The damage that smoking can do to human health has been established by scientists beyond doubt, while the unethical activities of leading tobacco companies have been documented repeatedly, and in detail.
How, then, can researchers maintain their academic rigour when tasked with exposing cigarette manufacturers’ wrongdoing?
That is the task facing Anna Gilmore, professor of public health at the University of Bath. Although she trained as a doctor, she described herself as having switched to “research on what I would describe as the commercial determinants of health, because increasingly the things that kill us are the products of major corporations”. When she joined Bath in 2007, she set up and became director of the Tobacco Control Research Group.
The rationale, as described by Professor Gilmore, was simple. “The product that kills more people than anything else is tobacco…if you want to improve health, you have to reduce tobacco use,” Professor Gilmore said. “Repeatedly we’ve seen the tobacco industry misbehave – on all fronts – influencing policy, manipulating science, involvement in smuggling and bribery.”
Although “committed to peer-reviewed research” as a way of “answer[ing] key questions in a rigorous way”, Professor Gilmore told Times Higher Education that it was crucial to “make the research useable and accessible”. A journal article might, for example, mention but not describe in detail the dozens of lobbying organisations. Yet “the World Health Organisation, civil servants and NGOs”, recalled Professor Gilmore, “would call me and say ‘Have you come across this organisation? Do you think they are working for the tobacco industry?’ I realised we had a lot of information that wasn’t reaching people in the format they needed.” They therefore set up the TobaccoTactics website in 2011, which she now regarded as “the global go-to site for information on the tobacco industry”.
Anyone who takes on a major industry can expect a concerted response, and Professor Gilmore said that the group was “continuously attacked and abused on social media by those we know are linked to the tobacco industry. They make defamatory claims about where our funding comes from. They have set up a fake Twitter account, and fake Facebook and LinkedIn accounts, [and] a counter website. We have had phone calls threatening violence, [and] Freedom of Information requests designed to slow us down and undermine us.”
Speed was often essential as a way of fighting back.
At the time when the UK government was proposing plain packaging for cigarettes, Professor Gilmore explained, “we were able to start [our] research early because, based on our previous research, we could predict what the industry would do. We had previously shown that it has been hugely influential in setting up a system known as Better Regulation, by which every policy has to have an impact assessment and a stakeholder consultation…We predicted that they would hijack this system because it provides them with a conduit to submit so-called ‘evidence’ to government consultations. And that is absolutely what they did.”
Claiming that “plain packaging wouldn’t have been implemented” if they hadn’t intervened, Professor Gilmore also pointed to other areas of success. As a result of their work in Africa on ways of monitoring the tobacco industry, they “were approached by a whistleblower from British American Tobacco. That led to a [2015] BBC Panorama documentary, on which we acted as advisers, about the use of bribery in Africa to secure influence over government policy. The Serious Fraud Office has since launched an official investigation.”
Yet academic research is obviously based on different standards and rules than campaigning or investigative journalism. So how does Professor Gilmore ensure that the group’s work is totally rigorous and brings an open mind to each new claim made by the tobacco industry?
On the specific issue of harm reduction, she acknowledged that “e-cigarettes can play a role in reducing harm. Of course I’m not going to oppose them just because the industry sells them.” Nonetheless, a global perspective revealed that “they are still massively promoting cigarettes and obstructing policies which would reduce smoking. Their claim they are just committed to harm reduction and are ‘giving up cigarettes’ is therefore highly misleading. Of course they also want to sell their novel products, but there is no way they want to cannibalise their existing market.”
More generally, Professor Gilmore claimed that she “always say[s] to my team that you have to ask a clear research question at the beginning…and be open to any possibility”. Furthermore, they ignored the kind of hearsay or circumstantial evidence journalists might focus on: “We examine [industry] documents in intricate detail, triangulating them with other material and each other. The vast majority of them are released through litigation; some are leaked; we put what we are able to on a public website [at the University of California, San Francisco]…We would never make claims on the basis of ‘So and so saw so and so’.”
