T

he branch of the National Institutes of Health that studies alcohol abuse has not funded any new research by outside scientists specifically on the effects of alcohol advertising since its current director took over in 2014, according to a STAT analysis of grants.

At least seven such studies were funded in the decade before George Koob became director of the National Institute on Alcohol Abuse and Alcoholism in 2014. No new grants have been awarded since.

An NIAAA spokesman denied that the institute’s priorities have changed. Koob “has maintained the Institute’s long-standing strategic areas of focus,” the spokesman said, and NIAAA support of research on “epidemiology and prevention, treatment, metabolism and health effects, and neuroscience and behavior have remained at the same level that they were.” He added that “behavioral and social science research to prevent and reduce alcohol misuse remains an Institute research priority.”

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STAT reported Monday that Koob told an alcohol industry lobbying group in 2014 that he would not fund studies on the impact of advertising by a researcher whose work industry objected to. That scientist’s 2015 grant request was denied. To see whether Koob’s vow was carried out more broadly, STAT searched NIAAA’s grants database for funded studies from 2004 to the present.

Koob also made it clear in a January 2015 meeting with that researcher and a colleague that NIAAA would be pulling back from such research. The meeting took place while other NIAAA officials were trying to get the alcohol beverage industry to fund a $100 million study on the health benefits of “moderate drinking.” That has led to concerns among some outside scientists and advocates that NIAAA is choosing what research to fund based not on scientific merit alone but also on whether it aligns with the industry’s agenda.

Starting around 2014 or 2015, “advocates were sensing that times were changing,” said Diane Riibe, executive director of the U.S. Alcohol Policy Alliance, which works to translate research into policies that have been shown to reduce underage drinking. She and three researchers who conduct such “translational science” — that which can be used to inform policy — told STAT that, under Koob, the agency has stepped back from supporting policy-related studies.

That aligns with the priorities of the alcohol industry. It supports work on the neuroscience of alcoholism, which Koob studied before he joined NIAAA. In the early 1990s, said an NIAAA spokesman, Koob received grants of up to $40,000 a year from an industry group to fund his studies, which during his 30 years at the Scripps Research Institute focused on the neurocircuitry of drug abuse and the role of various neurochemical systems in addiction. That research brought him many accolades, including election to the National Academy of Medicine in 2017 and induction into the French Legion of Honor in 2016.

Industry “is happy to study genes and brains” as they relate to alcohol abuse, said one scientist, since those can be used to explain alcohol abuse as a problem that arises from, and can be treated as, individual failings. “But policy research can affect the alcohol industry’s bottom line, so industry hates it.” She asked not to be named for fear of antagonizing NIAAA.

Policy research has long been used to buttress anti-smoking initiatives, such as higher taxes and indoor smoking bans, which have cut rates of smoking more than any individually targeted smoking-cessation therapy. Riibe and others say the same could happen with underage drinking and alcohol abuse. “There is a convincing body of evidence that these policies have a strong influence on drinking behavior, including that of teenagers,” said economist Frank Chaloupka of the University of Illinois at Chicago. Studies have shown that higher alcohol taxes and lower density of liquor stores reduce alcohol abuse, for instance.

During a February 2015 meeting Riibe had with Koob at a drug conference, she said she asked whether NIAAA would sponsor travel scholarships for graduate students to attend an upcoming scientific meeting on alcohol policy.

“We went to the end of a hallway,” Riibe recalled. “His insistent, very forceful reply, was, ‘I can tell you what I will not fund: anything on taxes or anything on advertising,’ It was like he looked at this science that advocates [of stricter alcohol policies] need when we go to legislatures or city councils, and said I want nothing to do with that.” (After going back-and-forth with Riibe over four months, Koob agreed to $10,000 for the scholarships, she said.)

“Our gut sense,” said Riibe, referring to others in the anti-alcohol-abuse community, “is that things changed at NIAAA when he came in.”

Their observation is supported by STAT’s analysis of investigator-initiated grants funded by NIAAA since 2005. Using “advertising” as a key search term, the analysis looked for studies that began before Koob’s tenure and those that began in 2014 or later, and which centered specifically on the effects of alcohol advertising.

The overall number of such projects supported in the recent past is not large. In the years just before Koob’s arrival, NIAAA funded projects on “Alcohol Advertising, Drinking and Driving: A Study of Underage Youth and Adults” (first funded in 2011); “Alcohol Marketing and Underage Drinking” (2013); and “Motivated Attention: Effects of Alcohol Advertising on Youth Drinking” (2012). Projects are typically funded for three years, and all those that were ongoing when Koob arrived continued to receive funding.

One project that did receive additional funding starting last year was a continuation of other research that has tracked people, now in their early 20s, since they were 10 to see what influenced their use of alcohol and drugs. Advertising is just one of many possible factors being examined.

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Emails shared with STAT — and first described in Monday’s story — show Koob telling an industry official in July 2014, “I will NOT be funding this kind of work under my tenure.” The reference was to research by a scientist at Johns Hopkins University, on the effect of advertising on underage drinking, that critics called “anti-alcohol advocacy.” It had been funded by NIAAA three years before, under Koob’s predecessor.

NIH Director Francis Collins said in a statement that his office’s advisory committee “will be looking into” the reported solicitation of funds from the alcohol beverage industry for the moderate drinking study, but he has not commented on Koob’s communications with the industry.

Even critics of Koob and his leadership at NIAAA acknowledge that his preference for studies on brains more than policy could reflect honest scientific disagreement, not the influence of the alcohol industry.

Koob, who declined through an NIAAA spokesman to speak to STAT, had financial ties to the industry during his decades at Scripps, from which he is formally on leave. In addition to receiving industry funding in the early 1990s, from 1999 to 2003, he served on an advisory council of the Alcohol Beverage Medical Research Foundation, which was funded by industry.

He holds significant power over what NIAAA funds with its roughly $500 million annual budget. The institute has an advisory council of outside experts who meet three times a year to make recommendations about research and policy. It also makes the final call on what studies to fund, after subject-matter experts evaluate them for scientific originality, rigor, and other factors.

Koob controls the meetings, said one member who asked not to be identified so as to preserve professional relationships, and sometimes closes down discussions of topics that don’t interest him. Koob has made clear that he doesn’t much care about policy research, such as studies on the effect of lowering the blood-alcohol threshold for drunk driving, the member said. He prioritizes basic biological research, his own field.

Other council members, however, said they felt Koob understood that his role required him to apply lessons learned in the lab. Tom Donaldson, president of the National Organization on Fetal Alcohol Syndrome, said Koob believes in the importance of reducing the stigma around alcohol use disorders.

“I think Dr. Koob is a natural spokesperson for the issues,” Donaldson said. “It seems to me that for him, the outcome isn’t just in the laboratory, but it’s in society and reducing the consequences across lifespan.”

Some groups that interact with NIAAA said they had not seen the agency change under Koob, but said that the appearance of any collaboration with the alcohol industry was worrisome.

“That’s always a little concerning, when you have industries weighing in on studies,” said J.T. Griffin, the chief government affairs officer at Mothers Against Drunk Driving. “I don’t know whether or not that’s happened.”

After Monday’s story, one public health group called for Koob to resign.

“STAT’s story raises troubling issues about his relationship with industry,” said Dr. Michael Carome of Public Citizen. “It paints a very disturbing picture, and I think he should step down.”

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  • Thank you for this excellent and fair reporting. More like this please.
    I note the contrast to some STAT reporting – often regarding pharma and the opioid crisis – which feels narrative-based rather than objective.

  • Why is NIAAA Director George Koob posing for a publicity photograph wearing a white lab coat over a suit coat? Odd, no?

  • The study does not accept healthy volunteers. Participants must be at “high risk for the occurrence of a new cardiovascular disease event.” But the study also excludes individuals who receive dual antiplatelet therapy from participating. This stacks the study in favor of light drinkers faring better than abstainers in cardiovascular risk.

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