Seeking out 'easy targets'? Tobacco companies, health inequalities and public policy

Introduction: The prominence of socioeconomic and ethnic disparities in tobacco use has led to increased policy attention on smoking inequalities in many countries. In 2008 the UK Department of Health held a consultation on the future of tobacco control, including a focus on reducing socioeconomic inequalities in smoking, to which tobacco companies made written submissions. These organisations have historically opposed regulation, favouring a depiction of smoking that emphasises individual choice and downplays broader influences such as industry activities.

Methods: We undertook thematic analysis of submissions from tobacco manufacturers and allied organisations, with particular focus on industry engagement with health inequalities.

Results: Alongside well-established arguments (including defence of individual liberty and challenges to scientific evidence), industry actors adopted and misrepresented the language of health inequalities and the social determinants of health in order to oppose specific tobacco control interventions including tobacco taxation, denormalisation of smoking and cessation support. While industry submissions generally opposed state regulation of the tobacco market, tobacco companies argued for increased government investment in harm reduction products and in countering illicit trade.

Conclusions: Tobacco companies co-opted and misrepresented a social determinants model of health to argue against government regulation of the tobacco market. By drawing on this model, tobacco companies are misappropriating a powerful public health discourse in an attempt to create a false dichotomy between reducing inequalities and regulating of the tobacco market. Such tactics highlight the need for ongoing monitoring of industry attempts to undermine tobacco control policy, particularly with reference to harm reduction.