Corporate Political Activity: Taxonomies and Model of Corporate Influence on Public Policy

Background

Non-communicable diseases (NCDs) kill 41 million people every year, the majority in low- and middle-income countries (LMICs).¹ A few commercial products, notably tobacco, ultra-processed foods, and alcohol, are responsible for much of this health burden.²

Taxation on products, restricting or banning advertising, restricting availability and altering product presentation – all designed to reduce sales or consumption of harmful products or ingredients – are identified by the World Health Organization (WHO) as the most cost-effective policy interventions, or ‘best buys,’³ for reducing NCDs. Unhealthy commodity industries (UCIs) which we define here as tobacco, ultra-processed foods (which includes sugar sweetened beverages and baby milk formula), alcohol and gambling, in particular, face a growing global risk to their operations, markets, and profits as more countries adopt these policies.^4,5 Their response is to engage in corporate political activity (CPA) to avert immediate and future regulatory risks. CPA is a major obstacle to reducing the burden of NCDs globally.^6-9

The release of millions of internal tobacco industry (TI) documents through litigation in the 1990s provided unique insights into CPA, igniting a wave of research on TI behaviour.¹⁰ Systematic reviews used to make sense of this extensive literature, largely in the form of country case studies, show the TI consistently uses the same strategies across time and place.^6,11 This in turn enabled the development of evidence-informed taxonomies of TI CPA^6,12 which have been used to successfully predict and counter the TI’s influence. The taxonomies’ subsequent application to the ultra-processed food,^13,14 alcohol,¹⁵ and gambling¹⁶ showed that these industries use very similar influence strategies.¹⁷ There is also evidence that a wider set of industries use similar practices to shape science.¹⁸ The fact that corporations operating in diverse industries have financial,¹⁰ operational¹⁹ and board level ties²⁰ and use the services of the same public relations companies^17,19 and also sometimes work collectively,¹⁹ may help explain these similarities in practice.

To date however, despite this growing evidence that UCIs engage in similar practices, posing a formidable challenge to progressing public interest policy-making, there is no pan-industry conceptual framework of UCI CPA.

We therefore aim to develop evidence-informed cross-industry taxonomies and a model applicable to a range of UCIs globally, aimed at a broad audience including academics, advocates, regulators, and policy professionals. Such a framework would aid comparative research and allow the public health and policy communities to systematically document, predict and effectively counter corporate strategies.

Methods

We focused on four UCIs: tobacco; alcohol; food (which here refers to ultra-processed foods, sugar-sweetened beverages and baby formula); gambling. We use the terms ‘UCI’ and ‘industry’ to refer to specific industries or groups of industries and the terms ‘corporate’ or ‘corporations’ when referring to a more generic group of corporate actors. Over the period December 2020 to September 2021, we used five complementary methods to develop and test our taxonomies: (1) critical interpretive synthesis review, (2) brief interviews, (3) expert co-author knowledge and recommended papers, (4) stakeholder workshops, and (5) testing. This is similar to Moher and colleagues’²¹ reporting guidelines development process, although we opted for a consultative model with our stakeholders rather than consensus-building. The study protocol was developed by four of the authors (KL, SU, AF, and ABG) who met frequently to discuss progress, analysis and emerging constructs. The wider team, including BH, MM, LH, and VT, met every six to eight weeks. These discussions and the findings from interviews, workshops and the testing were all integrated into the analysis and guided successive revisions and refinements of the taxonomies and the model.

Developing the Taxonomies

Data Sources

Critical interpretive synthesis (CIS) review²²: The review aims were to explore (1) definitions, conceptualisations and schematic representations of UCI CPA and (2) instances of CPA. Search terms developed with help from a specialist librarian related to CPA, policy areas, industries and theories/concepts.²³ We searched Scopus, Web of Science, Business Source Complete, and the International Bibliography of Social Sciences (from inception in 1951 to 18 December 2020). One researcher (KL or AF) screened the titles and abstracts and both assessed the full texts of the remaining records for inclusion. If consensus could not be reached, a third researcher adjudicated (SU). Only peer reviewed papers in English with an original conceptualisation of tobacco, alcohol, food and/or gambling industry CPA and/or reporting use of an original conceptualisation were included. In line with established CIS methodology, we did not conduct formal quality screening or exclude papers based on quality.²² We did, however, want to exclude opinion-based papers, so we required a methods section or other evidence that the work was based on empirical research for eligibility. The full search strategy and inclusion/exclusion criteria are in Table S1 (See Supplementary file 1). In line with the CIS method, we also included papers suggested by research team members.

Brief interviews: Two researchers (SU and KL) conducted seven online interviews (taking contemporaneous notes) with users of existing frameworks to elicit views on their usability and content and suggestions for the new taxonomies.

Expert co-authors: The research team had expertise across the four industries and had published extensively in this area, including developing and using the frameworks and papers included in this study.

Analysis

Theoretical orientation: Our approach was critical and interpretive, based on a social constructivist ontology in which we conceptualised policy-making as a complex adaptive system²⁴ mediated by power relations and discourses. Our work was informed by: Stone’s²⁵ concept of policy as narrative where actors compose ‘stories’ to define policy problems, attribute causes and blame, and formulate responses; Asen’s²⁶ view of policy-making as a mediation between the rhetorical and the material; Russell and colleagues’²⁷ view of policy-making as a rhetorical enterprise involving value-based argumentation. Our work was also loosely informed by Lukes’²⁸ ‘three dimensions of power’ theory examining the behavioural/agentic and ideological/structural manifestations of power. Finally, we adopted some concepts from the positivist policy literature, such as agenda setting, venue shopping and policy cycles.²⁹

Analysis: We combined CIS²² and constructivist grounded theory using conceptual coding, constant comparison within and across papers, memo writing and attention to divergent cases and discourse^30,31; SU led the analysis. All included papers were analysed using the Atlas.ti 9 software; interview and workshop notes were analysed in Microsoft Word. Each paper was interrogated in two ways: (1) overall conceptualisation of CPA, figurative structures and terminology, comprehensiveness, analytic insights and use by others and (2) reported instances of CPA. We critically – and iteratively – examined and compared the different conceptualisations with each other and our previous work and inductively categorised instances of CPA to develop the model and taxonomies. Two researchers (SU and KL) double coded three papers and discussed and resolved coding differences.

Testing the Taxonomies

We conducted two online stakeholder workshops with academics, advocates and policy professionals with knowledge or experience of UCI CPA to elicit views on the emergent taxonomies and their usability. Small group testing, where the emerging taxonomies were populated using CPA vignettes, was followed by whole group discussion. The workshops were recorded to aid analysis, but not transcribed. Finally, we conducted a review of the empirical CPA literature (Table S2, Supplementary file 1) to purposively select case-study papers that drew on in-depth primary data on one of the four industries against which the taxonomies could be tested. For this testing, two researchers (KL and AF) individually coded three papers and double coded one paper to ensure coding alignment.

Results

We report our results in the following order: the review; interviews and testing; the taxonomies; strengths and weaknesses of industry CPA; the CPA Model.

The Review

We identified 249 records for screening and included 35 studies: 11 contained an original conceptualisation of tobacco, alcohol or food industry CPA and 24 reported use of one of these original frameworks^{6,12,13,18,32-38} (Figure 1). All bar two^32,37 included a methods section. Of the two, one paper³² contributed considerably to our understanding of CPA, referred to a literature review in ‘authors’ contribution’ and was extensively and consistently referenced despite not having a methods section and the other³⁷ reported in its abstract that it was based on ‘publications’ and offered a novel conceptualisation. We noted that methods reporting in many papers was inadequate with scant details.

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Figure 1. The PRISMA Flow Chart. Abbreviations: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; CPA, corporate political activity.

Existing Conceptualisations of Corporate Political Activity

The 11 conceptual frameworks varied in theoretical approach, methods, policies, industries, geographies, and structure^{6,12,13,18,32-38} (Table 1). One paper³³ drew on concept mapping; all others were based on a form of literature review, with three^6,12,36 using systematic reviews. All but two covered general CPA; one paper focused on specific issues around trade and investment agreements³⁸ and another on science and use of science in policy.¹⁸ Most did not include a formal definition of CPA but two^13,34 referred to the definition in a 1984 paper by Baysinger³⁹ and one³⁵ to the CPA paper by Hillman and Hitt,⁴⁰ both defining CPA as attempts to shape public policy in ways that favour business interests. All but two^35,37 paid attention to long-term (eg, forming relationships) as well as short-term manifestations (eg, blocking policies) of CPA. Two papers^32,38 considered the impact of macro drivers of CPA, such as the political economy of neoliberal capitalism and corporate-friendly regulatory regimes. All but one³⁴ paid attention to both the actions of corporate actors and their narratives, with the majority (9) using the concept of ‘framing’ in examining narratives.

Of the 11 conceptualisations, five were structured/presented as ‘taxonomies’^{6,12,13,34,35}; two^32,38 used theories of power to organise their analysis schematically; one³⁷ was a ‘mnemonic’ encapsulating industry CPA in an easy-to-remember acronym; one³⁶ used a simpler classification system; one³³ was a very detailed list combined with a cluster map of frequencies.

Of the five taxonomies, one³⁵ (food) had a limited number of categories within an accompanying diagram. The other four (in food and tobacco) were closely related: two on tobacco^6,12 were based on systematic reviews and led to the development of the other two on food^13,34 with minor modifications (Figure S1). Three of the four^6,12,13 distinguished explicitly between actions and narratives. In line with the original two,^6,12 all four adopted a tabular, multi-level structure, going from the more general to the more specific, commonly using terminology such as ‘strategies,’ ‘tactics,’ ‘practices,’ and ‘arguments.’ These four taxonomies with tabulated details were the only frameworks within our dataset that had been used by other researchers, featuring collectively in the 24 review papers (Figure S1).

Papers Reporting Use of the Original Frameworks

The review of 24 papers^{7,15,16,41-61} (Table 2) that used one of the four taxonomies showed that all four were applicable and useful for examining the same industry in different geographical and policy contexts, with two^6,12 also being used to study a different industry (Figure 2). Users of all taxonomies introduced changes or additional practices or arguments based on their data.^{7,15,44,48,59} In the case of alcohol industry influence on road safety policy,¹⁵ Ulucanlar and colleagues’ dystopia idea, where industry predicts that policies will have catastrophic consequences, was not relevant; instead, the alcohol industry adopted an active harm-reduction approach, supporting interventions with little impact on sales such as education campaigns. In applying Savell et al⁶ to the gambling industry,¹⁶ the authors found the separation of actions and narrative led to some ‘significant overlap’ and used only the actions framework with some modifications while a related paper by Martino and colleagues⁶² used only the narrative framework.

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Figure 2. The Corporate Political Activity Model.

Interviews, Stakeholder Workshops and Testing Against the Literature

Interviews with seven users of taxonomies, who had experience in tobacco, alcohol and food, indicated that the existing taxonomies were useful, but could be improved. Overlap between categories, where a practice could potentially be assigned to more than one strategy, was identified as a common problem. However, during stakeholder workshops (9 participants each), it was suggested that some overlap was inevitable as corporate actions were often directed at multiple strategic ends and close examination of the data and judgement were needed in categorising these. Another issue was the specificity of corporate arguments in one taxonomy¹² which reduced their applicability to different contexts. Workshop participants suggested that the new taxonomies should be visually and linguistically simple, include well-established rhetorical devices (eg, ‘nanny state’), have fewer levels and broader categories but also include some detail and examples for clarity, and be applicable to all levels of governance including global organisations. This feedback led to a major revision.

For the final testing of the taxonomies, we purposively selected seven papers,^63-69 two for each industry except for gambling where we only identified one paper. The papers included a mix of policies and geographical settings; six were at the national level while one covered both state and federal jurisdictional levels. We populated the taxonomies with data from the papers to explore their fit to different industries and settings. This process showed that they were fit for purpose, but a number of new practices and arguments were added.

The Proposed New Taxonomies

First, we offer a synthesized and updated definition of CPA: Practices to secure preferential treatment and/or prevent, shape, circumvent or undermine public policies in ways that further corporate interests. In developing our taxonomies, we opted for the well-used tabular format, but drew on ideas from all the review papers. In line with interview and workshop findings, we sought to use simple, clear and neutral terminology and a balance between abstraction/parsimony and detail/clarity. In common with most papers, we distinguish between industry actions and frames and present separate but complementary taxonomies of each. Our framing taxonomy loosely follows Benford and Snow’s⁷⁰ typology of ‘diagnostic,’ ‘prognostic’ and ‘motivational’ frames, but with the addition of ‘actors.’ It details how corporate actors construct and present meanings for social phenomena, often in ways amenable to their interests.^71,72 Our taxonomy of ‘action strategies’ details the means by which corporations seek to secure outcomes that will ultimately lead to favourable policies, including by persuading policy-makers, the public and other businesses of the need to base decisions on industry frames. We suggest that, in most cases, users will need to pay attention to both taxonomies. For example, UCIs argue that a particular policy is illegal (framing) and may or may not take legal action against it (action); or they claim that the policy is not evidence-based (framing) and produce pseudo-scientific critique to discredit papers that support the policy (action). The taxonomies are also represented in our CPA model which contextualises them within socio-political and economic systems.

Like most existing taxonomies, ours have two levels: (1) higher, overarching categories (frames or strategies) and (2) explanatory or constitutive categories (frame-supporting claims or mechanisms). A third column provides more illustrative detail. We have tried to ensure that categories are mutually exclusive; however, as noted widely in the literature, it is likely that some CPA instances will fit into more than one category, posing a challenge to users. We advise that users consider contextual information and objectives of the categorisation when populating the taxonomies. Furthermore, users are advised to treat the illustrations in the third column as a guide and not as prescriptive or exhaustive lists. We expect future applications will uncover many different examples that are not currently in the taxonomies, but that will be accommodated by the higher categories, while additional claims or mechanisms may also be identified. Here, we give an overview of each taxonomy section; empirical examples for each category with references to the dataset can be found in Table S5 (Supplementary file 2) and Table S6 (Supplementary file 3).

Taxonomy of Framing Strategies

We propose that UCI framing is nested within an overarching and simplistic dichotomy: corporate intentions, values and actions are ‘good’; those of the proponents of industry-opposed policies are questionable or ‘bad.’ An inversion is implied, whereby corporations position themselves as representing and speaking for the public interest while they position those proposing the policy as damaging the public interest through incursions, restrictions and non-market interventions. UCIs use this simple ‘good/bad’ dichotomy to frame three key issues – the actors, the problem and the solutions – in ways that make strong, regulatory public health responses less politically acceptable and less likely to be implemented. The intended audiences of framing include other businesses, policy-makers, civil society organisations, and the public (Table 3).

The good actor: corporations. UCI corporate actors construct for themselves a range of identities that position them as key commercial entities with high levels of competence, integrity and foresight. Moving beyond business and the claim of positive economic contribution, they profess a concern with and claim expertise in public health, science and social justice. Crucially, they present themselves as legitimate policy partners to government, meriting extensive access to policy-makers and possessing unique and essential information. When necessary, they also claim victimhood, arguing policy-makers make the conduct of business difficult or demonise corporations.

The bad actors: proponents of whole-population, statutory policies or regulations which industry opposes. Corporate actors portray proponents of such policies – whether they are government departments/global organisations with public health duties or public health professionals/advocates – as ineffective, misguided or disingenuous. They accuse them of making incompetent policy choices, having a hidden agenda of wider prohibitions (‘slippery slope’), or acting as the ‘nanny state’ and interfering in peoples’ lives. Similarly, independent scientists whose findings counter industry interests are charged with scientific misconduct, providing inaccurate information, giving bad advice to policy-makers and authoritarianism. In other contexts, for example where policies or approaches favour corporate interests, UCIs may frame the relevant organisations (including global ones) and governments more positively, claiming an alignment with industry and even producing shared narratives.

The trivial problem: created by a minority of consumers. Central to UCIs’ framing of the public health problem is the suggestion that their products or services do not harm health – and can, on the contrary, contribute to it. Any health problems are caused by a minority of uninformed or irresponsible users, for example ‘problem’ drinkers or gamblers, with the public health community exaggerating the problem. However, this framing has become less convincing for tobacco, an addictive product whose harms are universally acknowledged; instead, the TI refers to the ‘public health benefits’ of smoke-free products and promotes its role in a ‘smoke-free future.’^73,74 In the same vein, the alcohol and gambling industries are keen to differentiate their products/services from tobacco products, arguing that unlike tobacco, the former are not intrinsically harmful but can be if misused. Another, deflective, framing technique is to argue that governments are wasting time and resources on a trivial problem and ignoring more urgent/bigger problems.^75,76

The acceptable, ‘good,’ solution: individual-focused, corporate supported. Having framed the public health problem in this way, corporate actors define the solution as targeted interventions aimed at individual behaviour change through, for example, education and information particularly for the ‘irresponsible user’ or ‘harm reduction’ approaches that also enable industry products to be seen as part of the solution. They posit self-regulation and voluntary codes as appropriate and cost-effective ways to align industry practices with the public interest and people’s health. These framings are designed to minimise impact on market transactions and profits.

The unacceptable, ‘bad,’ solution: whole-population, statutory. UCI actors reject statutory public health interventions that target product supply and availability and impact on whole populations (and corporate profits). They produce and publicise a suite of reasons for why proposed policies are unacceptable and likely to fail with significant negative consequences. These include policy redundancy, incoherence, irregularity or illegality and the arguments that policies are regressive, not evidence-based and too restrictive, infringing on personal freedoms. In terms of negative consequences, UCIs consistently present potential corporate losses as public catastrophes. Thus, potential business impacts such as implementation costs, loss of sales, revenue, competitiveness, return on investment, possible closures and industry-specific job losses are almost always linked to and interwoven with impacts on the wider economy such as business closures across other sectors (eg, farming, advertising, informal sector), unemployment, smaller gross domestic product (GDP), reduced tax revenue, reduced foreign investment and slowed development for LMICs, and loss of industry investment in social justice projects or competitive sports. Meanwhile, UCI actors tend to remain silent on potential impacts on share prices, dividends and, sometimes, sales, all primary concerns for corporations but less likely to produce public sympathy or alarm. Another claim is that policies will fail or have failed elsewhere and will lead to perverse consequences such as confusing consumers. In some cases, especially in tobacco and alcohol, UCIs also argue that the policy will increase illicit trade and smuggling (despite, for example, the TI engaging in these⁷⁷). The gambling industry argues that domestic restrictions will encourage people to seek (illegal) off-shore gambling sites.⁷⁸

Taxonomy of Action Strategies

Corporations take a wide range of actions to persuade policy-makers and the public of the legitimacy and value of their framings. We identified six strategies of which four target the central domains of policy-making: policy-makers and policy processes; the law; evidence; support from diverse sections of society. A fifth targets how public health is conceived and delivered on the ground and aims to shape these in line with corporate interests. The last, managing reputations, is a cross-cutting strategy that permeates and facilitates all the others. Importantly, individual strategies and practices can both overlap and work synergistically, enhancing their effectiveness. While we have teased them out into separate categories to create the taxonomy, in real life they often represent composite actions or chains of events. The following is an example: corporations pay for research (shape evidence to manufacture doubt); issue press releases about the findings and put forward experts to the media (manufacture public support for industry position); and take research summaries to meetings with policy-makers (access and influence policy-making) (Table 4).

Access and influence policy-making. A prime corporate strategy is to infiltrate the centre of policy-making – governments at all levels, global organisations and regulatory agencies – in order to proactively shape, delay, or stop policies. Access mechanisms include incentives (money, resources, hospitality, gifts, bribes) and, conversely, threats (industry pulling out of operations or investments). Corporations use revolving door practices to offer current and former politicians and officials positions within industry and secure roles for their staff within policy-making bodies, creating conflict of interest conditions within the policy space and sometimes leading to ‘regulatory capture’ (especially in LMICs) where regulatory and policy-making bodies are effectively beholden to corporations and no longer able to take independent and public interest decisions. Additionally, they seek to influence standard setting bodies and standards that have regulatory implications, sometimes through science and health and safety companies. Influence is also sought through gathering and presenting information/evidence, offering help, conducting various forms of lobbying, and participating in formal consultations. Two important mechanisms of influence are (1) venue shifting: transferring policy-making to politically more favourable jurisdictions where industry preferred outcomes are more likely, and (2) preemption: introducing less restrictive regulation at higher jurisdictions to foreclose stronger public health legislative possibilities at lower jurisdictions, sometimes for many years. Once a policy is adopted, corporations may attempt to undermine implementation through the use of administrative barriers or non-compliance.

Use the law to obstruct policies. Corporate actors try to stop policies by threatening or taking legal action under domestic and international laws or by supporting countries to initiate dispute procedures at global bodies like the World Trade Organization (Table S3, Supplementary file 1). Cases may be unlikely to succeed, but are initiated to delay policy implementation and to create a deterrent to other countries and future policy-making, known as ‘regulatory chill,’ especially in under-resourced LMICs. Industry also uses the law to interfere with policy-making bodies and remove their powers, influence judges and obstruct public health campaigners through (threat of) injunctions.

Manufacture support for industry position. To complement direct involvement, corporations try to give the impression of favourable public opinion through a wide variety of alliances. First, the various industry actors work to mitigate normally competitive relationships and to pool resources and ideas so they can speak in unison, often with input from public relations and other consultancies. Support is secured from indirectly affected peripheral businesses and other sectors – advertising or hospitality sectors, for example. Beyond business, public support is engineered by recruiting a wide range of civil society organisations (professional, consumer, patient, community), key individuals and foreign governments, using payments and false narratives where there is no interest convergence. Further, UCIs fabricate allies, setting up and/or funding a variety of industry-supporting organisations which can take the form of third parties, front groups or astroturf organisations.⁷⁹ Allies add value to corporate campaigns, amplifying industry framings in (social) media and undertaking lobbying, litigation and agitation while keeping their links with corporations hidden or obscured. In this way, they create the impression that they are independent and that a very large segment of society supports the industry position. The use and manipulation of (social) media are critical in achieving this and UCIs use money and relationships (sometimes called ‘media capture’) as well as advertisements and promoted content to maximise favourable coverage.

Shape evidence to manufacture doubt. UCI corporate actors also try to create the impression that the health harms of their products and services, and the effectiveness of regulatory action are genuinely contested, despite the weight of evidence demonstrating both. They undermine studiesthat report harms or policy effectiveness/legality through pseudo-scientific and unscientific critique. More proactively, they create a parallel scientific literatureusing their own scientists and commissioning others to produce contradictory evidence on health harms and policy effectiveness, as well as to promote industry products or policy alternatives. They complement this with a very large body of non-scientific information, often containing falsehoods or half-truths, to be used as lobbying materials aimed at policy-makers, the media, the public, professionals and civil society organisations. The key to creating doubt is to amplify corporate-favourable research and information and to blend these into the body of evidence and public discourse, removing corporations’ fingerprints in the process through a variety of practices and the use of the diverse allies outlined above.

Displace and usurp public health. An increasingly important strategy is to create an apparent redundancy for regulation through policy substitution, or self-regulation and voluntary codes, as well as to shape public health provision. Corporations thus contribute to the funding, planning, delivery and evaluation of services through a variety of organisational forms and partnerships with public bodies (sometimes referred to as public-private partnerships). These are often less effective interventions with less impact on sales. The appropriation of the concept of ‘harm reduction,’ an established approach in drug addiction,^80-82 enables corporations to narrow the focus of policies and to create new markets for ‘reduced harm’ products. UCI actors promote this weaker version of public health through providing education materials and activities to public health professionals. Finally, they engage in negative action to fragment the public health community by creating divisions or through monitoring and intimidation.

Manage reputations to corporations’ advantage. Although tobacco is an outlier, many UCI corporations suffer from a reputational deficit in the public health arena owing to their exclusive focus on profit maximisation. So they engage in corporate social responsibility (CSR) and “good deeds” and, particularly in under-resourced settings or countries, present themselves as a substitute for government, using their operational scale and resources to become involved in poverty alleviation, crisis management, law enforcement, etc. They also seek respectability by association, appearing at academic events, publicly declaring links with respected scientists, national and international organisations and government agencies and even using their logos on industry information materials. Conversely, they seek to undermine the reputation of researchers, advocates and organisations by attacking and defaming them through (social) media, blogs, correspondence, freedom of information requests, data access requests and official complaints.

We now offer an analysis of the strengths and weaknesses of corporate strategies.

Strengths and Weaknesses of Corporate Strategies

The CPA literature generally points to the well-resourced, well-organised and well-executed nature of CPA. These are features that we have also identified. At the same time, however, we have elicited weaknesses in corporate strategising, an understanding of which may be useful to public health advocates and policy-makers (Table S4, Supplementary file 1).

Strengths

Extensive financial resources – or ‘heaps of money’³⁷ – allow corporations to bankroll their various activities. The ability to cooperate and coordinate with other corporations and industries, and to speak with a unified voice is an obvious advantage, although there are exceptions to this.^11,16,36 Well organised and often professionally managed campaigns produce homogeneous, widely circulated messages. Creating synergy – combining multiple strategies and practices for greater impact – is also a key strength.³⁶ As shown in our framing taxonomy, taking on multiple identities – scientist, public health expert, policy-maker, development economist, consumer, citizen – allows UCI actors to create the impression of broad support but also to ‘colonise’ and shape different social domains. Ubiquity allowsthese actors to have presence in all potential policy venues and situations where influence may be exerted. We identify a further strength that we term ‘hyper-adaptability,’ defined as a continuous ability to adapt to conditions and contexts by altering positions and methods. Underlined by pragmatism and manifested as contradictions, hyper-adaptability enables corporations to use their strategies in different cultural, social, political, economic and jurisdictional settings and at different time points by selecting strategically from the menu of claims and practices and tailoring their narratives and actions to the cultural zeitgeist.⁸³ One example is their approach to the transferability of evidence between settings. Where evidence from other countries is unfavourable to UCIs’ interests (eg, showing product harms or policy effectiveness),^57,61 corporate actors argue the evidence cannot be valid elsewhere; where that evidence serves their interests (often evidence they have produced), they promote it, claiming it is relevant.⁵³ Depending on context, UCIs try to stymie policies using two contradictory arguments: that population-level policies are too extensive and heavy-handed^36,44 and that they are too simplistic.^13,36,60 They give rhetorical support to evidence-based policy-making^36,56,60 while misrepresenting high quality independent research and promoting alternative evidence, often its own, of poor quality and misleading.^12,33,57,60 Corporations’ actions generally appear collaborative and constructive, for example offering help with policy-making, but, as the action taxonomy makes clear, when necessary, they engage in hostile and destructive action, for example issuing threats to governments. They encourage high-income countries (HICs) to counter policies of LMICs and vice versa³⁸; they form alliances with chambers of commerce and businesses^58,60 as well as with trade unions.^58,44 Finally, their practices are on a continuum of visibility, ranging from the covert (bribery, undermining advocates, front groups) through opaque (lobbying, sponsoring research, directing allies’ activities) to overt (media campaigns).

Weaknesses

Hyper-adaptability can also be understood as a weakness, as it exposes the incoherence of corporate messaging and actions. Furthermore, notwithstanding hyper-adaptability, the core strategies are highly predictable, showing consistency over time and place and across industries, constituting a ‘play-book’ used not just by the industry sectors we examine here, but more broadly, including fossil fuels.^84-86 Corporate actors make ample use of easily fact-checked falsehoods. Many corporate alliances represent ‘grafted common interests’⁸⁷ or ‘stitching’⁸⁸ and veil over a dissonance of interests between corporations and their allies. Occasionally, businesses compete and clash publicly over policies. A more subtle but crucial weakness is the caricaturised accounts of social life offered by corporate actors, where everything they represent and do is good and everything opponents represent and do are bad, for example: proposed policy is utterly bad, has no redeeming features and will have catastrophic consequences; only corporations (not the public health community) has the public’s interest at heart and the expertise to address the health problems. Finally, UCI actors’ reluctance to publicly acknowledge obvious risks to themselves, for example loss of sales, points to the dishonesty of their messaging. Awareness of the predictability of corporate actions, aided by tools such as the current taxonomies, will provide an opportunity to pre-empt them; exposing the inconsistencies and incoherence in corporate narratives will expose much of it as propaganda.

Contextual Variation

Corporate Political Activity Model

We have presented our detailed taxonomies of UCI political strategies and their strengths and weaknesses. We are conscious, however, that these strategies are embedded within a wide nexus of economic, political, scientific, cultural, and social systems that can facilitate or hinder corporate strategies and success. Our analysis also focused on these wider phenomena and we present here the CPA model (Figure 2). The model captures the systemic nature of corporate influence on public policy and underlines the impact of context.

The model first highlights that the strategies detailed so far (both the framing and action strategies in the outer circles of the model) are directed towards a range of objectives: short-term/reactive objectives aimed at solving specific policy ‘problems’ and long-term/proactive objectives directed at creating an enduring corporate-friendly policy environment. In the short term, corporate actors seek to influence all the stages of the policy cycle²⁹: suppress public health concerns and keep them out of public discourse (agenda setting); contribute to shaping policy (formulation); block, substitute or amend policy to weaken it (deliberation/adoption); sabotage policy by preventing, delaying, undermining or reversing it (implementation); present policy as failed and ineffective so it will not be implemented elsewhere (evaluation). In the long term, they seek to: normalise industry as a policy partner; disenfranchise the public health community; re-configure and constrain public health as a non-regulatory, individual-focused practice in which corporations are essential; de-normalise precautionary approaches to narrow policy scope; re-configure scientific standards to make it more difficult to demonstrate both the need for and effectiveness of policy. Both the framing and action strategies are used eclectically to achieve these goals as the model shows. Second, the model draws attention to two types of context: structural and dynamic. The structural context refers to the dominant political and economic system and norms and stage of development where the policy is being made. The integration of capital and state and the dominance of their interconnected interests from national to global level in most settings constitute a corporate-enabling structural eco-system with political, economic and regulatory manifestations.⁸⁹ These include, for example, neoliberalism as the global political/economic norm, the focus on GDP growth, global trade and investment rules that privilege economic exchange over public health and corporate-friendly regulatory regimes.⁸⁹ Many corporate strategies are thus made possible by and benefit from an underlying receptivity of the state and society. At an empirical, dynamic level, policy outcomes at a variety of settings (local, national, regional, and global) provide important precedents for and shape the policy context for other settings. These precedents define the boundaries around political acceptability and financial costs of policy, for example when corporate actors claim policy has failed or initiate legal action against it, making other governments unwilling to pursue it.

We suggest that an illustration of the impact of structural and dynamic contexts can be found in the more aggressive and possibly more successful CPA strategies corporations deploy in LMICs.^38,57,61 The contextual factors that account for this include: the importance of LMIC markets to UCIs as HIC markets shrink and as LMIC economies and populations expand; the urgent goal of economic development in LMICs including investment (which can involve external pressure for trade and investment liberalisation including in products harmful to health) and dependence on exports for revenue; fewer technical, financial and legal resources of LMIC governments; greater power differential between governments and transnational corporations; less developed democratic institutions and traditions such as a free press and civil society advocacy.

The CPA model thus goes beyond specifying the different strategies corporations use by offering an explanation for why industry actors use these strategies and how their use can be facilitated by invisible or unproblematised social and political norms and arrangements.

Discussion

In this study, we have sought to de-construct CPA into its micro elements (taxonomies of framing and action strategies) and also offer a macro-level view (the model), a holistic approach that we hope scholars, advocates and policy-makers will find useful. The CPA model recognises the complex, contingent and generative nature of policy-making and locates it within much broader social, political, economic, and cultural structures and empirical contexts that impact on it. Our taxonomies distinguish between framing strategies that define the policy actors, the public health problem and the appropriate solutions in ways that promote corporate goals, and action strategies designed to persuade policy actors of the legitimacy and value of these framings as guides to decision-making. We have highlighted the strengths and weaknesses of corporate strategising as a starting point to developing counter strategies.

Our model and taxonomies are based on peer-reviewed data on four UCIs, systematic qualitative analysis, insights from expert co-authors and input from a stakeholder group of advocates, academics and policy professionals, who, between them, had experience of a range of industries (including all four covered here), countries and jurisdictional levels. However, our literature searches were restricted to peer-reviewed papers that developed or used a conceptual framework and it is likely that we missed some forms of CPA reported in papers without a conceptual focus or in the grey literature. Our sample had more papers relating to the food industry and only two for gambling (but was more evenly distributed across HICs and LMICs). Nevertheless, the majority of claims and practices were used by all four industries (though as noted, we had more limited evidence for gambling), suggesting that our taxonomies are widely applicable. Our use of reported data interpreted by other researchers enabled access to a much larger body of evidence than primary research would have allowed. Finally, reducing social complexity to the tabular format of a taxonomy was challenging, necessitating some compromise, for instance, simplification and artificial demarcations.

Our evidence confirmed that all four UCIs employed very similar practices. It is also increasingly clear that mining,⁹⁰ pharmaceuticals,^91,92 fossil fuels⁸⁶ and other industries^84,93 also deploy similar CPA strategies. Policy influence by corporations in non-democratic states is less well understood, but there is some evidence that it follows similar patterns.⁹⁴ As we have shown and as others have also highlighted,^95-97 corporations are agile and opportunistic political actors who draw on both ideational (narrative) and material (resource-based) sources of power. Using multiple voices, they co-opt the fields of policy-making, science production, public health and public opinion, ultimately making it difficult to disentangle the propaganda from the genuine, rendering corporate-sponsored values, norms, standards and definitions dominant.^89,98 Through the use of combined strategies and in particular the practice of preemption, they remove communities,’ countries’ and global organisations’ right to legislate to protect health, creating a dangerous democratic deficit. In deploying these strategies, corporations are enabled by a global, consolidated and networked base of corporate institutional power - which can even dwarf state power on occasion.^89,99 In most countries, this power results in a pro-business agenda in which corporate objectives are assumed to be synonymous with the public good^100,101 and neoliberal values are internalised. The ideological allegiance to free-markets and the aversion to regulation means that politicians are often willing to accommodate business objectives at the expense of the public interest.^102-104 It also limits what policies may be considered or adopted.¹⁰⁵

As both human and planetary health come under increasing threats from the way capitalism is currently organised and in particular the single-minded pursuit of GDP growth,^106,107 there is an urgent need for policy-makers, advocates and scientists to fully understand the nature and implications of CPA. This means understanding CPA not as an ordinary and legitimate phenomenon in participatory democracy but as a corruption of democracy and an illegitimate colonisation of both the public and the private spheres.¹⁰⁸ As corporations become increasingly integrated into political decision-making and public deliberation, they become more than one stakeholder group among many and act instead as powerful entities that ‘attempt to use the power of government to advance private ends.’⁴⁰

Effective strategies to counter CPA and protect public policy from harmful corporate strategies are urgently needed to reverse the growing burden of NCDs on world populations. Notwithstanding Article 5.3 of the Framework Convention on Tobacco Control,¹⁰⁹ work to identify and evaluate the best approaches is in its infancy.¹¹⁰ Here, we suggest some potential directions for this important work based on our taxonomies and model, although we recognise that this can only be a partial view of a much wider field of study.

Our work highlights the predictable nature of UCI CPA and our model and taxonomies can therefore be used to develop simple tools to track, effectively expose and counter it. Such tools can be used both in the acute policy window to help ensure passage of specific public health policies and to monitor ongoing CPA. This surveillance of CPA can play an essential role in increasing transparency, addressing the democratic deficit in policy-making and ensuring that appropriate and timely counter-actions are taken. As such there is a case for institutionalising it into national public health surveillance systems as occurs for environmental pollution and vectors of communicable diseases.

However, as lessons from tobacco control highlight, more sustainable approaches require us to understand and address the long-term strategies of corporations¹¹¹ and our model can again be used here. It highlights, for example, corporate actors’ longer-term focus on normalisation, on reconfiguring scientific standards and on nudging policy-making towards risk-based rather than precautionary approaches. Public health must seek to redress such efforts, through denormalisation for example, and prevent their spread by being alert to corporate efforts to globalise such approaches to policy-making.⁸⁹ This would, in turn, be enabled by more structural approaches including, for example, a global instrument modelled on Article 5.3¹⁰⁹ which would seek to prevent corporations’ disproportionate access to policy spaces and increase transparency,^20,54,112 and a statutory commitment to public health representation in trade and investment negotiations.¹¹³ It is clear, however, that Article 5.3 is not a panacea; the TI has used its power to adapt its influence strategies in light of 5.3 and is now increasingly operating via third parties and investing in ever more elaborate normalisation campaigns.^111,114 This then requires a more systems-based approach^17,115 that pays attention to how power circulates within political, economic and scientific systems¹¹⁶ and addresses the sources of power available to corporations. Adequate taxation systems to address extensive tax avoidance¹¹⁷ and the use of a tax on corporations to fund independent research, preventing their ability to use science as a political tool,¹⁸ are two examples. Governments and civil society can also make better use of their power.¹¹⁸

Our findings call for a research and advocacy agenda that combines expertise, resources and insights across industry sectors and, at the same time, pays close attention to structural factors, in particular neo-liberal capitalism as the fundamental cause of health harms^89,119,120 and focuses on solutions to CPA. While there is always scope for more case studies that track corporate strategies at different geographical, jurisdictional, political and sociocultural settings, with representation from LMICs,¹¹⁹ particularly on the gambling industry, above all studies must shift to focus on potential solutions. A significant research gap is the perspectives and practices of policy-makers at national, regional and supranational levels with regard to CPA; researchers must find creative and sensitive ways to engage the policy community in ethnographic studies that will shed light on this relative ‘black box.’⁵³ Finally, researchers should engage with policy-makers, the public and civil society organisations through (social) media to transfer their knowledge on how corporations influence policy-making and harm people’s health and to expose the faulty logic implied in corporate narratives that UCIs can be both ‘problem makers’ and ‘problem solvers.’⁶⁴

Acknowledgements

We thank the anonymous reviewers for their insightful comments and our stakeholder participants (those who are named below and those who wished to remain anonymous) for helping with the development of the CPA taxonomies: Safura Abdoolkarim, Petronell Kruger, Catherine Egbe, Pascal Diethelm, Connie Hoe, Anca Toma, Maisha Hutton, Stella Bialous, Nason Maani, Erin McEvoy, Camila Maranha, Andre Silva, Joana Madureira Lima, Adam Bertscher, Katherine Severi, Maik Duennbier, Paula Johns, Niamh Fitzgerald, and Samantha Thomas.

Ethical issues

This research was approved by University of Bath Research Ethics Approval Committee for Health (REACH ref: EP 20/21 012).

Competing interests

Authors declare that they have no competing interests.

Funding

This work was supported by Bloomberg Philanthropies’ Stopping Tobacco Organisations and Products (STOP) funding (https://www.bloomberg.org/) and by the UK Prevention Research Partnership (MR/S037519/1), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome. The funders had no role in the design and conduct of the study, data collection, data management, data analysis and interpretation and preparation, review and approval of the manuscript.

Supplementary files

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