How the tobacco industry works to disrupt public health policies in low- and middle-income countries

Posted in: Industry tactics, LMICs, Research

Throughout the decades, the tobacco industry has developed a set of techniques and arguments that it employs whenever it wants to derail, dilute, and delay public health policies that threaten to harm its enormous profits. In this piece, researchers from the University of Bath’s Tobacco Control Research Group (TCRG) explain their recent research on industry interference in low- and middle-income countries, which shows how we might predict industry responses to tobacco control measures.


Research shows that the tobacco industry has repeatedly used similar strategies to pre-empt, dilute, delay, and counter tobacco control measures. Previous work conducted by TCRG has categorised these strategies into the Policy Dystopia Model (PDM). The PDM demonstrates, in a structured way, expected industry responses to proposed regulatory action aimed at tackling the toll of tobacco products on public health. Since its publication in 2016, the PDM has been widely used in tobacco control, and has been adapted by researchers working on the corporate political activity of other unhealthy commodity industries such as junk food and alcohol.

Updating the Policy Dystopia Model for low- and middle-income countries

When the PDM was created, the vast majority of evidence on tobacco industry strategies came from high-income countries (HICs). In our new paper, we sought to check whether the PDM was relevant to low- and middle-income countries (LMICs). This is particularly important, as in recent years we have seen that in view of its declining sales in many countries, the tobacco industry has been aggressively targeting LMICs. In addition, LMICs tend to lag behind HICs in the implementation of tobacco control policies, and industry interference is a leading factor hindering regulatory progress. The urgency of addressing this gap is further increased because more than four out of five smokers live in LMICs.

About the research

We interviewed 22 tobacco control advocates and researchers from eight LMICs in four global regions. We found that the industry uses a broadly similar set of arguments and techniques to those identified in the PDM. However, our interviews  also showed that the industry tweaks its approach depending on the context in which it operates. For example, while in many HICs its focus is on rehabilitating its tarnished image, for example through PR campaigns, in the countries included in our study we found that the industry rather seeks to maintain an existing favourable reputation. The tobacco companies were reported to repeatedly emphasise their contribution to a country, for example, as a major job provider and taxpayer. They also engaged in various ‘corporate social responsibility’ activities and attempted to present themselves as potential partners of LMIC governments in tackling crises as diverse as droughts and civil conflicts. This suggests that in some LMICs much more work is needed to denormalise the tobacco industry.

Additional industry strategies identified in the study

Our study identified three new arguments that, according to our participants, the industry used in LMICs. First, the industry claimed that regulation would have negative consequences for the national economy and development more broadly. The industry would use this argument when targeting, for example, ministries of finance. Secondly, in countries where tobacco was grown, the industry stressed the tobacco control policy's supposed impact on tobacco farmers and farming communities. It was claimed that farmers would struggle to switch to other crops or activities. Finally, in one country with a considerable domestic tobacco sector, the transnational tobacco industry claimed that tobacco control would not be in the national interest but serve an international agenda. The local advocates perceived this argument as having considerable impact as the industry also used it when trying to push for a cancellation of civil society organisations' foreign funding for tobacco control work.

We also identified two potential new industry techniques in our interview data. First, the interview participants shared several instances in which tobacco control advocates in LMICs experienced intimidation. Examples included receiving anonymous messages and phone calls, being followed, and cyberattacks. However, participants reported that finding evidence for who the perpetrator was often proved difficult. Secondly, the industry made significant efforts to build and maintain long-term relationships with media professionals, for example by inviting journalists on study tours.


Developing the model further

Overall, we found the model was fit for purpose and we have been able to make minor additions to ensure its relevance to LMICs. We hope that more research will scrutinise and possibly further refine the updated Policy Dystopia Model. We encourage researchers who undertake case studies of industry corporate political activities to test the proposed model and draw on multiple data sources to do this. Since the industry tailors its strategy to the context in which it operates, we perceive the PDM as a living resource to which more strategies can, and should, be added.

We hope that our work can also support LMIC-based advocates in learning from each other’s experiences and effectively predicting and countering industry strategies aiming at undermining the progress of tobacco control in their countries.


About the paper

This blog is based on the paper ‘Developing a more detailed taxonomy of tobacco industry political activity in low-income and middle-income countries: qualitative evidence from eight countries’ (2021) by Britta Katharina Matthes, Kathrin Lauber, Mateusz Zatoński, Lindsay Robertson and Anna Gilmore, published in BMJ Global Health.

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Posted in: Industry tactics, LMICs, Research