The Policy Dystopia Model: An Interpretive Analysis of Tobacco Industry Political Activity
Open accessAbstract
BACKGROUND: Tobacco industry interference has been identified as the greatest obstacle to the implementation of evidence-based measures to reduce tobacco use. Understanding and addressing industry interference in public health policy-making is therefore crucial. Existing conceptualisations of corporate political activity (CPA) are embedded in a business perspective and do not attend to CPA's social and public health costs; most have not drawn on the unique resource represented by internal tobacco industry documents. Building on this literature, including systematic reviews, we develop a critically informed conceptual model of tobacco industry political activity. METHODS AND FINDINGS: We thematically analysed published papers included in two systematic reviews examining tobacco industry influence on taxation and marketing of tobacco; we included 45 of 46 papers in the former category and 20 of 48 papers in the latter (n = 65). We used a grounded theory approach to build taxonomies of "discursive" (argument-based) and "instrumental" (action-based) industry strategies and from these devised the Policy Dystopia Model, which shows that the industry, working through different constituencies, constructs a metanarrative to argue that proposed policies will lead to a dysfunctional future of policy failure and widely dispersed adverse social and economic consequences. Simultaneously, it uses diverse, interlocking insider and outsider instrumental strategies to disseminate this narrative and enhance its persuasiveness in order to secure its preferred policy outcomes. Limitations are that many papers were historical (some dating back to the 1970s) and focused on high-income regions. CONCLUSIONS: The model provides an evidence-based, accessible way of understanding diverse corporate political strategies. It should enable public health actors and officials to preempt these strategies and develop realistic assessments of the industry's claims.
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The Policy Dystopia Model and WHO categories of industry interference provide a helpful framework for understanding tobacco control debates in low/middle-income countries as in high-income countries.
“The Policy Dystopia Model and WHO categories of industry interference provide a helpful framework for understanding tobacco control debates in low/middle-income countries (LMICs) as in high-income countries.”
From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [22]
The Discussion (page unavailable) says similar industry strategies are used in developed and developing economies, while cautioning that the studies underlying the model were dominated by high-income regions. The Conclusions (page unavailable) present the model and its taxonomies as useful at national, regional, and international levels. The paper discusses WHO FCTC guidance, but does not present WHO categories of industry interference as part of this framework. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe Policy Dystopia Model can be used to assess tobacco control advocates' strategies to preempt and counter the tobacco industry in LMIC.
“In addition, it can be used to assess tobacco control advocates’ strategies to preempt and counter the tobacco industry in LMIC.”
From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [22]
The Discussion says the model can help public health advocates anticipate and counter industry opposition, and the Conclusions say it can help them plan strategies. But the paper does not say the model assesses advocates’ strategies; it also cautions in the Discussion that its source literature was dominated by high-income regions, limiting certainty about applicability in LMICs. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe majority of the substantial body of literature on TII is based on HICs.
“Furthermore, while there is a substantial body of literature on TII, the majority is based on HICs.13–15”
From Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews (2020) · cites this paper as [15]
The Discussion (page unavailable) says the taxation and marketing papers reviewed were heavily dominated by North American, European, and Australasian sources. The Methods (page unavailable) show that these were selected bodies of literature, so the paper does not establish that a majority of all literature on tobacco industry interference is based on high-income countries. (LLM, conf=0.84)
Experimental — accuracy not yet measuredFar more significant information and financial resources are available to the tobacco industry than to CSOs, and it has greater ability to access key stakeholders, particularly in powerful non-health ministries.
“Far more significant information and financial resources are available to the tobacco industry than to CSOs and it has greater ability to access key stakeholders, particularly in powerful non-health ministries.”
From Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews (2020) · cites this paper as [15]
In Results, under Taxonomies of Instrumental Strategies (page unavailable), the paper describes the industry's extensive information production, financial incentives, and access to senior politicians and civil servants, including interventions that weakened health ministers. It does not establish that its information and financial resources or its access to key stakeholders are greater than those of CSOs, particularly in powerful non-health ministries. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThe Policy Dystopia Model and the six WHO categories of tobacco industry interference were developed using examples largely from high-income countries.
“The Policy Dystopia Model22 and the six categories of tobacco industry interference identified by WHO23 were developed using examples largely from high-income countries.”
From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [22]
The Policy Dystopia Model broadly categorises tobacco industry strategies into discursive and instrumental strategies.
“The Policy Dystopia Model22 broadly categorises tobacco industry’s strategies into discursive (argument-based) and instrumental (activity-based) strategies.”
From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [22]
The strategies the tobacco industry used to interfere with tobacco control policy in Nigeria are similar to documented tobacco industry tactics in high-income countries and other LMIC.
“The strategies the tobacco industry used to interfere with tobacco control policy in Nigeria are similar to documented tobacco industry tactics in high-income countries222358 and other LMIC,3111359–61”
From Role of stakeholders in Nigeria’s tobacco control journey after the FCTC: lessons for tobacco control advocacy in low-income and middle-income countries (2019) · cites this paper as [22]
Politicians' links to tobacco companies enable tobacco industry access to key stakeholders.
“Politicians’ links to tobacco companies also enable such access,15”
From Needs of LMIC-based tobacco control advocates to counter tobacco industry policy interference: insights from semi-structured interviews (2020) · cites this paper as [15]
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- Authors
- Ulucanlar, S., Fooks, G. J., & Gilmore, A. B.
- Affiliations
- UK Centre for Tobacco & Alcohol Studies (GB)
- Aston University (GB)
- Corresponding author
- Ulucanlar, Selda
- Venue
- PLOS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2016-09-20
- Volume
- 13
- Issue
- 9
- Pages
- e1002125
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC5029800
- OpenAlex
- W2522368004
- Cited by
- 252
- References
- 3
- Citations by year
- 2026: 10 · 2025: 25 · 2024: 29 · 2023: 47 · 2022: 26 · 2021: 43 · 2020: 31 · 2019: 22 · 2018: 12 · 2017: 6 · 2016: 1
- FWCI
- 26.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Aston Publications Explorer (Aston University) (acceptedVersion, public-domain)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Explore Bristol Research (submittedVersion, cc-by)
- Funders
- National Cancer Institute of the National Institutes of Health (RO1CA160695)
- Topics
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Global Public Health Policies and Epidemiology
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Social Sciences › Business, Management and Accounting › Strategy and Management › Political Influence and Corporate Strategies
- Keywords
- tobacco industry, corporate political activity, tobacco taxation, tobacco marketing, metanarrative, tobacco control, industry documents
- MeSH terms
- Health Policy, Humans, Models, Theoretical, Politics, Public Health, Nicotiana, United States, Tobacco Industry, Marketing
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