The case for developing a cohesive systems approach to research across unhealthy commodity industries

Cécile Knai; Mark Petticrew; Simon Capewell; Rebecca Cassidy; Jeff Collin; Steven Cummins; Elizabeth Eastmure; Patrick Fafard; Niamh Fitzgerald; Anna B Gilmore; Ben Hawkins; Jørgen Dejgr ard Jensen; Srinivasa Vittal Katikireddi; Nason Maani; Nicholas Mays; Modi Mwatsama; Rima Nakkash; Jim F Orford; Harry Rutter; Natalie Savona; May C I van Schalkwyk; Heide Weishaar

doi:10.1136/bmjgh-2020-003543

The case for developing a cohesive systems approach to research across unhealthy commodity industries

Cécile Knai, Mark Petticrew, Simon Capewell, Rebecca Cassidy, Jeff Collin, Steven Cummins, Elizabeth Eastmure, Patrick Fafard, Niamh Fitzgerald, Anna B Gilmore, Ben Hawkins, Jørgen Dejgr ard Jensen, Srinivasa Vittal Katikireddi, Nason Maani, Nicholas Mays, Modi Mwatsama, Rima Nakkash, Jim F Orford, Harry Rutter, Natalie SavonaMay C I van Schalkwyk, Heide Weishaar

Research output: Contribution to journal › Article › peer-review

56 Citations (SciVal)

Abstract

Objectives Most non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs.Methods We held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries.Results There are clear commonalities across UCIs’ strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types.Conclusion UCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and also to inform a more effective and coherent response.

Original language	English
Article number	e003543
Journal	BMJ Global Health
Volume	6
Issue number	2
DOIs	https://doi.org/10.1136/bmjgh-2020-003543
Publication status	Published - 16 Feb 2021

Bibliographical note

Publisher Copyright:
©

Funding

Coca-Cola’s The Real Experience ‘flagship ‘Smashed’—educational plays in schools education programme for secondary funded by Diageo140 schools, colleges and universities in Great Community Alcohol Partnerships (CAPs)141 Britain’139 GamCare, Gambling Therapy and Gordon Moody Association, supported by industry-funded GambleAware One example of this phenomenon is a former director-general of the WHO who, having previously publicly defended the WHO publication of evidence-based sugar intake guidelines60 against direct threats from The Sugar Association to lobby Congress to remove US funding to the WHO,61 took a role as consultant to PepsiCo.62 During the same period, the executive director responsible for the prevention of chronic disease, and an early champion of the Framework Convention for Tobacco Control, also followed his WHO tenure with a spell at PepsiCo. Supported by a 12-year funding commitment from Philip Morris International of $1 billion, he then launched the Foundation for a Smoke-Free World in supporting ‘tobacco harm reduction’ and identifying alternative livelihoods for tobacco farmers.63 Additional examples include the chief executive of the UK Wine and Spirit Trade Association having previously been deputy director of European Union Affairs and International Agriculture Policy within the Department for Environment, Food and Rural Affairs.64 Moreover, in the context of the UK Department of Health’s Public Health Responsibility Deal (RD), a public–private partnership with the food, alcohol and other industries in England, with the stated goal of improving health,65 the UK Government Cabinet Office official formerly responsible for the RD alcohol network then took on a leadership role in the Portman Group, a UK body representing the alcohol industry, and with The International Alliance for Responsible Drinking, the industry’s global social aspects and public relations organisation. Such behaviour may have contributed to the RD including measures which were largely ineffective (and would have been known to be in advance, based on the evidence at the time).66 67 The US provides a range of examples of the ‘revolving door’ between the public and private sectors,68 including a Center for Science in the Public Interest lawyer moving to become a lobbyist for The Sugar Association.69 A recent study on the ‘revolving door’ in Australia found that a significant proportion of lobbyists were previously government representatives, citing several examples of government employees going to work directly for alcohol, food or gambling industries, often in roles directly related to their previous employment in government.70

Funders	Funder number
Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council
Scottish Government Chief Scientist Office	SPHSU13, NIHR300156
Tobacco industry funded youth smoking cessation programmes152 Foundation
National Rosacea Society	SCAF/15/02, MC_ UU_12017/13
Department for Employment and Learning, Northern Ireland
Wellcome Trust	MR/ S037519/1
Medical Research Council
Economic and Social Research Council
Natural Environment Research Council
National Institute for Health Research
British Heart Foundation
Department for Environment, Food and Rural Affairs, UK Government
Cancer Research UK
Health Foundation
Public Health Agency
Health and Social Care Research and Development Division

Keywords

public health
qualitative study

ASJC Scopus subject areas

Health Policy
Public Health, Environmental and Occupational Health

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1136/bmjgh-2020-003543Licence: CC BY-NC

https://gh.bmj.com/content/6/2/e003543

Cite this

Knai, C., Petticrew, M., Capewell, S., Cassidy, R., Collin, J., Cummins, S., Eastmure, E., Fafard, P., Fitzgerald, N., Gilmore, A. B., Hawkins, B., Jensen, J. D. A., Katikireddi, S. V., Maani, N., Mays, N., Mwatsama, M., Nakkash, R., Orford, J. F., Rutter, H., ... Weishaar, H. (2021). The case for developing a cohesive systems approach to research across unhealthy commodity industries. BMJ Global Health, 6(2), Article e003543. https://doi.org/10.1136/bmjgh-2020-003543

Knai, C, Petticrew, M, Capewell, S, Cassidy, R, Collin, J, Cummins, S, Eastmure, E, Fafard, P, Fitzgerald, N, Gilmore, AB, Hawkins, B, Jensen, JDA, Katikireddi, SV, Maani, N, Mays, N, Mwatsama, M, Nakkash, R, Orford, JF, Rutter, H, Savona, N, van Schalkwyk, MCI & Weishaar, H 2021, 'The case for developing a cohesive systems approach to research across unhealthy commodity industries', BMJ Global Health, vol. 6, no. 2, e003543. https://doi.org/10.1136/bmjgh-2020-003543

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abstract = "Objectives Most non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs.Methods We held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries.Results There are clear commonalities across UCIs{\textquoteright} strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types.Conclusion UCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and also to inform a more effective and coherent response.",

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AU - Eastmure, Elizabeth

AU - Fafard, Patrick

AU - Fitzgerald, Niamh

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AU - Maani, Nason

AU - Mays, Nicholas

AU - Mwatsama, Modi

AU - Nakkash, Rima

AU - Orford, Jim F

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AU - Savona, Natalie

AU - van Schalkwyk, May C I

AU - Weishaar, Heide

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N2 - Objectives Most non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs.Methods We held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries.Results There are clear commonalities across UCIs’ strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types.Conclusion UCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and also to inform a more effective and coherent response.

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The case for developing a cohesive systems approach to research across unhealthy commodity industries

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

SPECTRUM

Cite this

The case for developing a cohesive systems approach to research across unhealthy commodity industries

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

Other files and links

Fingerprint

Projects

SPECTRUM

Cite this