The policy dystopia model: an interpretive analysis of tobacco industry political activity

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 policymaking 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 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 meta-narrative 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 focus 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 pre-empt these and develop realistic assessments of the industry’s claims.