World Cup "will be as much a festival of alcohol as it is of football" warns The BMJ
Brazil may be favourites to win the 2014 World Cup, but whichever team hoists aloft the trophy on 13 July, the real winner will be the alcohol industry, concludes a special report published in The BMJ.
As part of an ongoing examination of the influence of the alcohol industry on public health, the journal looks at the lengths to which the industry has gone to ensure that the World Cup "will be as much a festival of alcohol as it is of football."
It describes how the UK government was forced to change its licensing laws and how the Brazilian government was persuaded to abandon its long-standing ban on alcohol in sports stadiums - introduced in an attempt to end often fatal violence between rival fans at games.
Brazilian health professionals say the alcohol industry is "running the show" and fear that the changes may become permanent.
The report outlines how lobbying pressure from the alcohol industry has forced a humiliating U-turn by the UK government, which initially refused to relax licensing hours to allow pubs to stay open longer during the World Cup.
At the end of last year, Home Office minister Norman Baker announced he would not be relaxing licensing laws during the tournament, despite a campaign by the British Beer and Pub Association to persuade him to "back Roy's boys" in Brazil.
But within three months, a determined alcohol industry, fresh from its victory over minimum unit pricing, forced the government to "rethink" and by the end of March was celebrating "really great news, which will put pubs at the heart of a great national event."
During a World Cup, the host country must waive tax on any profits made by Fifa's commercial partners, including Budweiser, the tournament's official beer sponsor - leaving them free to walk away with every real they pocket and depriving Brazil of an estimated £312 million in revenue.
Anti-poverty campaign InspirAction calls it "obscene" saying "the price of these tax breaks for corporate giants will be paid by people living in poverty in Brazil."
Further evidence of alcohol's influence came last month, when Budweiser and Coca-Cola, another Fifa partner, persuaded the Brazilian government to postpone plans to increase taxes on beer and other beverages until after the tournament. Bloomberg reported the decision had been made after a meeting between Brazil's finance minister and AB inBev executives - the world's largest brewing company and owner of Budweiser - in the capital, Brasilia.
Public health can also be one of the losers of a World Cup. A recent study found a 37.5% increase in A&E visits due to assaults "often associated with alcohol use" on the days England played during the 2010 tournament. This echoes similar findings from the 2006 World Cup and a Welsh study on admissions after international rugby and football matches.
Budweiser's World Cup sponsorship was recently extended to 2022, meaning that it will be the official beer for the 2018 World Cup in Russia and - depending on the outcome of the current controversy over bribery allegations - Qatar in 2020.
It remains to be seen whether Russian resolve will waver over the World Cup (this year's Sochi winter Olympics were alcohol-free), says the report, but such is the power of Fifa that Qatar, a strictly Muslim country with tough drinks laws, has already agreed to sell alcohol in fan zones at games in 2020.
The industry is adept at getting its way with governments, yet the report points out that sport in France, which banned sports advertising and sponsorship by drinks companies in 1991, appears to have survived intact, casting doubt on the claim that alcohol support is vital for sport.
What is clear, however, is that sport - and especially football - is vital to the health of the drinks industry, concludes the report.
In an accompanying article, Clifford Mann, President of the College of Emergency Medicine, believes a relaxation of licensing laws for the World Cup "sets an unwelcome precedent." He points out that the consequences of alcohol abuse are seen daily in the country's emergency departments.
Those with vested interests, he argues, "must not be allowed to peddle the notion that sporting events are best enjoyed with alcohol and we must certainly reject the argument that licensing laws should reflect sporting timetables and television schedules."
Finally, an analysis article, published on bmj.com last week, explores how government support for the alcohol industry by promoting trade and exports may be jeopardising global health.