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Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation, particularly stakeholder consultation, provide an opportunity for highly resourced corporations to slow, weaken, or prevent public health policies.

Standardised tobacco packaging has been, and remains, a contentious policy globally, attracting corporate, public health, political, media and popular attention. In January 2015, the UK Government announced it would vote on draft regulations for the policy before the May 2015 General Election. We explored reactions to the announcement on Twitter, in comparison with an earlier period of little UK Government activity on standardised packaging. We obtained a random sample of 1038 tweets in two 4-week periods, before and after the UK Government's announcement. Content analysis was used to examine the following Tweet characteristics: support for the policy, purpose, Twitter-user's geographical location and affiliation, and evidence citation and quality. Chi-squared analyses were used to compare Tweet characteristics between the two periods. Overall, significantly more sampled Tweets were in favour of the policy (49%) in comparison to those opposed (19%). Yet, at Time 2, following the announcement, a greater proportion of sampled tweets opposed standardised packaging compared to the period sampled at Time 1, prior to the announcement (p<0.001). The quality of evidence and research cited in URLs linked at Time 2 was significantly lower than at Time 1 (p<0.001), with peer-reviewed research more likely to be shared in positive Tweets (p<0.001) and in Tweets linking to URLs originating from the health sector (p<0.001). The decline in the proportion of positive Tweets was mirrored by a reduction in Tweets by health sector Twitter-users at Time 2 (p<0.001). Microblogging sites can reflect offline policy debates and are used differently by policy proponents and opponents dependent on the policy context. Twitter-users opposed to standardised packaging increased their activity following the Government's announcement, while those in support broadly maintained their rate of Twitter engagement. The findings offer insight into the public health community's options for using Twitter to influence policy and disseminate research. In particular, proliferation of Twitter activity following pro-public health policy announcements could be considered to ensure pro-health messages are not overshadowed by anti-regulation voices.

ObjectivesTo investigate opposition to standardised tobacco packaging in the UK. To increase understanding of how transnational corporations are adapting to changes in their access to policymakers precipitated by Article 5.3 of the Framework Convention on Tobacco Control (FCTC).DesignCase study web-based documentary analysis, using NVivo V.10. Examination of relationships between opponents of standardised packaging and transnational tobacco companies (TTCs) and of the volume, nature, transparency and timing of their activities.SettingUK standardised packaging policy debate 2011–2013.ParticipantsOrganisations selected on basis of opposition to, or facilitation thereof, standardised tobacco packaging in the UK; 422 associated documents.ResultsExcluding tobacco manufacturing and packaging companies (n=12), 109 organisations were involved in opposing standardised packaging, 82 (75%) of which had a financial relationship with 1 or more TTC. These 82 organisations (43 actively opposing the measure, 39 facilitating opposition) were responsible for 60% of the 404 activities identified, including the majority of public communications and research production. TTCs were directly responsible for 28% of total activities, predominantly direct lobbying, but also financially underwrote third party research, communication, mass recruitment and lobbying. Active organisations rarely reported any financial relationship with TTCs when undertaking opposition activities.ConclusionsThe multifaceted opposition to standardised packaging was primarily undertaken by third parties with financial relationships with major tobacco manufacturers. Low levels of transparency regarding these links created a misleading impression of diverse and widespread opposition. Countries should strengthen implementation of Article 5.3 of the FCTC by systematically requiring conflict of interest declarations from all organisations participating in political or media debates on tobacco control.

ObjectiveTo examine the quality of tobacco industry-funded data on the illicit tobacco trade (ITT) through a systematic review of existing assessments of industry-funded data on ITT.Data sourcesPapers and reports assessing tobacco industry-funded data on ITT were obtained via searches of 8 academic databases, Google searches and correspondence with ITT experts.Study selectionInclusion criteria identified 35 English-language papers containing an original assessment of tobacco industry-funded data.Data extractionUsing a coding framework, information was extracted from the assessments regarding the quality of tobacco industry data. Documents were second-coded, achieving 94% intercoder reliability with all disagreements resolved.Data synthesisOf the 35 assessments reviewed, 31 argued that tobacco industry estimates were higher than independent estimates. Criticisms identified problems with data collection (29), analytical methods (22) and presentation of results (21), which resulted in inflated ITT estimates or data on ITT that were presented in a misleading manner. Lack of transparency from data collection right through to presentation of findings was a key issue with insufficient information to allow replication of the findings frequently cited.ConclusionsTobacco industry data on ITT are not reliable. At present, the tobacco industry continues to fund and disseminate ITT research through initiatives such as PMI IMPACT. If industry data on ITT cannot meet the standards of accuracy and transparency set by high-quality research publications, a solution may be to tax tobacco companies and administer the resulting funds to experts, independent of the tobacco industry, who use previously developed reliable models for measuring ITT.

Standardised tobacco packaging, which commenced in the UK in May, 2016, has been vehemently opposed by transnational tobacco companies. Previous research has concluded that companies invoke the existence of an illicit trade in tobacco to oppose tobacco control policies and exaggerate its true scale. The argument they make is that such policies will further increase this trade. Independent peer-reviewed evidence does not support claims that illicit tobacco increased after the 2012 implementation of standardised packaging in Australia. In the UK, leaked Philip Morris International documents revealed the tobacco company's intention to utilise third-party “media messengers” to make the argument that the policy will exacerbate the illicit tobacco trade. We aimed to explore whether and, if so, how, transnational tobacco companies presented their data on illicit tobacco in UK newspapers during the standardised packaging policy debate and whether Philip Morris implemented its media messengers plan. Articles about illicit tobacco published in English language UK newspapers from April 1, 2013, to March 31, 2015, from LexisNexis were examined for presence, nature, and timing of tobacco industry data, which included any illicit tobacco monitoring initiative commissioned or undertaken by transnational tobacco companies in the UK or overseas. Search terms included combinations of “illegal”, “illicit”, “smuggling”, “tobacco”, “cigarette”, all four transnational tobacco companies, and known tobacco industry consultants. 428 articles about illicit tobacco were identified. 157 articles (37%) cited industry data, of which 90 (57%) referred to undercover test purchases, the remainder citing data from empty pack surveys, seizures, polls, or data of unknown methodology. 98 (62%) of the 157 articles mentioned ex-Scotland Yard Detective Chief Inspector Will O'Reilly, who conducts undercover test purchases for Philip Morris International; in 34 of these articles, this funding was not disclosed. Most articles were published in regional newspapers (77%, 121/157) and the majority mentioned counterfeit tobacco, so-called cheap whites, or both (72%, 113/157). However, the Institute of Trading Standards revealed that between May and November, 2014, over 70% of the illegal tobacco seized was tobacco industry contraband. Philip Morris International's investment in undercover test purchases appears to have enabled the tobacco industry to secure significant press coverage of its data on illicit tobacco. With over half of the articles in this study referring to a consultant working on behalf of the tobacco company, its plan to use third party media messengers as part of its anti-standardised packaging strategy appears to have been mobilised. Industry-funded third party spokesmen, notably former policemen, are now appearing in other countries, suggesting that this is an industry tactic that should be expected in other jurisdictions. Transparency in all media coverage is essential. KAE-R is supported by Cancer Research UK (C27260/A20488). JLH is supported by the UK Centre for Tobacco and Alcohol Studies (MR/KO23195/1). AR is supported by the New Venture Fund.

Objectives To examine the volume, relevance and quality of transnational tobacco corporations’ (TTCs) evidence that standardised packaging of tobacco products ‘won't work’, following the UK government's decision to ‘wait and see’ until further evidence is available. Design Content analysis. Setting We analysed the evidence cited in submissions by the UK's four largest TTCs to the UK Department of Health consultation on standardised packaging in 2012. Outcome measures The volume, relevance (subject matter) and quality (as measured by independence from industry and peer-review) of evidence cited by TTCs was compared with evidence from a systematic review of standardised packaging . Fisher's exact test was used to assess differences in the quality of TTC and systematic review evidence. 100% of the data were second-coded to validate the findings: 94.7% intercoder reliability; all differences were resolved. Results 77/143 pieces of TTC-cited evidence were used to promote their claim that standardised packaging ‘won't work’. Of these, just 17/77 addressed standardised packaging: 14 were industry connected and none were published in peer-reviewed journals. Comparison of TTC and systematic review evidence on standardised packaging showed that the industry evidence was of significantly lower quality in terms of tobacco industry connections and peer-review (p<0.0001). The most relevant TTC evidence (on standardised packaging or packaging generally, n=26) was of significantly lower quality (p<0.0001) than the least relevant (on other topics, n=51). Across the dataset, TTC-connected evidence was significantly less likely to be published in a peer-reviewed journal (p=0.0045). Conclusions With few exceptions, evidence cited by TTCs to promote their claim that standardised packaging ‘won't work’ lacks either policy relevance or key indicators of quality. Policymakers could use these three criteria—subject matter, independence and peer-review status—to critically assess evidence submitted to them by corporate interests via Better Regulation processes.

In 2012, the UK Government consulted on standardised packaging (SP) of tobacco products. Four transnational tobacco companies (TTCs) submitted large responses opposing SP, criticising evidence cited and citing alternative evidence to support their case. We examine the problems faced by policy makers assessing large volumes of diverse evidence submitted by well-resourced corporate interests to public consultations, and discuss potential strategies for evidence management in public health policy making. We synthesise the results of three UK-based studies. Data were identified from four TTC submissions (available online). Assessment criteria for content analyses were developed by literature review. Independent second coding of data was used to validate findings (studies 1 and 2: 100%; study 3: 13%), examine convergence, and resolve interpretation differences. Study 1 was a comparative content analysis of quality (independence, peer-review) and relevance (subject matter) of 77 research documents cited by TTCs to argue that SP will not work, and 37 research documents from a systematic review (SR) of SP. Two-tailed Fisher's tests were used to compare datasets. Study 2 was a content analysis of quality, relevance, and type (eg, research, opinion, policy) of 92 documents and quotations cited by TTCs to argue that SP will have negative, unintended consequences for the UK economy and illicit trade. Study 3 was a qualitative interpretive analysis of techniques used by two TTCs to undermine evidence of SP's effect on smoking behaviour. 120 purposively selected pages (of 1037) were analysed using a verification-oriented cross-documentary analysis, comparing use of research with originals, and a thematic analysis, informed by principles and techniques of constructivist grounded theory—conceptual coding for a-priori and emergent themes, constant comparison, discourse sensitivity, and attention to divergent data. In 1521 pages, the four TTCs cited 143 formal research documents to underpin their opposition to SP and made extensive reference to policy documents, quotations, and media coverage. In study 1, 12% of TTC research evidence that SP will not work was both relevant (addressed SP or tobacco packaging) and fulfilled one or more quality criteria (independent of TTCs, published in a peer-reviewed journal, or both), compared with 100% of SR evidence. In study 2, 16% of data were both independent and relevant. TTCs offset the scarcity of outcome-based evidence on the consequences of SP with industry-commissioned research and used independent and industry-connected opinion to inflate the risk of unintended consequences. In study 3, TTCs misused published evidence through inaccurate reporting, attempted methodological deconstruction through mimicked scientific critique, and sought to promote a parallel evidence base to reduce the power and credibility of evidence supportive of SP. TTCs used sophisticated, complex, and mutually reinforcing evidential presentation strategies to oppose SP. Assessment of submissions and associated evidence represents a substantial challenge and cost, causing delay or even abandonment of policies. Two strategies could address this. First, implement evidential management processes at submission (eg, requiring respondents to record evidential funding sources, conflicts of interests, and accuracy of evidential representation). Second, introduce a formal post-submission evidence assessment framework. Such strategies could reduce costs imposed on policy makers by the present requirement to invite and assess evidence from stakeholders. They might also reduce the ability of corporate interests to use evidence misrepresentation to oppose policy change. The resource advantage of TTCs is a substantial challenge to potential reforms. JLH and KAE-R are supported by Cancer Research UK (CR-UK; grants C38058/A15664, C27260/A12294). SU, GJF, and ABG are supported by the US National Cancer Institute (R01CA160695). All authors are members of the UK Centre for Tobacco and Alcohol Studies, a UK Centre for Public Health Excellence (MR/K023195/1) funded by the BHF, CR-UK, ESRC, MRC, and NIHR, under the auspices of the UK Clinical Research Collaboration. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Background Standardised packaging (SP) of tobacco products is an innovative tobacco control measure opposed by transnational tobacco companies (TTCs) whose responses to the UK government's public consultation on SP argued that evidence was inadequate to support implementing the measure. The government's initial decision, announced 11 months after the consultation closed, was to wait for 'more evidence', but four months later a second 'independent review' was launched. In view of the centrality of evidence to debates over SP and TTCs' history of denying harms and manufacturing uncertainty about scientific evidence, we analysed their submissions to examine how they used evidence to oppose SP. Methods and Findings We purposively selected and analysed two TTC submissions using a verification-oriented cross-documentary method to ascertain how published studies were used and interpretive analysis with a constructivist grounded theory approach to examine the conceptual significance of TTC critiques. The companies' overall argument was that the SP evidence base was seriously flawed and did not warrant the introduction of SP. However, this argument was underpinned by three complementary techniques that misrepresented the evidence base. First, published studies were repeatedly misquoted, distorting the main messages. Second, 'mimicked scientific critique' was used to undermine evidence; this form of critique insisted on methodological perfection, rejected methodological pluralism, adopted a litigation (not scientific) model, and was not rigorous. Third, TTCs engaged in 'evidential landscaping', promoting a parallel evidence base to deflect attention from SP and excluding company-held evidence relevant to SP. The study's sample was limited to sub-sections of two out of four submissions, but leaked industry documents suggest at least one other company used a similar approach. Conclusions The TTCs' claim that SP will not lead to public health benefits is largely without foundation. The tools of Better Regulation, particularly stakeholder consultation, provide an opportunity for highly resourced corporations to slow, weaken, or prevent public health policies. Please see later in the article for the Editors' Summary