Article Text

Developing more detailed taxonomies of tobacco industry political activity in low-income and middle-income countries: qualitative evidence from eight countries
  1. Britta Katharina Matthes1,
  2. Kathrin Lauber1,
  3. Mateusz Zatoński1,2,
  4. Lindsay Robertson1,3,
  5. Anna B Gilmore1
  1. 1Tobacco Control Research Group, Department for Health, University of Bath, Bath, UK
  2. 2Institute - European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
  3. 3Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
  1. Correspondence to Dr Britta Katharina Matthes; bkm28{at}bath.ac.uk

Abstract

Introduction Historical evidence, predominantly from high-income countries (HICs), shows that the tobacco industry uses a recurring set of arguments and techniques when opposing tobacco control policies. This data formed the basis of a model of tobacco industry political activity known as the policy dystopia model (PDM). The PDM has been widely used in tobacco control research and advocacy and has subsequently been shown relevant to other unhealthy commodities industries in both HICs and low-income and middle-income countries (LMICs). Before it can be validated as a generic tool for researching corporate influence on policy, one needs to determine whether the PDM successfully captures contemporary corporate political activities in LMICs.

Method We conducted semistructured interviews with 22 LMIC-based advocates and used the transcripts as the primary data source. The discursive and instrumental taxonomies constituting the PDM served as the starting point for the coding framework. Using thematic analysis, we combined deductive and inductive coding to ensure we captured all strategies from the PDM and the interviews.

Results This study found that the tobacco industry uses a set of discursive and instrumental strategies that is largely consistent across LMICs and with the PDM. We identified several minor contextual nuances absent from the PDM. Some of these nuances were characteristic to individual countries, while others to LMICs more broadly. They included the argument that tobacco control policies unfairly punish reputable tobacco industry actors, and an emphasis on instrumental strategies centred around maintaining a good image, rather than rehabilitating a tarnished image as emphasised in the PDM.

Conclusions Allowing for the nuances identified in this study, the PDM has been found to be fit for purpose. The revised model should now be tested through in-depth LMIC case studies and could be used to facilitate comparative studies of unhealthy commodity industries’ political activities.

  • public health
  • health policy
  • qualitative study
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Footnotes

  • Handling editor Seye Abimbola

  • Twitter @kathrin_lauber, @ZatonskiMateusz

  • Contributors ABG gained project funding and LR gained ethics approval. ABG, LR and BKM conceptualised the project and designed the interview questionnaire. BKM and LR collected the data. BKM coded the data with KL and MZ as cocoders and prepared the draft manuscript. ABG contributed substantially to the writing of the paper. KL, MZ and LR provided feedback during manuscript preparation.

  • Funding This project was supported by Bloomberg Philanthropies Stopping Tobacco Organisations and Products project funding (www.bloomberg.org). The opinions expressed are those of the authors alone. The funders had no role in study design, data collection, analysis, decision to publish or preparation of the manuscript.

  • Competing interests n/a

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval for the study was obtained from the University of Bath’s Research Ethics Approval Committee for Health (REACH) (Reference: EP 18/19 012).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.

  • Author note Tobacco Control Research Group @BathTR

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.