,whichwehaveto besureof. 151

152 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription! Interviewwithemployee,EuropeanAlcoholPolicyAlliance(Eurocare) 152

153 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription(of(interview(with(employee,(European(Alcohol(Policy(Alliance( (Eurocare)( FollowingisatranscriptionofaninterviewconductedwithanemployeeoftheEuropeanAlcoholPolicy Alliance(commonlyreferredtoasEurocare)on9April2015.EurocareisanAllianceofnon governmentalpublichealthandsocialorganisationsworkingonthepreventionandreductionof alcoholrelatedharmineurope.theidentityandpositionoftheindividualisknowntotheauthors. Comments,whichhavenothingtodowiththetopicofthepaperhavenotbeenincluded,hencethe transcriptionbeginsandendsabruptly. SRBstandsforSimonRedderBerthelsen. EEstandsforEmployeeatEurocare. ***** SRB:CanyoubrieflyintroduceyourselfandEurocare sworkandareasofinterest? EE:IhavebeentheSecretaryGeneralforEurocaresincejustbeforeChristmas2007,soinrealityfrom 2008.Eurocare,ortheEuropeanAlcoholPolicyAlliance,whichisitsfullname,isamembership organisationandwehavemembersacross25europeancountriesandaround58organisations.someof thesemembersareumbrellaorganisationsintheirowncountries,andothersaresmallorganisations workingveryfocusedononeissue,suchashomelesspeople,socialproblems,alcoholicsoraddiction problemsingeneral.theorganisationwasestablishedtwentyfiveyearsago,in1990,withthebrussels officebeingestablishedin1996. SRB:Thatisquitealongtime.Areyouinvolvedinalltypesoflegislativemeasuresrelatedtoalcohol,or doyouhaveanyareasofspecificinterest? EE:Ourmainpurposeandvisionistofollowanythingthatisconnectedtoalcohol.Whatourmembers askustofollowisprimarilytheeuinstitutionsandwhatishappeningthere,andreportback.wealso trytoinfluencetheinstitutionstopreventandreducealcoholrelatedharmthroughapopulationbased approach. SRB:Ok.YoumentionthatyoutrytoinfluencealcohollegislationatEUlevel.Howdoyoudothis,and whichactivitiesdoyouengagein? EE:Wetrytoinfluenceasearlyaspossibleintheprocess,asthatiswhereyoupotentiallyhavemost influence.ifyoucomeinlate,itbecomesdifficult.wetrytobeearlyandfollowdiscussions,andwedo thatbyhavingformalmeetings,informalmeetings,organiseeventsourselves,deliverpositionpapers 153

154 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco etc.thepositionpapersdonotalwaysworksowell,soitismoreimportanttohavethisfacetoface contact. SRB:AndthathappenswithboththeEuropeanCommissionandParliament? EE:Yes,itgoesforeverything.ForboththeParliamentandtheCouncil,wetrytouseourmembers,as theycandoitintheirownnationallanguage.fortheparliamentarians,theyaremoreinterestedintheir nationalmembers,thantheyareintheeuropeanorganisations. SRB:Ok.Togetanideaastotheenvironmentinwhichyouoperateasanorganisation,doyouworkin anadvocacycoalition?isawinrelationtotheeuropeanparliamentmotionforresolutiononalcohol thateurocarejoinedforceswithotherpublichealthngos. EE:Yes,wedo.Thevoicegetsstrongerwithmoreorganisationsonboard,sonormallyweworkclosely withotherngosthatareinterestedandsharesameinterests,mainlyonprevention.thenwealsohave thehealthngos,suchastheheartnetwork,thecancerleague,europeanpublichealthalliance(epha), theliverdoctors,medicalassociationsetc.itdependsabitonwhatweareworkingon.sometimeswe alsogetotherorganisationstotakethelead,likesomeyearsagoweworkedwithinjuryprevention,and theytooktheleadratherthanus,whichismuchbetterattimes. SRB:CorrectmeifIamwrong,butEurocareistheonlyspecificallyalcoholfocusedNGOatEuropean level? EE:Yes,wearetheonlyonessolelyfocusedonalcohol. SRB:Doyoualsoworkwithotherpartnersorstakeholdersoutsideofalcohol,forexampletheTTIP discussions?forexample,doyouworkwiththetobaccocontrolngosorthelike? EE:Well,formallyno.Informally,yes.Inaway,tobaccoandalcoholhavealotofsimilarities,butthey alsohavebigdifferences.tobaccocontrolngoshavedoneaverygoodjob,sowetrytolearnfrom themandtrytofollowsomeofthesamethings.someofeurocare smemberswanttocomparealcohol andtobacco,whileothersarguethattheycannotbecompared,sowehavetoworkinthemiddle.there arealotofsimilarities,whenitcomestoforexamplemarketingandlookingathowtobaccomanagedto getcrossborderregulationofmarketing.thereareotherissues,wherethereisalargedifference.you wanttobantobacco,andalltobaccocontrolngoswouldbehappyifallthetobaccoindustrywouldjust disappear,becausethatistosomeextentthegoal.formostofeurocare smembersthatisnotthegoal foralcohol.wedonotwanttogetridofthealcoholindustry.manyoftheeurocaremembersenjoya glassofwineorspiritorbeer,andthatisnotourgoal.youcansaythattobaccoistotallyunhealthy,or thatyouwanttobaccobanned,butthatisslightlydifferentforalcohol,wherewewanttopreventand reduceharm.wedonotwanttogetridofthealcoholindustry.eurocarealsohavemembersthatwant togetridoftheindustry,buttheyareaminority. SRB:Interesting,becausethatactuallyanswersinpartoneofmysubsequentquestions,whichwecan takenow.youseesomedifferencesandsimilaritiesbetweenalcoholandtobacco.canyouelaborateon that? 154

155 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EE:Themainsimilarityisthatbothcauseaddictionandyoucanbecomeaddicted.Themaindifferenceis thattobacco,wewanttogetridofandfromahealthperspective,wedonotwanttohavetobacco. Whenitcomestoalcohol,wearenotthere.Wewanttokeepalcohol,butwewanttokeepitstrictly regulatedandensurethatpeoplearenotharmedbytheuseofalcohol.thatisaquitedifferentissue. Therearesimilaritieshoweverwithinregulationofadvertising,wherewealsowantacrossborderban onalcoholadvertisement,asyouhaveontobacco.anotherareaislabelling,wherewealsowantlabels onalcoholproductswithbothingredientlistingandhealthinformation.wedonotpromotedramatic pictureslikeontobacco,butwewanttohaveinformation.thereyoualsohaveasimilarityand difference,becausewedonotwanttototallybanalcohol,butsimplywantinformationthatismore neutralcomparedtothetobaccoimages. Otherareasagainincludemarketing,availabilityandage,wherewearealongthesamelinesaswith tobacco.wewant18yearstobethelegaldrinkingage,andwewantrestrictedsales,soitisnot available24hours,7daysaweek.licensingandensuringthatwehavestrictenforcementisyetanother area,wherewesharesimilaraskswiththetobaccopublichealthcommunity. SRB:Whataboutwhenitcomestotaxation?WouldEurocarealsolikesomesortofminimumunit pricing(mup)? EE:Itdependsonthecountry.ForScotland,theywantMUPandforthemitwouldbeveryhelpful,and wesupportthat.insomecountries,itwouldbegoodtohaveanmup,butthatshouldreallybeupfor eachcountrytodecide.wedohoweverwantahigherpriceonalcohol,sowhetheryoudoitwithmup, withtaxationorwhatevermeansyouuse,wesupportthemeasuresthatbestfitthenationalcontext. Thatisalsoasimilarasktotobacco,becauseweknowthathigherpricescomesreducedconsumption. SRB:Whydoyouthinkwehaveseensomuchwithintobacco,andnotwithinalcohol?Isitduetothe differenceinproductsorthepublicperception? EE:Yes,Ithinkitisboth.Ithastakenyearstogettothatpoint.Itisreallynotthatlongagothatwe couldsitandsmokeintheairplanes,trainsandbusses.wearetalkingapproximately20yearsago, wheneverybodywassmokingeverywhere,sotheattitudehaschangedslowlyandittakestimetoget thatchange.also,ithinkthatthemessageismuchclearerwhenitcomestotobacco. SRB:SoyouexpectthatlegislationwithinalcoholwillbeforthcomingatEUlevel? EE:Thatdependsverymuchonthepeopleweelect.Withtheparliamentwehavenow,Idoubtthatwe willseestrictregulationonalcohol.jeanclaudejuncker(thecurrentpresidentoftheeuropean Commission)issayingthathewillbebigonbigthingsandsmallonthesmallthings.Ithinkalcohol policywillbeleftverymuchtomemberstates.however,atthesametime,wedidjustmanagetogeta resolutionintheparliament(theepmotionforresolutiononalcohol),whichcallsforaneualcohol Strategyandcallsforregulationonmarketing,MUPandlabelling.Itwasverypleasingtoseethatgo throughintheenicommittee,soyouneverknow.ofcoursewewillfighttogetgoodlegislation through,andwhenitcomestolabelling,ithinkwewillsucceedingettinglegislationatsomepoint. Whenisalwaystheloomingquestion,buteventhebrewers(BrewersofEurope)arenowcallingfora 155

156 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco levelplayingfieldandwilladdintheingredientlisting.whenthebrewersarecallingforit,itwillhappen andwillmoveforward.soonsomeissuestheremightbelegislation,butonothersitverymuch dependsonmultiplefactors. SRB:Inyouropinion,wouldyouliketoseemorelegislationbecomeanEUcompetence,orwouldyou preferitasis,withnationalmemberstateshavingsubsidiarityontheseareas? EE:Aslongasitgetsdone,Idonotreallycarewhereithappens.Whatweoftenhavehappen,iswhenit islefttomemberstates,youwillseesomememberstatesputinagoodpolicyefforttoprotectits citizens.then,theinequalitieswillcontinue,whichisoneareaofconcern.anotherareaofconcernis thatmemberstatestendtousetheeuasanexcuse,sotheysaythat thisisfortheeu,sowewill wait.thereareissueswithinalcoholthatareveryclearlycrossborderissues,suchaslabellingand advertising.fortaxes,itisverydifficultforonecountrytoincreaseitstaxiftheneighbouringcountries donotdoit.wesawthatexampleindenmarknotlongago,wheredenmarkraiseditstaxes,anditdid notlastlonguntiltheyhadtolowerthemagain.ijustdrovethroughdenmark,andittakesonlythree hours,soifiwanttogoshopping,ijustgotoflensburg(ingermany)onasundaytrip.thishappens. Therefore,thecrossbordertradeisreallyaproblemforMemberStates,andthatiswhyIwouldliketo seelegislationateulevel,becauseifyouthenincreaseitacrosscountries,itbecomesthesame situationforeverybody,andyoudonothavepeoplecrossingborderstobuyinaneighbouringcountry. SRB:SothesearesomeofthemessagesthatyouwouldalsoliketoseebeincludedinafutureEU AlcoholStrategy? EE:Yes.IthinkthatthefocusinanEUAlcoholStrategyshouldbeonwhatcanbedonecrossborders. Forthespecialities,itwouldthenbeuptoMemberStates,becausetherearedifferences,suchas differentdrinkingpatterns,culturesandhistories.thatisfine,soeachmemberstatewouldneedtoput inplacespecificlegislation,whichconcernstheircountry. SRB:Ok.TouchingupontheEUAlcoholStrategyagain,seeingasitranoutin2012andwasnot renewed,whydoyouthinkitwasnotrenewed? EE:Yes,thatisagoodquestion.TheinterestingpointisthatMemberStateshavebeencallingforit.The Commissionhasreceivedlettersfrom14healthministersonthematter.Thealcoholindustry,soboth thebrewers,thespiritsandthewinesector,haveallsupportedaneweualcoholstrategy.thepublic healthexpertshavecalledforit.severalindustrieshavecalledforastrategy.itisonlythecommission whodonotwantit,sowhydoesthishappen?idonotknow.inaway,icanunderstandthattheydonot wantallthesesmallstrategies.butthentheydidnotprolongthehealthstrategyeither.ireallydonot knowwhy,anditishonestlyabitweird. SRB:Soitisakindofinstitutionalpreferentialism,withtheCommissioncallingtheshots? EE:ItlookslikeitistheCommissionwhoisdraggingitsfeetanddoesnotwantthework. SRB:AndthathasnotchangedwiththenewCommissioninplace? 156

157 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EE:Well,wearewaitingtoseewhatthenewCommissionisgoingtodo.TheHealthCommissionerhas notsaidthatheisnotgoingtodoanewalcoholstrategy,anditwillbeinterestingtoseewhathewill say,nowthattheparliamentiscallingforit.hehashoweversaidthatheiswaitingfortheparliamentto ask,andalsothatthecommissionwillworkonthechronicdiseaseagendaandputalcoholinthere.the questionis,howthiswilllook,andthattheyhavenotexplainedyet.itwillprobablybeachronicdisease agendaasanoverarchingagenda,buttheythenneedsomethingmorespecificnow,andthereweare stillhopingtogetactionplansandtogetsomethingspecificonalcohol.whatwehaverisenasour concern,isthatifwegounderthechronicdiseaseagenda,itisverydiseaseoriented,andwewantto havethesocialaspectincludedaswell.weshouldgetananswerthisspring. SRB:Ok.JumpingbacktotheEPresolutiononalcohol,whatkindofactivitiesdidyouengageintoget yourmessageacrosstheboard?isawthatyousentajointletteralongwithotherpartsofthepublic healthcommunity,butwhatotheractivitiesdidyouasanorganisationembarkon? EE:WehavehadalotofmeetingswithMEPsandtherapporteurs(draftersoftheresolution)fromall partiesandseveralmembersoftheenicommittee. SRB:Andyouwerepleasedwiththeresolutionasitstandsatpresent? EE:Yes,Iwasverypleasedwiththeresolution.Itwasfarbetterthanweexpected. SRB:Ok.Takinginthecoalitionconceptagain,fromyourperspective,which players orentitieswould youargueexistwithinalcoholintheeu,anddoyouasanorganisationfeellikeyouhave opponents? EE:Therearealwaysdifferentinterests.Wefightalotwiththealcoholindustry.Thenyouhavethe advertisers,andthenyouhavethehospitalitysector,andwedoworkbetterwithsomethanothers.we alsohavethepharmaceuticalindustryofcourse,wherewecanhavealotofplacesofsimilarinterest. Thiscouldalsobethecaseforthehospitalitysectorandothers,wherewecouldworkbetterthanwe do,buttheboardofeurocarehasaverystrictlinewhenitcomestoworkingwitheconomicoperators. Itstrivesverymuchtoremainindependent,sothatisalwaysachallengetobalance. WhenitcomestothepublichealthNGOs,Ithinkthatalcoholwasverylowontheagendaformany organisations.slowlyovertheyears,ithasincreased,andwehaveseenapositivedevelopment.people havebecomemoreawareofalcoholasanissue,andmoreorganisationsaretakingitonboardand followingitup.forus,thatisverypositive. Tobaccohasaverystrongplace,whenitcomestoprevention.Thenyouhavenutrition,alcoholand physicalactivity,andallofthesearemuchlowerontheagendaforhealth. SRB:Youseetobaccoashavingpavedthewayforalcoholtonowbeprioritised? EE:Ihopeso.Also,whathappensnowisthattheworkontobaccoisalmostdone.Thus,peopleneed newfundingopportunities,whichincreasetheengagementonalcohol.thereyoucanseeashiftina way. 157

158 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco SRB:Doyouactivelyworkwiththealcoholindustry,andifnot,why? EE:Itisinourstatutethatwecannotworkwiththealcoholindustry.Whatthealcoholindustryhas donepreviouslyisthattheyhavecreatedtheirownorganisations,andthenforcedtheagenda.the samehashappenedfortobacco,wheretheybuiltthesesocialaspectorganisationsandthentheymake theseorganisationssaywhattheindustrywants.inaway,youcanseethesamewiththe pharmaceuticalindustryandpatientorganisations.alotofpatientorganisationshavefullfundingfrom thepharmaceuticalindustry,andthentheybecomeanindustryvoice,whichtheeurocareboardwas verystrictonnotbecomingforthealcoholindustry.wehavetobetotallyindependenttoavoidbeing acknowledgedwithanindustryvoice. SRB:Youarethenfundedbypublicinstitutionsandfunds? EE:Yes. SRB:Ok.DoyouseetheframeworkaroundtheEuropeanAlcoholandHealthForum(EAHF)asworking anddoyouhaveaconstructivedialoguewiththealcoholindustrythere? EE:Ithinkthattheintentionoftheforumisgood,andIliketheideapersonally.Ifitisgoingtowork well,itneedsastrongleadership,whereweallhavetogiveandtake.wedonotreallydothatinthe forum.thengosdonotgiveandtake,theindustrydonotdoiteither,sowetendtowalkaroundin circles.latelyihavefelt,strongerthanpreviously,thatithasbecomeawasteoftime.unlesswe managetodosomethingconcretelynow;wehaveagovernancegroup,wherewetrytodosomething tomakeitworkbetter,andifwecanmanagethat,thenihaveahope.wewillneverbefriends,butat leastwecouldseesomeprogress,andwedoseesomeprogresswiththebrewersonalcohollabelling andingredientlisting.ithinkthatisgreatandwepraisedtheminapressrelease.iwasattendinga meetingwiththem,andiwasverypleasedtoseeandhearwhattheywanttodonowonthat.ifthey keepthatpromise,iwouldsaythattherehasbeensomerealprogressononeissueatleast. SRB:Partsofmythesiswillcentreonthecomparisonbetweentheindustryandthepublichealth community,andhowtheydifferinapproachestolobbyism.haveyouexperiencedalcoholindustry lobbyismanddoesitdifferfromtheactivitiesyouundertake? EE:Yes.ThealcoholindustrycangototheParliamentandforthespiritssector,theyhaveanopenbar, wheretheygetalotofparliamentarianscomeandgetfreedrinks.thebrewershaveforexamplea culturaleventwithbeer,orthewinesectorinvitestheparliamentariansonatriptothechampagne districtandshowsthemaround,sointotaltheyhavefarmoreinterestingthingstooffer.whenicome totheparliament,itiswithadeadboringdocumentorsomefigures. SRB:Soitisamatterofresources? EE:Yes,itisamatterofresources,butalsoamatterofapproach.Iftheindustrywantstolobbyon something,eventhoughthebrewersofeuropeorspiritseuropeisnotsomuchbiggerthanus,when somethingisneeded,theycanthenbringinheineken,carlsbergetc.,andthosebusinesseshave 158

159 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco resources.theycanthenpullintheirinformation,reports,data,technology,websitesetc.,sotheyhave enormouslymuchmore.icanpullinmymembersaswell,buttheyarepoorandhavenomoney. SRB:Thatleadsmetomyfinalquestion;howdoyouseethepublichealthcommunitywithinalcohol anddoyoufinditstrongandcoherentenoughtobeabletopushbackonthisresourcefulalcohol industry?doyouseeitasanequalfight,ifyouwill? EE:No,Idonotseeitasanequalfightatall.Sinceyouaskedjustnowwiththeresolutioninplace,I thinksometimesthatwearesuccessful,evenwithsmallresources.therewere280amendments,all fromtheindustry,sotherewehadagoodstrategyandthatbecameveryvisible.gettingalsothe ingredientlistingwiththebrewersonboardthisweek,icantrulysaythatwehavesucceededinsome areas.hadyouaskedmebefore,iwouldhavesaidno.itisdifferentfromtimetotime,butsometimes, likeinthepublichealthprogrammefor2014,alcoholwasnotapriority,whichhadenormous consequencesforourfunding.now,wehavebeenlobbyinghardtowardsthecommissiontogetalcohol includedagainasapriority,sowhenthehealthprogrammecomes,ifalcoholisnotinthereasapriority, Iwouldsaythatweareweak,otherwisewehavesucceeded.Youwillbeabletoseethis,ifyouhavenot handedinyourthesisbeforehand. SRB:Iwillkeepthatinmind.Asyoumentionedearlier,yourmemberscanberathersplitintermsof abstinenceversusreductionofalcoholconsumption.comparingtotobacco,whereitisquite straightforwardasyousaidpreviously,doyouseeanyproblemshereinnotgettingthatcoherencein termsofpolicyasks? EE:Ithinkthatitisok.Itisverygoodtohavesomeorganisationsthatareverystrongandwant abstinence,butiamverygladthateurocare,asanumbrellaorganisation,donotstandforthat.europe isnotthereyet,andiamnotevensurethatiwouldwanteuropethere.idonotthinkthattobethe wayforward,frommypersonalperspective.itismoreimportanttogetalcoholwellregulated,soit doesnotharmpeoplesomuch,andsowecanuseitasaguiltypleasureandforenjoyment,likewedo withchocolate. SRB:Sowhencomparingthealcoholandtobaccopublichealthcommunity,doyouexperienceitas beingsimilarintermsofresourcesandcapacity? EE:Ithinkthetobaccocontrolcommunityisstrongerinmanyways.Theyhavebeenaroundlonger,and theyalsohavegoodrelationswithmanyotherngosacrossareas,sotheyincludetobaccoinmany otherareas.further,theyhavefarmoreresources.also,forthepublichealthprogrammefor2014, whichimentionedearlier,tobaccowasincluded,whereasalcoholwasnot.tobaccocontrolstillhasa verystrongplaceinsocietyandinthefundingandresearch. SRB:Itisbothamatteroftimeandresourcesthen? EE:Yes.! 159

160 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription! Interviewwithemployee,SpiritsEUROPE 160

161 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription(of(interview(with(employee,(SpiritsEUROPE( FollowingisatranscriptionofaninterviewconductedwithanemployeeofSpiritsEUROPEon9April 2015.SpiritsEUROPEisaninterestgroupandtheEuropeanrepresentativebodyforproducersofspirit drinkswithamembershipcomprisingof33nationalassociationsrepresentingtheindustryin25 countries.theidentityandpositionoftheindividualisknowntotheauthors. Comments,whichhavenothingtodowiththetopicofthepaperhavenotbeenincluded,hencethe transcriptionbeginsandendsabruptly. SRBstandsforSimonRedderBerthelsen. ESstandsforEmployeeatSpiritsEUROPE. ***** SRB:Canyougiveabriefintroductiontoyourselfandyourorganisation? ES:IhavebeenworkingwithSpiritsEUROPEforfouryearsnow.Here,Iaminchargeofwhatwecall spiritsandsociety,relatingtocorporatesocialresponsibilityinthebroadsense,butiamnotdealing withenvironmentalissues,asthoseareverytechnicalinoursector.oneofmycolleagues,whoisa scientist/engineer,isinchargeofenvironmentalissues,whereasidealwitheverythingthathastodo withresponsibilityinthebroadsense,includingcommercialresponsibility,advertisingstandardsand rulesforexample.thisalsoincludeseducation,prevention,consumerinformationfromahealth perspective,butnotfromatechnicalpointofview,suchasadditivesandingredients.whenyoubuya fridgeoramicrowave,youaregivenanoticetohandle,andmyjobistodevelopanoticetohandle alcoholforpeoplebuyingourproducts. Ourmembershiprepresents33nationalorganisationsacrossEurope.Thisdoesnotmean33countries, becauseinsomecountries,wehaveseveralassociationsandinotheroftheeu28countries,wedonot haveamember.werepresentbyandlargethespiritsproducingindustryineurope,sowhenwehave twoassociationsforexample,itisincountrieswherethereisageographicalindicationthatrequiresa specificprotection.soinfranceforexample,wehavethefrenchspiritsfederation,whichrepresentsall thetraditionalfrenchspirits,butwealsohavethebureaunationalinterprofessionelducognac,who representsspecificallycognac,whichhasitsownspecificitiesandregulations.itissimilarintheuk, wherewehavethewineandspiritstradeassociation,aswellasthescotchwhiskyassociation.the geographicalindicationelementsandspecificitiesoftheproductcategoriesexplainthenumberof memberswehave.ontopofthose33nationalassociations,wehaveagroupofeightcompanieswho arememberstoo. SRB:Ok.Isitcorrectlyunderstoodthatyou,asanorganisation,dealwiththeentirespectrumofareas relatedtoalcohol? 161

162 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco ES:Yes.Weareasmallsecretariatof78personshereinBrussels,soIaminchargeofallthehealthand consumeraspects.ihaveacolleaguewhoisinchargeoftheinternalmarket,sothisincludesthe technicalregulationandmovementofgoods,whichimentionedbefore.anothercolleagueislookingat externaltrade,whichincludesfreetradeagreementsandmovementofproductsbutonaglobalscale. SRB:BeingbasedinBrussels,doyoualsoworkwithpolicymakersanddoyouengageinspecific advocacyactivities? ES:Yes,thatispartofmyjob.Youcandivideitinthreeparts;onethingistheservicesweprovidetoour members,beittraining,capacitybuildingorsupport,whichinmyareawouldbeforprevention programmes,educationandinitiativesthatmemberswouldliketotakepartin,relatingtoconsumer informationetc.wewillhelpthemsetupthings,wherewewillprovidememberswiththeopportunity toexchangeinformationwithpeoplewhohavedonesaidactivitypreviously.wealsoorganisedbest practiceexchangemeetings,formemberstobasicallylearnandgetbetteratthejobtheydoatnational level. Theothertwopartsaremorerelatedtointerestrepresentationandlobbying.Ontheonehand,this includesexplainingtoourmembershipallthedecisionsandactivitiesgoingoninbrusselsthatcould impacttheirbusiness,becauseitdoesrequiresometranslationintolayman stermstoexplainthe impactitcanhaveontheirbusinessandoperations.thethirdpartisgatheringtheviewsofour memberstocometoapositionforthesector,andthenrepresentthatpositionwiththecommission andtheparliament,aswellastheoreticallythecouncil,eventhoughthecouncilisverynational,sowe donotreallyintervenehere.weareverymuchinadialoguewiththecommissionasthevoiceofthe spiritssector,andthenintheparliament,whenthereisaneed. SRB:SoifwetakeforexampletheCommission,doyoufocusontheHealthCommissionerthen,ordo youhaveworkingrelationswithothercommissionareasaswell? ES:MycolleaguewhoisinchargeoftheinternalmarketwillbeworkingmorewithDGAgri(Directorate GeneralforAgriculture)onallthetechnicalregulationsfortheproducts,andhewillbeworkingwiththe DGsfortheinternalmarketandenterprises.MyothercolleagueisworkingverymuchwithDGTrade, becauseitfollowsallthefreetradeagreementsandhowthemarketopensupfortechnicalandnon tariffbarriersetc.thedgsimostlyworkwith,isdgsanté(dgforhealth),formerlydgsanco.also, marginally,iworkwithdgcnect,becausetheyareinchargeofallthemediaandadvertisingdossiers, soifolloweverythingthathastodowithadvertisingregulationandconnectedmediaaswell. InalltradeassociationshereinBrussels,youwouldsplittheDGsonthecompetencesthatyouhave,so youwouldmaybefollowoneortwodgsandonetothreecommitteesintheeuropeanparliament, whichareofmostrelevancetoyourworkanddossiers.withthecommission,wehavespecific structureddialoguegroups,whichexistsontechnicalissueswithmycolleagues,andformyareas,the EuropeanAlcoholandHealthForum(EAHF),whichisamultistakeholderplatformwhereyouhave representativesfromtheproducers,thebrewers,thewinesector,thesupplychain(retailersand supermarkets),advertisingindustryandthemedia,andthepublichealthcommunity.thepublichealth 162

163 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco communityisalsoverybroad,becauseitrangesfromregularhealthrepresentation,suchasdoctors,to thenordictemperancegroups. SRB:Itmustbesomeratherinterestingdiscussionsthattakeplaceintheforum ES:Itisaninterestingdynamic. SRB:Icanimagine.Inthisregard,doyouworkinanyadvocacycoalition,anddoyouhaveacoalitionof differentgroupsthatyouworkwith,suchasthebrewersofeuropeetc.? ES:No,notreallycoalitions,butmoreonanadhocbasis.TheEAHFisamultistakeholderforum,sowe dodiscussthere,underthechairmanshipofthecommission.anothergroupiscommissionled,the EAHFGovernanceGroup,wherewediscussissuesofgovernanceoftheEAHF.Allmembersoftheforum havetohaveacommitmentandreportonit,andthereisacharter 43 onwhichinteractionmustbe based.inthisgroup,wearetryingtodiscussthecurrentapplicationofthischartertogetherwiththe brewersandthewinesector,aswellasthengos.itisalooseallianceandonanadhocbasis.for examplewhenthereareadvertisingtechnicaldossiers,iwillbuildontheexpertiseoftheadvertising andmediarepresentatives,whowillthenbriefme,andwewillattendthemeetingtogether,asthey havethetechnicalexpertise.itisnotreallyacoalitioninthebroadsense,butmoregettingknowledge whereitis,basically. SRB:Sokindofanadhocapproach ES:erymuchanadhocapproach.Areyouinterviewingrepresentativesfromotherfederations?Ifso, theywilltellyouthatbrusselsisasmalleububble,sopeopleknoweachotherandthereareusually fewpeopletodoalotofwork.wetendtouseeachother sassetsandexpertiseondossiers,soidonot havetolearnthemediatechnicalregulationsinoneday,butjustcalltherightpersonandheprovides mewiththeinformation. SRB:Iamtryingtogetawidegroupofinterviewees,butIhavenotbeenincontactwithotherindustry federations.atleastnotyet. ES:Itisinterestingforyoursubject.SomeNGOsalsocometogethertodealwithawidearrayofissues basicallyalcohol,tobaccoanddrugsinthesamegroup.theytendtoapplythesamemethodtodifferent problemswhereasthatisnotatallhowweseeit. SRB:Iwillactuallygetbacktothatalittlelater,butjusttofinalisemycoalitionquestion,yousaythatit isverymuchonanadhocbasis.iknowthatyouarenotworkingspecificallyontheexternalaspects relatedtottipforexample ES:Well,mycolleaguefollowsit,butwealreadyhaveverylowtariffsonspiritsandtradewiththeU.S.is notwherewehaveproblems.wehaveproblemswithothercountries,whoareprotectingtheirlocal

164 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco industryandputtingtariffsthatare throughtheroof inordertopreventeuropeanproductsfrom enteringtheirmarket,butthatisnotthecasewiththeu.s. SRB:DoyouhaveanybestandworstcaseswithintheEUintermsofcountries? ES:Itdependsonthetopic.Itiscyclicalandvariable,anddependsonwhatyouarelookingat.Ona numberofinternalmarketissuesandsemiprotectionismissues,hungaryhaspoppedupquiteafew timesrecentlywithtechnicalregulations,whichcouldbeconsideredasdisguisedmeasurestointerrupt theinternalmarket.otherissuesofdiscriminatorytreatmentbetweenproductsincludecountriesthat givepreferabletreatmenttobeerincomparisontowineandspirits,becausetheyhaveaverylarge brewingindustryinthatcountry. SRB:Ok.Iamalsojustthinkingaboutnationalregulation,becauseFranceforinstancehastheLoiEvin (nationalalcohollegislation),soitseemstodifferalotbetweenthedifferentcountries.youdonothave agoldstandard,whichyourefertoforcountriestofollow? ES:Itisdifficulttosay.Allnationalregulationexistsbecauseofanationalcontext,soitisdifficulttocast thatjudgement.however,objectively,itistruethatthesituationortheperceptionofourproductsby theswedishgovernmentforexampleandthetreatmentgivenbytheitaliangovernmentforexampleis notatallthesame,butitcomesfromahistoryofreligious,politicalandsocialhealthmovementsover centuries.whatisinterestingtodoistoincludeanalcoholharmperspectivetolookatthelevelsof alcoholharminacountrylikefinland,whichhasalmostacompletebanonalcoholadvertising,has taxes throughtheroof,andaverystrictdistributioncontrolsystem,andcomparethelevelofharmas listedbywhoforexample,withthelevelofharmyouhaveinitaly.initaly,thetaxesareextremelylow, alcoholisavailableeverywhere,itispartofthesocietyandculture,anditisadvertised.inallcountries therearerestrictionsonadvertising,whichisnormal,becauseyoucannotdoeverythingwhenyou advertiseaproductlikeours.however,thelimitationsaremuchlessinitalythaninthenordic countries,andyettheyhavelowerlevelsofproblemsandharm. SRB:GoingbacktotheEAHF,youmentioneddifferentactorsor players withinthefield.doyouhave opponents,anddoyoufeel,withanyoftheactors,thatyouarecompletelydifferentintermsof thinkingandasks? ES:Ifyouaresittinginfrontoforganisations,whosesolepurposeistoeliminatealcoholfromsociety,or lookfora neoprohibition kindofapproach,itwillbedifficulttofindacommonground.whenyouare sittingaroundthetablewithorganisationsthathaveagenuineinterestinreducingalcoholrelated harm,thenyoucanfindacommonground.whaticanassureyouisthatmymembersandthepeoplei meetinthecompaniesthatareaffiliatedwithushaveaveryemotionalattachmenttotheproductthe produce.thelastthingtheywant,istobeassociatedwithsocietalorhealthharms.theyseethemselves asbeingabletoeducate,informorpreventtheharmthatcanresultfromtheabuseoftheirproduct.as example,thedrinkdrivingcampaignshavebeengoingonforabitmorethantwentyyears.butallthe issuesrelatedtoconsumereducation,informationandtellingpeoplewhentodrinkandwhenhow muchistoomuchisalsopartofwhattheyeducatepeopleabout.butthisismorerecent.goingbackto 164

165 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco myexamplewiththefridgeandthemicrowave,thatisverymuchwherethespiritsproducersarenow. Theyareputtingalotofeffortsinthewhiskyandcognacstheyproduce,andthoseproductsarenot intendedtobeabused,theyareintendedtobeenjoyed.iftheperceptionofenjoymentisthatyouhave togetdrunk,thisisnotwhattheirproductismeantfor.theproductismadetobepartofsocietyina mature,enjoyableway.theyarenotproducingdrugs. SRB:Ok.Alongtheselines,doyoufindanyEUlegislationinyourorganisationthatyouoppose?There hasbeensomebackandforthregardingminimumunitpricing(mup),advertisingetc.,butdoyouhave anylegislationthatyouactivelyworkagainst? ES:Wewouldbeagainstmeasuresthatdonotchangetheproblemofalcoholrelatedharm.The dilemmawearefacingisthatfromapublichealthngoangle,whichisdrivenbytheverywellfunded Nordictemperancemovements,theproblemistheconsumptionitself,nottheharm.Therefore,they areseekingmeasurestoattacktheconsumptionoftheproduct.fromourangle,aswellasotherpublic healthrepresentatives angle,thosewhoactuallywork ontheground,theproblemisnotthe consumption,buttheabuse.targetingtheabuseefficientlyisnotdoneinthesamewayastargeting consumption.ameasuresuchasmup,whichispresentedasameasuretotackleabuse,isactuallyjusta consumptionmeasure.itaimstoreducetheconsumptionofaproductbyincreasingitsprice.mupis increasingthepricenotthroughtaxation,whichisalegitimateandlegalmean.inthecaseofmup,the moneydoesnotgobacktothepublictothenfundotheractivities. TheproblemwithMUPisthefactthatitisameasurethatdisruptsthemarketandisillegal,butalso thatitisaprofitmarginthatjustgoesinthepocketsoftheretailers.thisissomethingthathasnot reallybeenpresentedinthedebate.themeasureisdisruptive,asevidencedbyasimulationmodelbya universityintheuk,whichpostulatedthatifyoureduceconsumption,youwillreducehospital admissionsandaccidents.themodelthussaythatifyouapplymup,xamountofpeoplelesswillbuy alcoholandthereforeyouwillgetlessdeathsandaccidents.however,ifyoulookatwhathappenedin reallifeintheukfromwhentheystartedadvertisingtheirmodel,consumptionhasdroppedmorein theukthanwhatwaspredictedintheirmodel,buttheproblemsrelatedwithalcoholharmhasnot followedwhatthemodelpredicted.someindicatorsofharmhavegonedown,butothershavegoneup. Itisnotbecauseyouhavelesspeopleoverallinthepopulationthatconsumealcohol,thatyouhave fewerproblems.peoplewhodrinkmoderatelyconsumeless,butthepeoplewhoabusecontinueto drinkatthesamelevelorevenmore,whichmeansthatyouwillcontinuetoincurproblems,even thoughyouhavelesspeopleconsuming.thisiswhatishappeninginthenordiccountries;youhavea verybroadpercentageofthepopulationthatareabstinent,beitforreligiousorotherreasons,but whenpeopledrink,theydrinkexcessively,andthereforeimpactsthepercapitaconsumption.theper capitaconsumptionisthusnotanaverageoftheaverageconsumer,becausemostofthepeopledonot drink.thisistheproblemwehavewiththepercapitaconsumptionmodel,andwhyweopposepolicies thatsolelylookatreducingconsumptioninordertoimpactharmlevels.wehavesufficientexperience nowtoshowthatwhenyouactuallyimplementpoliciestargetingharm,youhaveadirectimpactonit. SRB:Whatwouldyourorganisation sasksthenbe,andwhatdoyouspecificallyproposeinsteadof thesemeasures? 165

166 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco ES:Wehavetheexperiencenow,sotakeforexamplethetwomostpressingsocialproblemsrightnow withalcoholabuse,whichisunderageandbingedrinking,andoftenbingedrinkingbyunderagepeople. Wehavelawsinplacesayingthatitisnotlegaltosellalcoholtominors.Thoselawsareinsome countrieswellapplied,andinotherslessso. Theresponseofthepublichealthcommunityistosaythatthebestmeasuretopreventunderagebinge drinkingistobanalcoholadvertising,asalcoholappealstominorsandthereforeminorswanttodrink andincreasinglybingedrink.thisisforusatypicalpositionthatwewouldchallengefromascientific standpointandwithempiricaldataverifyingit.weknowthatwhatworksisworkingatthecommunity levelwithmunicipalities,thepeoplewhoaresellinganddistributingthealcohol,becauseweare producersandthusnotsellingthealcohol,togetherwithlocalschoolsandtheparentalcommunity embarkonaprogrammetoreduceunderagebingedrinking.sothelicensingauthoritiesandthe distributorswillagreetoaschemewhereyouhavetoshowyouridbeforeyoucanbuyalcohol,aswell asfrequentchecksandsanctionsonthosewhoselltominors,therebymakingthemagreetoimplement theseresponsiblesellinginitiatives.themunicipalitiesshouldembarkinofferingalternativeactivities forminors,becausewhatwesee ontheground isthatwhenpeoplearebored,theytendtositina parkandgobuyabeerorsomethinglikethat.ifyouhavealternativeactivities,suchassports,theyare lessinclinedtojusthangaroundthestreetsanddonothing.then,youalsohavetoinvolvethe prescribersofthebehaviour,inthiscasetheparents,teachersandpeers.forthat,thereareanumber ofevaluatedprogrammesthatexist,whicharebasedonwhatwecallthelifeskills,teachingyoung peopletohavetheconfidenceinthemselvestosayno.thoseprogrammesaredeliveredbytheteacher, theparents,asthesearethefirstpersonstogivealcoholtominors,andthepeers.whenyouhave thosethreeanglesatcommunitylevelsaying enoughminorsaredrinkinginourstreets,inourcity, thisworksandhasadirectimpactonunderagebingedrinking. Advertisingbans,ifjustforthesakeofhavingone,willhavezeroeffect,ifyoudonotlookatthesources ofwheretheyoungpeopleactuallygettheiralcoholfromandwhytheydrink.theydonotdrink becauseofadvertising. SRB:Fromwhatyouaresaying,IunderstandthatyouaresupportingtherecentEUActionPlanonYouth andbingedrinking ,whichthecommissionhasputforth? ES:TheActionPlanwasnotputinplacebytheCommission,butbytheEUCommitteeonNational AlcoholPolicyandAction(CNAPA).ThisgroupconsistsofnationalexpertsnominatedbytheMember States,butitisnotaCommissiondocument,anditistotallyindependent.ItonlyappliestotheCNAPA members,andnottoanybodyelse. SRB:Ok.Soyoudonotdealwiththisgroup? ES:No.ThatgroupconsistsofdelegatesfromMemberStates,includingfromhealthministries,butalso fromnationalpreventioninstitutesorngosincollaborationwithgovernments.theyadoptedthis ActionPlantosaythatamongtheirgroup,whattheywilldointheircountriestohelpreducealcohol relatedharm.itisnotacommissiondocument,anditisnotlinkedinanywaywiththeactivitiesofthe 166

167 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EAHF,whichweregret,becausewethinkthatitshouldhavebeencreatedindialoguewiththeEAHF members. SRB:Mymistake. ES:Itisacommonmistake,andamistake,whichthepublichealthcommunityisverymuchinclinedto make,inordertomakebelievethatthisisinfactaneuactionplan,whichitisnot. SRB:Goodtohavethatclarified.Movingon,asyouareprobablyaware,therewasarecentEP ResolutiononAlcoholvotedthroughintheENICommittee(andsubsequently,plenary).Haveyouhad anyactivitiesinthatregard,suchasmeetingswithmeps,toputforwardyourmessages? ES:Yes,wehave,andImetoftenthemembersofthepublichealthcommunityinthecorridors,who wereseeingthesamepeopleasiwasseeing.itistheruleofthegame.thereasonwhywemetwith MEPsisverysimple;itisanewParliamentwithnewMEPscomingin.IntheENICommitteeyouhave somefamiliarfacesbutalsoalotofnewpeople,andtheywerediscussingaresolutionontheeu AlcoholStrategy,whichstartedin2006andalthoughcarriedthrough,itshouldhavefinishedin2012. Thepeople,whoweretakingadecisiononwhetherornottheEUAlcoholStrategyhasworkedand whetheritshouldcontinueandhow,hadnoexperienceorknowledgeonwhathashappenedinthelast sixyears. WhatwehavebeendoinginthedebateswiththeParliamentarians,isverymuchtogoandexplainwhat hasbeengoingonforthepastsixyears.thestrategyisnotastrategyintheoriginalsense,buta guidancedocument,whichhastwopillars;theeahfandthecnapa.youhadalotofpeoplewho neededtomakedecisionsandgiveguidancewithoutknowingthehistory,soitwasverymuchan informationalmeeting. WehavebeenveryclearalsoonourpositionregardinganewEUAlcoholStrategy.Whenitranoutin 2012,wecameoutwithareportcallingforanewStrategyandgivingdirectionsonit,andwehavesince thenkeptcallingforanewstrategyineupublications,whichyouwillfindonourwebsite.this correspondstowhatihavebeensaying;findingactionswhereitismoreusefulandinvolvingall responsiblepeopleisnecessary.theproblemwecurrentlyfaceisthatalltheactionsareextremely fragmented,andpeoplehavetheperceptionthattheproducersarethesoleresponsible.however,we areproducerswhoproducespirits,wearenottheentirevaluechain;wearenottheonessellingit,we arenotthesupermarkets,wearenotthebars.therefore,alloureffortsgotowardsgettingpoliciesthat firstofallfocusonharm,andsecondofall,inordertoworkonharm,theyhavetoinvolvemorepeople thanjusttryingtoslamtheproducers.somemembersofthepublichealthcommunityseemtobelieve thatifyoueliminatetheproducers,youeliminatetheproblem. SRB:Youtoucheduponityourself,theEUAlcoholStrategy.Whydothinkithasnotbeenrenewed? ES:Ithinkitispurelyaquestionofcalendar.Thereisnoconspiracybehindthefactthattherewasnota newone.ifyoutalkwiththeservicesofthecommission,theywillbeverytransparentwithyou.thelast onestartedin2006,andithad2012asasetdate,whereitwouldbeevaluatedandrenewed,soatthe 167

168 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco endof2012theylaunchedaverybroadevaluation,whichlookedatwhathadtakenplaceatmember Statelevel,aswellasintheEAHF.Theydidnumerousgroupsandinterviews,aswellaschecksand evaluationsofreportsetc.,tocomewithaverycomprehensivereportin2013,whichstatedthatthe prioritiesaretherightones,thatthestrategyhaddeliveredresults,andthatonetheproblemsisthat MemberStatesdonotcollectproper,uptodatedata.Thismakesitdifficulttoconductcrosscountry comparisonsonwhatworksbest.italsogaveacoupleofrecommendationstoimprovethefunctioning oftheeahfandthedialoguewiththecnapa,whichiswhythegovernancegroupoftheeahfwas created.then,inthemiddleof2014,itwastheendofthecommission,becauseinordertocomeup withastrategylikethat,itwilltaketwoyearsataminimum.therefore,itwouldnothavemadesense forthepastcommission,knowingallthepoliticalchangesineuropeandthatsixmonthslater,they wouldbasicallyallchangejobs,wouldembarkuponcreatinganeweualcoholstrategy.thenyouhad theelections,andnowisnow. SRB:SoyouexpectanewEUAlcoholStrategytocomeintoplace? ES:Well,itisdifficultformetosaybecausetheCommissionerwilldecide,butthepublichealth communityhasbeencallingforaneweualcoholstrategy;theeconomicoperators,usincluded,have beencallingfortakingtheconclusionsoftheevaluationandusethatforaneweualcoholstrategy;the ParliamenthascalledfortheCommissiontostartworkonanewEUAlcoholStrategy;andintheendof April,youwillhaveadocumentfromtheCouncilofHealthMinisters(EPSCO),whowillalsoprobablysay tothecommissionthattheyshouldstartworkingonaneweualcoholstrategy. Youknowhowitworks,withtheCommissionembarkingonitanddraftingit,buttheotherscangive recommendationsforthemtostartacting,whichiswhatishappeningrightnow.thenitisuptothe Commissiontodecidewhetherornottheybelievethattheyhaveroomandrelevanceenoughattheir level,orwhetheritshouldbepickedupatnationallevel.itisverymuchapoliticaldiscussionand decision,andinpracticealltheactions,beitonprevention,regulationorrestrictions,isallhappeningat nationallevelsanyway. SRB:Inyouridealscenario,wouldthissubsidiaritycontinue,orwouldyouprefermoreissuesbecome aneucompetence? ES:Itisanecessitytohaveboth.MypositionisthatyouneedaEuropeanframeworkonwhichMember Stateselaborateandmoveforwardwiththetopicsmostappropriatetotheircontext.Ifyoulackthat framework,thenyoubreakupthelevelplayingfield,andyoucanendupwithdisruptivemeasures, whichwillthenbeincompatiblewithcurrenteulaw.whatyouneedateuropeanlevelisaframework foraction,whichgivesthedirectionandpreventsexcessesinbothways. Itisimportanttosaythatwearenotagainstregulation,andinfact,insomecountrieswearesupporting moreregulation.itisjusthavingtherightregulationinplace,whichactuallymakesadifference.weare thefirsttosaythatourproducts,ifabused,cancauseharmandthereforehavetobehandledwith caution.thus,wecannotdoeverythingwewantwithouradvertisinganddistribution,andithastogo viacertainchannelsandrestrictions,whichisperfectlynormalandlegitimate.wearenotcallingfora 168

169 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco totalabolitionofanyregulationofspirits,butinsteadcallingfortherightframeworkandthe appropriatemeasures,whicharemostrelevantatthelocallevel. SRB:SoyouseetheEUAlcoholStrategyastheframeworkthatcouldassistMemberStates? ES:That,forus,isthemostrationalthingtodo.Whenitwasadoptedin2006,itwasquiteground breaking,becausetherewasnothingthereateulevelbefore.itisasoftlawapproach,butitisnota freepass.itissomethingthatyoudiscuss,monitorandevaluate,andthatyouchallengeintheeahf. Youfurtherhaveindependentevaluatorswhogradeandratealltheactionsfromprivateandpublic actors,soeverythingisdonetransparentlyandisaccessibletoeveryone,soitisveryrobustdespite beingsoftlaw. Youhaveanindependentevaluation,whichsaysthattheprioritiesandactionsoftheEUAlcohol Strategyweretherightones.Ithasproducedresults,andalthoughthereareacoupleofadjustmentsto bemade,itshouldbecontinued.wearenotsayinganythingelsethanwhattheevaluationsaid,inthat somethingsneedtobechangedinordertobreakthebarriersthatwehadwiththecurrentstrategyto putmeasurableactionsinplace.measurableisthekeyword,becauseoneoftheproblems,as mentioned,isthelackofcomparablestatistics.letusembarkonsettingmeasurableactions,havethe datatomeasureitandcontinuetoworkonsomethingthatisproventoshowresults.whyrevolutionise somethingthatisproventoshowresults?letuscontinue,letusimproveitandletusintegrateitbetter. SRB:Soyouaresayingthattheevaluation,whichtookplaceaftertheEUAlcoholStrategyranoutin 2012,wascompletelyindependent? ES:Yes.TheCommissionworkedwithframeworkcontractswithconsultanciesforthemtoevaluatethe policiesindependently.theydothisonallaspectsoftheircommissionwork,andtheyhaveadutyto evaluatethepoliciestheyhaveundertaken. TheconsultancythatworkedontheevaluationiscalledCOWI,anditisaverythickandthoroughreport. SRB:Neitheryounorthepublichealthcommunitywasinvolvedintheevaluation? ES:Insomeaspects,yes,becausealargepartofitwasdeskresearchtoassessallthechangesthattook placebetween2006and2012atmemberstateandeulevel.partoftheprocessoftheseevaluations alsoincludesinterviewswithstakeholders,suchasusandthepublichealthcommunity.however,those weredonetogether,sowehad focusgroups withthecommission,usandthepublichealth community,about1012people,wheretheywouldaskquestionsaboutourperceptionsandlearnings.i thinkthatwehadthreefocusgroupmeetings,andtheydidthesamewiththememberstates,where theyintervieweddelegatestorefinetheirassessmentofwhatwasworkingandwhatwasnot. SRB:Alright.Movingtothefinaltopiconmylist,whichisthelinkbetweenalcoholandtobacco,doyou seesimilaritiesbetweenalcoholandtobacco,andwhydoyouthinkthattobaccohasseenmore legislationthanalcohol? 169

170 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco ES:Idonotseesimilaritiesbetweenalcoholandtobacco.Firstofall,becausetheproductsin themselvesaretotallydifferent,withtobaccobeingharmfulfromthefirstcigaretteyoutake.withour productsorthebeerorwinethatyoudrink,thatisnotthecase.itistheabusethatistheproblem,and moderatedrinking(2drinksperdaymaximumforwomen,3drinksperdaymaximumformen,and nevermorethan4drinksononeoccasion),whichistheestablished,scientificallybasedlowrisk drinkingguidelines,actuallycausebenefitsonanumberofhealthindicators.thisdoesnotrelateto whetheritisbeer,wineorspirits,butitcomesfromtheethanol,whichisinalltheseproducts.youalso havethesameamountofalcoholinoneglassofspirits,asinoneglassofwineorbeer. Idonotseeanysimilaritiesbetweenalcoholandtobacco.However,wedoseesimilaritiesinthepolicies thatpeoplewanttoapplytothetwoproducts.thisisbecause,andiknowiamgoingtosoundvery cynicalorfrank,butsomeofthepublichealthadvocateswhohavemadeacareerfightingtobacconow havetofindotherjobs,andalotofthemhavemovedtofightingalcoholorhighfatand sugar products,suchassodaorcereal.theyarethesamepeopleandthesameadvocates,sotheyapplythe samemethodstoproductsthatareentirelydifferent.theyarepushingfortobaccostylemeasureson spirits,beer,cereal,soda,chocolateetc.thatisasimplefactandtruthrelatedtojobopportunities. SRB:Ok,becauselookingattobacco,itseemsthatalotmorehastakenplacewithinregulationof tobacco,suchasthetobaccoproductsdirectiveandwho sframeworkconventionontobaccocontrol, whereasalcoholisnotsubjecttothesamemeasures.idohowevergetfromwhatyouaresayingthat youexpectthatitcouldperhapsbesubjecttomorelegislationmovingforward? ES:Youhaveveryactiveandverywellfundedgroupsthatarelobbyingforthat,andarelobbyingfora globalconventiononalcohol,graphichealthwarningsonbottlesandplainpackagingofbeverages.itis amatterofwhetherornotyouthinkthatitwillcomeandifso,when.willtheyhavethepoliticalpower toimposetheirviewonourproducts,orwillthecerealorthesodaandchocolatebarsbethefirst instead?whoknows?youcannotopentheguardianoranothernewspaperwithouttellingyouthat sugaristhenewtobacco,orchocolatebarsarethenewtobacco,orsodaisthenewtobacco.itisafact thatitisthere,butitremainsaquestionofrationaleandtime,sotimewilltell. OnefinalthingIwanttoletyouknowisthatwedonothaveanycontactwiththetobaccoindustry.Iam thinkingaboutthat,becauseyouwereaskingaboutcoalitions.inbrussels,prettymuchnoonetalks withthem,thereisnoforum,thereisnodialogue,andnoreasontoreallyhaveanythingincommonany way. SRB:Ok,sothatgoesbacktowhatyouweresayingaboutalcoholandtobacconotbeingsimilaras products. ES:No,theyarenotsimilar.AsIsaid,theproductsaretotallydifferent,butthepoliciesthatthepublic healthcommunitywantarethesame.weworkmorecloselywiththefoodrepresentativesforexample, suchasfooddrinkeurope.weregularlymeetwithotherfoodanddrinksrepresentativesbeyondthe beer,wineandspirits.thisisbecause,whenoneofthedossiersisbeingdiscussedinthewhofor example,itisusuallytodowithnoncommunicablediseases(ncds),whereweallfallunderthesame 170

171 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco umbrella.whentheyaredoinganupdateonwhatishappeningingenevaorcopenhagen,wherewe arenotsituated,somepeoplecanupdateusonthis.itmakessensethat,whentheydosuchanupdate, theywoulddoitwithallofus,asitisaboutncds,whichrelatestousall.itisnotacoalition,butjust informationgatheringandlooseexchanges.wearemembersoffooddrinkeurope.thatiswhereour interlocutorsfromthesectorandindustrystakeholderswillbe. SRB:Butyoudonotinanywayworkwithtobaccoundersuchanumbrella? ES:No,becausewehavenocommonfilesandnocommonalitiesintermsofproblemsormembership. 171

172 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription! Interviewwithemployee,EuropeanCancerLeagues(ECL) 172

173 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Transcription(of(interview(with(employee,(European(Cancer(Leagues((ECL)( FollowingisatranscriptionofaninterviewconductedwithanemployeeatEuropeanCancerLeagueson 11June2015.EuropeanCancerLeaguesisapanEuropeanumbrellaorganisationofnationaland regionalcancerleagueswithaspecificfocusontobaccoasariskfactor.theidentityandpositionofthe individualisknowntotheauthors. Comments,whichhavenothingtodowiththetopicofthepaperhavenotbeenincluded,hencethe transcriptionbeginsandendsabruptly. SRBstandsforSimonRedderBerthelsen. EECLstandsforemployeeatEuropeanCancerLeagues. ***** SRB:Firstandforemost,canyoubrieflyintroduceyourselfandEuropeanCancerLeagues workand areasofinterest? EECL:IworkfortheEuropeanCancerLeagues,whichhasmembersinmostEUcountries,andIfollow tobaccocontrollegislationintheeu. SRB:AndisEuropeanCancerLeaguesonlyfocusedontobaccoasariskfactor,orareyoualsofocused onalcohol? EECL:No,onlytobacco. SRB:Ok.Inrelationtotobacco,areyouinvolvedinalltypesoflegislativemeasures,ordoyouwork withinspecificareas? EECL:Mostofthem. SRB:DoyoualsoworkwithallEUinstitutions(theParliament,CommissionandtheCouncil)? EECL:Yes. SRB:LookingintotheTobaccoProductsDirective(TPD)alittlefurther,Iwaswonderingifyoucouldlet meknowyourroleinthesediscussions,andwhatlobbyactivitiesyouembarkedon? EECL:Well,inthebeginningitwasmainlyattheCommissionlevel.Ittookquitealongtimebeforewe hadtheproposalofthecommission.idonotknowifitwas2008or2009whenconsultationsbegan, wherewemetwiththecommissionandprovidedreportstothem,butinthebeginningitwasat Commissionlevel.Afterwards,whenitwassenttotheParliament,wehadcontactwiththerapporteur (MEPLindaMcAvan),withMembersoftheEuropeanParliamentofthedifferentpoliticalgroupsandI 173

174 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco wasalsoincontactwiththeirishpresidencyofthecouncilworkinggrouponthetobaccoproducts DirectiveandtheBelgianrepresentativeinthatfield. SRB:Ok.Ifyoudonotmindmeasking,whatwasyourorganisation smainasksandwhatdidyoufocus ontohaveincludedinthetpd? EECL:Wewantedtohave80%pictorialhealthwarningsatthefrontandbackofthepacks.Ispecifically lookedattheillicittradeelements,becausethatiswheremyexpertiselies,sothatincluded amendmentstotheparliament sstanceonillicittrade,whichiwasresponsiblefor. SRB:Inthatregard,didyouworkwithinanyadvocacycoalition,suchaswithotherNGOstoputforward thoseasks? EECL:Yes,theleadorganisationforthecoordinationwasSmokeFreePartnership(SFP),soweworked withthem,europeanheartnetwork,europeanpublichealthalliance(epha)andsomenational organisationsamongothers.assuch,wedidworkinacoalitionoforganisations,yes. SRB:eryinteresting.HowdoyouthenseetheprocessofrevisingtheTPD,becausereadingaboutit, thereseemstohavebeenalotofindustryinterestsinthedirectiveandalotofsuggestedrevisions weredrawnupbytheindustry?howdoyouseethat,anddidyouexperiencetobaccoindustry lobbyism? EECL:WesawthattherewerealotofindustrycontactandplentyofmeetingswiththeSecretary GeneraloftheCommissionandPresidentBarroso(thenPresidentoftheEuropeanCommission),and therewerealotofdelayofthedirectiveattherequestofthesecretarygeneral.wewerenotableto beincontactwiththehighestlevelofthecommission,buttheindustrywascertainlythere,andthey obtainedquitesomedelaysofthedirective.theforcedresignationofcommissionerdalliinoctober 2012hasbeenseenastheirbiggestsuccess,butitworkedmoreagainstthem,becauseattheendofthe day,thecommissionstillproposedthetpd. SRB:Whatareasdoyouthinkweremostofinteresttothem,then?Didtheyjustwantto waterit down,ordidyouexperiencethattheyhadspecificasksaswell? EECL:Yes,theyspecificallyaskednottohaveabanonmentholcigarettesandslimcigarettes,aswellas nottohavepictorialhealthwarningscovermorethan60%onthefrontandbackofthepacks.ofcourse theyalsodidnotwanttohaveplainpackagingorbanondisplaysinthetpd. SRB:Ok,soitwasinsharpcontrasttowhatyouwantedfromahealthperspective? EECL:Yes. SRB:LookingabitmoreattheadvocacycoalitionassociatedwiththeTPD,fromyourperspective,which playerswouldyouargueexistwithintobaccointheeu?doyouasanorganisationalsofeelthatyou have opponents? 174

175 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco EECL:Theindustryconsistsofasubsetofinterests,suchasthebigtobaccocompanies,thesmall tobaccocompanies,theindustryfederations,thedistributorsandretailsellers,thetobaccogrowers,so youhaveawholerangeoftobaccointerestsrepresentedinbrussels. SRB:Anddoyouworkinanywaywiththetobaccoindustry?Atleastwithinalcohol,thereisthe EuropeanAlcoholandHealthForum,whichtriestopromotecollaboration,oratleastknowledge sharing,betweenngosandtheindustry. EECL:Forthisdirective,therewerenojointmeetingsbetweenNGOsandthetobaccoindustry.Acouple ofyearsago,therewasanattempttohavesomethingonsmokefreelegislationtogether,butactuallyit neverhappened. SRB:Interesting.Goingbacktotheindustryversuspublichealthcommunity,howdoyouseethepublic healthcommunitywithintobacco?theindustryofcoursehasalotofmoneyandresources,sodoyou seeitasan equalfight betweenyouandthetobaccoindustry? EECL:Atthetimeofthedirective,youhad27countrieswith27governments,27Commissioners,and morethan750meps,sowiththesmallnumberofngosandpeopleinbrusselsworkingfulltime,ithink atmaximumbetween35people,wehadtofocusverymuchourlimitedresourcesonsomeofthem. SRB:Opposingthattotheindustry,whichwehearhavealotofresources,itdoesnotseemtobean equalfight betweenyouandtheindustry? EECL:Well,wehavetofightwithsomeindividualscomingfromsomeorganisationsagainstallindustry lobbyists. SRB:Iamalsocurious,nowthattheTPDisinplace,whatareyouasanorganisationnowstrivingfor, andareyouasanorganizationhappywiththeoutcomeofthetpd? EECL:Wewantedtohave80%pictorialhealthwarningscoveringthefrontandbackofthecigarette packs,butendeduphaving65%,whichwastheminimumofwhatwecouldlivewith.wewouldof coursehaveappreciatedmore,andalsowedidnothaveabanonslimcigarettes,butoverallwe securedthedirective,andthuscertainlyimprovedthesituation.itcouldhavebeenbetter,butweare certainlypleasedthatwehadthedirective. SRB:Yes,becauseitseems,havingspokenwithsomealcoholNGOs,thattheylookatwhathas happenedfortobaccoandseeitasa goldstandard forwhattheywouldliketoseehappenforalcohol. Doyouhaveanyperspectiveonwhywehaveseensomuchlegislationfortobacco,whereasithasnot beenthecaseforalcohol? EECL:Itisprobablylinkedtotwoelements;forone,thereisnoaddedvaluefortobacco,with consumption,nomatterthelevel,beingahealthrisktoanindividual.foralcohol,itisalittledifferent, asyoucandrinkmoderatelywithnohealthdanger.secondly,thealcoholindustryisperhapsbetter representedindifferentcountries,whilethetobaccoindustryisonlyrepresentedinsome. 175

176 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco SRB:WhichEuropeancountrieswouldyouargueismorepositiveontobaccoindustryasks? EECL:Ifyoulookatthebigexportersofcigarettes,youwillseethatPolandandGermanyarelarge exportersandthusdefendindustryinterests.thesameistrueforcountrieslikebulgaria,romaniaand CzechRepublic.WehadfourcountriesagainsttheTPD,whichwasPoland,Bulgaria,RomaniaandCzech Republic,allofwhichhavebigtobaccointerests.TheonesgoingtocourtagainsttheTPDisPolandand,I guess,theyhavenowbecomethebiggestexporteroftobacco. SRB:Ok.Fromyourperspectiveasanexpertonillicittrade,haveyouseenanychangeswiththerecent EUexpansions?Whereistheillicittradecomingfrom? EECL:WeseethatillicittradeiscomingfromcountriessuchasBelarus,Russia,Ukraine,Moldova,and outsideoftheeu,fromunitedarabemiratesespecially. SRB:WhatmeasurescantheEUimplementtocircumventthis?Iamassumingthatthiswould necessitateaneuwideapproach. EECL:Itisbothanational,EUandinternationalresponsibility.SoitisnotonlyfortheEUtohandle,as cigarettesalsocomefromoutsidetheeu.italsoneedstogothroughtheratificationoftheillicittrade protocoloftheworldhealthorganization,soitnecessitatesactionatalllevels. SRB:Soaskingintoyourpersonalpreferences,wouldyouliketoseehealthandtobaccolegislation becomemoreofaneucompetence,orpreferitasis? EECL:WhereitispossibletohaveEUlegislationitwouldbefine.Whereitisnotpossible,suchasfor plainpackaging,itisappropriatetostayatmemberstatelevel.attheendoftheday,pictorialhealth warningsareenforcedincountrieswithweaktobaccocontrolpolicies,suchassouthernandeastern Europeancountries,whichisapositivethingofEUlegislation. SRB:Doyouasanorganisationworkwithotherpartnersandstakeholdersoutsideoftobacco,for examplealcoholngos? EECL:No. SRB:Inrelationtothedifferencesandsimilaritiesbetweenalcoholandtobaccoasproducts,doyou haveanyinput? EECL:Ithinkthattheantialcoholorganisationsarelesspoliticalandlessagainstthealcoholindustry. Theyaremorefocusedondoctorsandpsychiatristsprovidinghelptoalcoholics,buttheyseelessthe politicalsphereandroleofindustry,whichperhapscouldalsobeanexplanation.40yearsago,thefight againsttobaccowasinthehandsofdoctors,andthatisthecasenowfortobacco. 176

177 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Appendix!!table!1! Textualchangestothe2014TobaccoProductsDirective 177

178 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Table(1( (Textual(changes(to(the(2014(Tobacco(Products(Directive((TPD)( % Source:%Peeters,%S.,%Costa,%H.,%Stuckler,%D.,%McKee,%M.%&%Gilmore,%A.%B.,%2014,%The%revision%of%the%2014% European%tobacco%products%directive:%an%analysis%of%the%tobacco%industry s%attempts%to% break%the%health% silo,%tobacco%control,%0;%1>10,% [accessed%7%july%2015]% % % % % % % % % % % % % % % % % % 178

179 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Appendix!!figure!1! LegislativeprocessundertakentoreviewtheTobaccoProductsDirective (TPD) 179

180 Berthelsen&Kraul M.Sc.InternationalBusiness&Politics,CBS 26/07/2015 Master sthesis InterestMightintheEuropeanUnion:HowAdvocacyShapedEU sstanceonalcoholandtobacco Figure(1( (Legislative(process(undertaken(to(review(the(Tobacco(Products( Directive((TPD)( Source:%Peeters,%S.,%Costa,%H.,%Stuckler,%D.,%McKee,%M.%&%Gilmore,%A.%B.,%2014,%The%revision%of%the%2014% European%tobacco%products%directive:%an%analysis%of%the%tobacco%industry s%attempts%to% break%the%health% silo,%tobacco%control,%0;%1>10,% [accessed%7%july%2015]%% 180