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The Truth about Standardized Packaging? Blow Some My Way

PLOS Medicine Associate Editor, Linda Nevin, discusses how a 2014 research article by Selda Ulucanlar and colleagues deconstructed advocacy documents submitted to the UK government by tobacco companies, and catches up with one of the authors for a Q&A.

Image credit: Rachel Chapman, Flickr
Image credit: Rachel Chapman, Flickr

As researchers, what is our duty to respond when corporate interests distort scientific evidence to influence policy? In a 2014 PLOS Medicine research article, Selda Ulucanlar and colleagues from the UK Centre for Alcohol and Tobacco Studies, University of Bath, used the lens of epistemology to search for truth, misleading arguments, and anything in between in expert testimony submitted to the UK government by British American Tobacco (BAT) and Japan Tobacco Inc (JTI). The testimony was submitted in response to a 15-question government survey issued in April 2012, inviting interested citizens, businesses and organisations to comment on a range of health and economic implications of standardised packaging (SP)—the strict specification of visual and physical pack attributes—of tobacco products. In their study, the authors checked the transnational tobacco companies’ (TTC) reference-based claims against the original sources to ascertain preservation of meaning, and assessed the scientific validity of TTC critiques of the evidence on SP. They found that the TTC reports misrepresented the evidence base in three ways: misquoting, mimicked scientific critique, and evidential landscaping (for explanation of these tactics, see the Editor’s Summary).

Much of the transnational tobacco companies’ (TTC’s) testimony was directed toward a seminal and influential paper in the field: Crawford Moodie and colleagues’ systematic review of 37 behavioural studies which, in sum, indicated that SP reduces the attractiveness and appeal of tobacco, increases the noticeability and effectiveness of health messages, and reduces the ability of manufacturers to mislead consumers about harmfulness to health. In the TTC critique of this review and the studies therein, Ulucanlar and colleagues explained, “Individual studies were examined in depth to determine whether any—on its own—constituted a warrant for SP and, following systematic deconstruction, none was found to be good enough to justify SP.” Based on this finding, the authors make an inspiring distinction between scientist and advocate: “In court, each piece of evidence (i.e., each study and the Moodie review) is treated as a separate piece of evidence and each needs to be undermined and discredited in turn until no evidence remains that could damage one’s client’s case. By contrast, in scientific work, it is essential that the extant research is synthesised and greater confidence in the findings established through the cumulative ‘weight of the evidence’.”

Advocates of SP were disappointed when, in July 2013, the UK government announced that the available evidence was inconclusive, and legislation would await results from the new SP policy in Australia. Fortunately for SP advocates, more pragmatic evidence is accumulating. According to Public Health England, data from the Australian Treasury showed a 3.4% fall in tobacco sales by volume in the first year following the introduction of standardised packs there in December, 2012. In June 2014, Michelle Scollo and colleagues reported that SP opponents’ concerns about unintended economic consequences of SP may be unfounded; sales of low-cost brands and unbranded illicit tobacco have not increased since SP was implemented in Australia, nor have small businesses suffered from a shift in sales to larger outlets or informal sellers. In the U.K., a potential inflection toward true evidence-based policymaking has been the publication in April 2014 of a government-commissioned independent review led by Sir Cyril Chantler, Chairman of University College London Partners that concludes favourably on the health and economic benefits of SP. The Chantler review cites the study by Ulucanlar and colleagues.

Given the tobacco industry’s obvious conflict of interest in relation to SP and history of fostering uncertainty about the harms of tobacco, one might expect industry reasoning to prioritise profits over health. Nonetheless, for policymakers it may be a challenge to distinguish industry arguments from sound science. This disconnect between science and governance may have real costs. According to published estimates, 567 children start smoking each day in the UK. Based on this number, in the 460 days from 13 July 2013, when the UK government decided to defer standardised packaging, and 16 October 2014, 260,820 UK children likely started smoking.

You can read the full research article here:

Ulucanlar S, Fooks GJ, Hatchard JL, Gilmore AB (2014) Representation and Misrepresentation of Scientific Evidence in Contemporary Tobacco Regulation: A Review of Tobacco Industry Submissions to the UK Government Consultation on Standardised Packaging. PLoS Medicine 2014

Q&A with the study’s Principal Investigator, Anna Gilmore at the University of Bath’s Department for Health, on the impact of the publication.

What was the state of the field before this research was published? Had anyone previously deconstructed tobacco’s debate tactics, or those of any other lobby, at this level of detail?

There was no comparable work published anywhere in the world when we embarked on our study; our team was the first to conduct detailed and systematic analysis of how evidence was used in tobacco company submissions to a policy consultation, in this case on plain packaging in the UK. Towards the end of our study period, a [PLOS Medicine] paper was published on alcohol industry use of evidence to influence alcohol policy. However, the analysis used in that study was not as detailed.

How was the study received by the research community?

Our paper was shared by many researchers in social media (Twitter and Facebook) as an impressive piece of qualitative work taking the lid off tobacco industry tactics and political activity. Our analytic methods were used as a model by Australian researchers studying the British American Tobacco submission to the New Zealand consultation on plain packaging. They also found instances of the ‘tweezer method’ [taking quotes out of their context] and ‘evidential landscaping’ amongst others. New Zealand researchers had the benefit of our research when giving evidence to parliamentary committees examining plain packaging.

Would you be willing to describe follow-up research that you are currently conducting?

We recognise that the (mis)use of scientific evidence in written consultation submissions is only one form of political activity that tobacco companies engage in. We are currently developing a critical taxonomy of tobacco industry strategies building on our earlier systematic reviews of industry influence on taxation and marketing policies. The taxonomy will show the remarkable scale and range of the industry’s strategic practices, both as a macro framework and in revealing detail. No such taxonomy has been published to date and we believe that our work will be of immediate use to policy makers around the world in developing tobacco related policy and planning and executing consultation exercises. It will also make an original contribution to the literature on corporate political activity.

We are also continuing to investigate the tobacco industry’s ongoing efforts to prevent standardised packaging in the UK.

Your paper was cited in Sir Cyril Chantler’s independent literature review on standardized packaging, which was released one week after your paper was published. Do you have any insight into how your findings impacted Sir Cyril’s conclusions?

It would appear our research was instrumental in alerting Sir Cyril Chantler’s team to the tobacco industry’s devious mis-representation of science and helped shape his very firm conclusions that the tobacco industry was presenting highly misleading arguments in order to prevent a policy that threatens its profits.

Whether this paper has had further impacts in the UK, remains to be seen. The government’s current impasse on plain packaging suggests it puts the interests of the tobacco industry ahead of those of our children. It has however, already shaped thinking in New Zealand as it too considers plain packaging for tobacco products.

 

This is post 6 of 8 in PLOS Medicine’s 10th Anniversary blog series on the most interesting and influential articles of the last ten years. You can find links to all the posts in the series as they are published here.

 

Discussion
  1. Not only in Standardized packaging, but the misuse of Scientific evidence in general should not be misused by any manufacturer. In fact, the policy makers must lay-out some strict parameters to stop this procedure and also to save the genuine ones from unnecessary checks.

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