Article Text
Abstract
Background Tobacco corporation Philip Morris International launched the Foundation for a Smoke-Free World (FSFW), a purportedly independent scientific organisation, in 2017. We aimed to systematically investigate FSFW’s activities and outputs, comparing these with previous industry attempts to influence science, as identified in the recently developed typology of corporate influence on science, the Science for Profit Model (SPM).
Design We prospectively collected data on FSFW over a 4-year period, 2017–2021, and used document analysis to assess whether FSFW’s activities mirror practices tobacco and other industries have historically used to shape science in their own interests. We used the SPM as an analytical framework, working deductively to search for use of the strategies it identifies, and inductively to search for any additional strategies.
Results Marked similarities between FSFW’s practices and previous corporate attempts to influence science were observed, including: producing tobacco industry-friendly research and opinion; obscuring industry involvement in science; funding third parties which denigrate science and scientists that may threaten industry profitability; and promoting tobacco industry credibility.
Conclusions Our paper identifies FSFW as a new vehicle for agnogenesis, indicating that, over 70 years since the tobacco industry began to manipulate science, efforts to protect science from its interference remain inadequate. This, combined with growing evidence that other industries are engaging in similar practices, illustrates the urgent need to develop more robust systems to protect scientific integrity.
- Tobacco industry documents
- Tobacco industry
- Surveillance and monitoring
Data availability statement
All data relevant to the study are included in the article or uploaded as supplemental information.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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WHAT IS ALREADY KNOWN ON THIS TOPIC
Litigation forced three tobacco industry-funded organisations to cease operating due to their role in spreading scientific misinformation.
Philip Morris International (PMI) launched a new scientific organisation, the Foundation for a Smoke-Free World (FSFW) in 2017. Many fear FSFW plays a key scientific and public relations role for the tobacco industry.
WHAT THIS STUDY ADDS
We show marked similarities between FSFW’s outputs and activities and previous corporate attempts to influence science.
Our findings indicate that FSFW should be understood as an industry-influenced scientific lobby group promoting tobacco industry interests, akin to the historical tobacco industry-funded groups that were forcibly closed.
HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY
PMI’s funding of FSFW endangers progress made in protecting science from the tobacco industry, including by rendering academic journal policies ineffective, and circumventing norms about the unacceptability of collaborating with the tobacco industry.
The development of more robust systems to ensure science is in the public interest is urgently needed.
Introduction
There is overwhelming evidence of the tobacco industry’s history of manipulating science—first to deny the link between cigarettes and cancer, and subsequently to deny the harms of passive smoking.1 2 The industry’s ability to influence science relied upon creating purportedly independent third parties to undertake key scientific roles.3 From the 1950s onwards, Philip Morris and others used the Tobacco Industry Research Committee (TIRC) to conduct science deflecting attention from tobacco harms1 and in the 1980s created the Center for Indoor Air Research (CIAR) to mislead the public about passive smoking.2
In the late 1990s, litigation settlements forced three tobacco industry-funded organisations based in the USA (the Tobacco Institute, TIRC and CIAR) to cease operating due to their role in spreading misinformation.4 A subsequent federal court order—which found the tobacco industry guilty of a ‘lengthy, unlawful conspiracy to deceive the American public’—banned US-based tobacco corporations from recreating such bodies.5
Since these landmark rulings, academic and public health communities have sought to better protect science from tobacco industry influence. Academics have proposed stronger firewalls between funding and research,6 and some scientific journals have implemented measures to manage or ban tobacco industry research.7 8
Despite this progress however, or perhaps because of it, in September 2017, Philip Morris International (PMI), which was not bound by the US litigation,9 launched a new scientific organisation, the Foundation for a Smoke-Free World (FSFW or ‘the Foundation’), pledging nearly a billion dollars in funds.10 With growing concern within the public health and academic communities about the nature and conduct of FSFW,11–15 there is a pressing need to better understand its involvement in science.
With this as our aim, we systematically assessed FSFW’s outputs and activities and compared these with strategies which diverse industries have historically used to shape science in their own interests, as identified in a recently developed evidence-based typology of corporate influence on science—the Science for Profit Model (SPM).16 The SPM was developed by the first and last authors, and draws on the extensive literature on corporate influence on science. It demonstrates that corporate sectors including the tobacco, pharmaceutical, chemicals, fossil fuels, alcohol and food industries have used the same collection of strategies to manufacture doubt and ignorance (or agnogenesis)17 18 about harms of industry products or the efficacy of policies affecting industry, promote industry-favoured solutions to public health issues and legitimise industry involvement in science.16 The typology outlines four macro strategies (comprising 17 meso-level strategies) through which industries have worked to influence science (see table 1). Despite other analyses providing rich accounts of the tobacco industry’s history of manipulating science,1 18 19 we chose to use the SPM as its comprehensive categorisation of industry strategies enables its use as an analytical framework. We address the following research questions:
In what ways, if any, does FSFW operationalise tobacco industry influence on science?
In what ways, if any, does PMI’s funding of FSFW jeopardise progress made to protect science from tobacco industry influence?
Method
We prospectively collected data on FSFW over a 4-year period, and used two types of document analysis to assess whether FSFW’s activities mirror previously documented industry attempts to influence science.
In September 2017, we established a system for monitoring FSFW’s outputs and activities. Beginning with FSFW’s website and relevant Google alerts (used to identify web sources), this grew to include other primary data sources, which in turn provided search terms (including names of grantee organisations and associated principal investigators) for secondary data sources (see table 2). Using these sources, we collected data related to FSFW’s work on tobacco harm reduction and smoking cessation (its agricultural diversification workstream not being the focus of this paper) until September 2021.
Our analytical method was twofold. First, we drew on Forster’s approach to the analysis of company documentation,20 a method used in previous analyses of tobacco and food industry documents.21–26 This method involved understanding the meaning of individual documents through reading and rereading them over time as knowledge increases, discussing their meaning, and considering multiple documents and types of documents concurrently. The purpose of this process is to look for corroborations and discrepancies between documents to derive meaning, and the ‘back-and-forth’ between data and interpretation helps to build understanding. Documents are then recontextualised using other data sources (for instance, we compared claims made by FSFW with the wider evidence base). While Forster’s approach is primarily inductive, we conducted our analysis in a more deductive way. That is, we combined Forster’s procedural steps with a deductive approach to searching for the industry strategies identified in the SPM16 (using a slightly adapted version of the typology—see footnote to table 1). We also worked inductively, remaining open to identifying the use of additional strategies.
Second, through the initial stages of our analysis, it became clear that a more detailed investigation into one of the SPM’s meso strategies—‘Fund and undertake ‘safe’ research’—could bring further insights. To do this, we conducted a content analysis27 (rather than the iterative, comparative analysis of documents described above) of a subset of the data—peer-reviewed and preprint articles funded by FSFW. Preprint articles are outputs hosted on online open science publishing platforms (such as MedRxiv, BioRxiv and F1000). These outputs are uploaded onto the platforms by their authors, and are not subject to independent prepublication peer review. For this analysis, we used the seven types of ‘safe’ research identified in the SPM as benefiting industry as a priori categories, coding any presence of these in the dataset while also searching for new categories.
Findings
We obtained over 700 items of data, and through our analysis found marked similarities between FSFW’s activities and outputs, and strategies previously used by corporations and their third parties to influence science. Key evidence is outlined below.
Strategy A: influence on the conduct and publication of science
The original 2018 ‘pledge agreement’ between FSFW and PMI indicates that FSFW’s funding is conditional on its research focusing on ‘tobacco harm reduction’,28 rather than on broader tobacco control measures. In 2020, this document was updated. A comparison of the original and updated versions of the agreement shows the description of FSFW as ‘free from influence’28 from PMI was changed to ‘free from improper influence’29 and the following was added:
Nothing in this section… shall be interpreted to prohibit the Foundation from exchanging information or interacting with any third party, including but not limited to the pledgor… [i.e. PMI] …, or other donors, in order to advance the Foundation’s purpose.29
This suggests PMI is exerting, and reserves the right to exert, influence over FSFW. Collectively, FSFW-funded research outputs remain within the narrow research field dictated by this pledge agreement. Through a content analysis of FSFW-funded peer-reviewed and preprint research outputs, we found evidence of all seven of the types of ‘safe’ research (strategy 1) identified in the SPM. Such ‘safe’ research benefits industry by distracting attention from industry harms, framing industry products as ‘solutions’ and promoting interventions that minimise damage to product sales (see table 3 for illustrative examples).
While it is not surprising that literature reviews on newer tobacco and nicotine products often include tobacco industry-funded research (since this comprises much of the current evidence base), several FSFW-funded literature reviews rely on tobacco industry-funded literature without acknowledging its funding source, and fail to detail how literature was selected for inclusion. Such reporting omissions create the risk that literature has been cherry-picked for inclusion, potentially mirroring previous industry attempts to influence the findings and conclusions of research syntheses (strategy 3). They also have the effect of obscuring the provenance of the included works, with readers unaware that a review’s findings and conclusions are based on science including that funded by the tobacco industry. One narrative review on e-cigarettes and respiratory health30 emphasised potential benefits of e-cigarettes, citing literature including that funded by British American Tobacco, Philip Morris USA, Lorillard, R.J. Reynolds and Imperial Tobacco-owned Fontem Ventures. This was only evident on inspection of the cited works’ funding declarations. A preprint systematic review of the relative risks of ‘nicotine products’31 commissioned by FSFW32 failed to list the included studies (as recommended by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines),33 making it impossible to determine the extent upon which industry-funded science was relied. FSFW bases its classification of nicotine products on this preprint, making no reference to its non-peer-reviewed status.32
Various FSFW’s activities have helped ensure research favourable to the tobacco industry is heavily represented in the evidence base (strategy 5). FSFW and its grantees often self-publish reports on their websites or use open science (‘preprint’) publishing platforms, creating an evidence base which has not had its robustness assessed through independent peer review. On one preprint platform, F1000, where authors invite reviewers who are required to disclose conflicts of interest (COIs), FSFW invited its own grantee who gave a wholly positive review (with no COI disclosure). In contrast, the other reviewer flagged several revisions needed.34
Several journals which have published FSFW-funded articles had FSFW-affiliated researchers in editorial positions. Between May and July 2020, Drugs and Alcohol Today published a serialised special issue on the Framework Convention on Tobacco Control (FCTC), comprising nine papers all authored by FSFW grantees or staff members.35 Both the editor-in-chief and the guest editor had financial links to FSFW, COIs which went undeclared by the journal in relation to their editorial roles.36 While it is unclear whether these connections improperly influenced the publication of these articles, in February 2021, all nine articles had an expression of concern added by the publisher because of ‘credible concerns’ about editorial processes.37–45 In 2022, Drugs and Alcohol Today was renamed Drugs, Habits and Social Policy.46 The previous editor-in-chief is no longer in that role, but as of April 2023 remains a member of the editorial board.47 It is unclear whether the publisher's investigation is ongoing.
This was FSFW’s second known attempt to publish a special issue on this topic, the first cancelled by the International Journal of Environmental Research and Public Health once the managing editor understood FSFW’s tobacco industry connections.36 Documents concerning that special issue show that FSFW’s public relations firm, Ruder Finn, emailed the journal asking that FSFW’s president be permitted to choose contributing authors from FSFW’s grantees (University of Bath’s Tobacco Control Research Group (TCRG) personal communication, 2019). While it may be common practice for an editor of a special issue to choose its papers, a tobacco industry-funded organisation controlling the content of a special issue on the FCTC (which the tobacco industry has fought to disempower)14 48 is a clear conflict.
Strategy B: influence on the interpretation of science
FSFW staff and grantees have attacked research which paints the tobacco industry in a bad light (strategy 9). In the 1990s, the industry adopted the phrase ‘junk science’ to censure science deemed unfavourable.16 This phrase has recently been invoked by both PMI,49 and by FSFW grantees, with one grantee organisation characterising concerns about e-cigarettes as ‘a fear-driven crusade’ of ‘lies and junk science’.50 FSFW staff and grantees have also misrepresented evidence on tobacco and nicotine products. One grantee discounted the evidence base on secondhand smoke to the New Zealand Health Select Committee when arguing against banning smoking in cars, saying ‘scientific studies have not proven that exposure to cigarette smoke in the car causes disease’.51 Overwhelming evidence as far back as the 1950s identifies secondhand smoke as a health risk,52–57 and newer evidence demonstrates that smoke-free policies lead to reductions in health harms.58 59 In an invited comment in the American Journal of Public Health,60 FSFW staff misrepresented evidence on the role of flavours in youth e-cigarette use, using a paper which identified flavours as the third most common reason for use61 to claim that flavours are not a main driver of youth e-cigarette use. Concerning the link between youth e-cigarette use and later uptake of combustible cigarettes, an article in FSFW-funded Filter Magazine asserted that this so-called ‘gateway’ theory had been ‘conclusively debunked’,50 despite the paper the article cited on this point concluding ‘the role of e-cigarettes in the future of youth smoking has yet to be definitively assessed’.62
FSFW and its grantees have spoken out in hostile terms against individuals and organisations that create and disseminate science unfavourable to the tobacco industry (strategy 10). They labelled authors of a report on FSFW and PMI guilty of ‘characteristic hypocrisy’ and of disseminating ‘false narratives’ about FSFW,63 and lamented the ‘constant (often exaggerated) bleating of public health’ about health harms of the industry’s products.64
Strategy C: influence on the reach of science
FSFW and its grantees act as messengers (strategy 12), disseminating science and ‘packaging’ it in ways supporting industry interests (strategy 13) while distancing those messages from industry. FSFW has published a quarterly newsletter entitled ‘Health, Science, and Technology’,65 which disseminates science including that funded directly by industry,66–68 without making any mention of these industry links. Other ‘packaged science’ includes commentary pieces in journals (promoting industry-friendly narratives on e-cigarettes60 and COVID-1969), and evidence submissions to governments endorsing deregulatory approaches.70 71
FSFW and its grantees fund children’s science competitions,72 webinars73 and events (strategy 14), such as a 2020 conference where speakers74 presented findings from the FSFW-led special issue of journal Drugs and Alcohol Today,35 and FSFW’s PR firm, Ruder Finn, invited selected media (TCRG, personal communication, 2020). Another event with links to FSFW, the annual Global Forum on Nicotine,75 has provided a platform for tobacco corporations and industry-linked researchers to disseminate their science to, and build relationships with, those working independently from the industry.76 77
FSFW has funded media outlets which disseminate industry-friendly scientific messages (strategy 15), including Filter Magazine and Vida News, which between them have received or had approved funding of over US$1.3 million since 2018.78–81 Over this same period, Filter Magazine’s funders have also included PMI, Altria, Reynolds American, Juul Labs and FSFW grantee Knowledge Action Change.82 These outlets cite FSFW staff, grantees and subgrantees83–88; report scientific events linked to FSFW89 90; and disseminate both FSFW-funded research91 92 and critiques of science which may threaten the tobacco industry.50 93
An organisation with links to FSFW-funded researchers30 94 has also influenced what messages are not received by journalists. The Consumer Advocates for Smoke-Free Alternatives Association worked to prevent a journalist speaking to tobacco control researchers. In September 2019, an email read ‘in the hope that… [the journalist] …doesn’t discover the… [University of] …Bath tobacco control people on her own, I offered to do a little of the legwork for her’. (TCRG, personal communication, 2019).
Strategy E: manufacturing trust in industry and its scientific messaging
FSFW promotes the tobacco industry’s credibility and its role in science in diverse ways (strategy 18). First, FSFW frames tobacco industry involvement in science and policy as the ‘solution’,37 45 and its exclusion as counterproductive. FSFW’s (now former) president condemned ‘entrenched hostility towards industry’,95 arguing industry-funded research is ‘robust’ and should ‘not be shunned simply on the basis of who executed or funded it’.96 This stands in contrast to his previous statement (before taking up this post at FSFW) that ‘academic naivete about tobacco companies’ intentions is no longer excusable’.97 FSFW has misleadingly likened itself36 to tobacco control organisations which either receive no funds from the tobacco industry98 or are funded by legally binding tobacco industry payments to the US government.99 100 Although FSFW repeatedly asserts101–103 that it closely adheres to criteria6 laid out for using tobacco industry funding for research, the authors of these criteria have specifically indicated that it does not.104
Conversely, despite FSFW citing transparency as one of its key tenets,105 its own activities (and that of its grantees) often obscure its industry links (strategy 19), thus increasing the perceived legitimacy of its science and advocacy. Several articles and commentaries lacked declarations explicitly outlining the output’s funding from FSFW when published,38 42 106–111 despite FSFW listing them as its publications.112–114 Even when a publication’s links to FSFW are made clear, FSFW’s links to PMI are often undisclosed.34 39 40 44 115–123
Beyond scientific publications, FSFW’s funding of one major grantee launched several subgrantee organisations positioned as experts on the science and policy of tobacco, none of whom mentioned FSFW or PMI on their websites.124–129 In 2020, FSFW distributed grant funds to establish ‘The Lung Trust’, ‘for the application, receipt and administration of future grant awards’,130 suggesting the complex network of organisations indirectly funded by PMI is likely to become ever more opaque.
Discussion
This study—within which we took a prospective approach, collecting data over 4 years—is the first systematic and comprehensive investigation of FSFW’s outputs and activities. It is also the first paper to use the SPM as an analytical tool to investigate a contemporary industry-funded scientific organisation. Our analysis revealed that in just its first 4 years, the organisation and its affiliates have already engaged in activities which mirror all four of the SPM’s macro (and many of the meso) strategies previously used by industries to influence science. FSFW and its grantees have:
Produced research and opinion which supports tobacco industry interests by: side-lining evidence-based tobacco control measures and endorsing interventions which ensure the sale of industry products42 43 45 123 131; advocating for tobacco industry involvement in science and policymaking39 45; and misrepresenting evidence on tobacco and nicotine products.50 51 60
Published research which obscures PMI’s involvement.34 39 40 44 106 109 115–123
Funded media outlets78 80 81 which frequently denigrate science that may jeopardise industry profitability.50 93
Rallied against researchers and advocates working in tobacco control.63 64
Pushed for renormalisation of the tobacco industry.95 96
The SPM identified that diverse industries have used these practices to achieve three proximal outcomes: (1) to create doubt about the harms of industry products, or the necessity or efficacy of policies which would affect industry; (2) to promote industry products as solutions to public health problems, and to promote industry-favoured policy responses; and (3) to legitimise the role of industry in the creation and use of science. Our analysis suggests that the launch of FSFW, and its subsequent outputs and activities, have served to help PMI, and the tobacco industry more broadly, realise these same outcomes.
Collectively, our findings indicate that FSFW should be understood as an industry-influenced scientific lobby group promoting tobacco industry interests, akin to historical tobacco industry-funded groups forcibly closed132 and contemporary organisations promoting the interests of the sugar,133 alcohol134 and pesticides135 industries. This case study adds to the body of evidence that these scientific third-party organisations play a key, and often hidden, role in operationalising industry influence on science.
FSFW is an effective vehicle for agnogenesis, not only about the evidence base on the safety and efficacy of industry products, but also about which public health solutions are optimal for society (framing consumption of industry products as essential for progress and health), and about what industry’s role should be in science and policymaking (despite evidence illustrating that industry involvement in these arenas brings negative consequences to society).136 137 Corporations and their third parties often conceal their agnogenic practices behind ‘superficially coherent’138 arguments—in this case, FSFW’s pronouncements of transparency and independence. References to agnogenesis by FSFW-funded researchers serve to redirect attention away from tobacco industry-created ignorance, with one lamenting the current ‘topsy-turvy era in which the truth is framed as a lie and lies are believed as if they are true’.70
Strengths and limitations
We illustrate the breadth of FSFW’s activities and outputs, demonstrating that PMI’s influence on science goes far beyond creation of its own evidence (which has recently again seen its robustness questioned).139 140 We also demonstrate the relevance of the SPM to contemporary tobacco industry involvement in science—highlighting that science continues to be an important component of the industry’s political strategy, and corroborating previous investigations16 141 142 which concluded that science is a ‘critical resource for contemporary corporations in managing their relationships to their critics’.142
We make no claims about whether FSFW and those it funds are intentionally working to further the tobacco industry’s interests, but instead show how it can work to that effect. Although FSFW argues that PMI’s funding has no effect on its research,63 evidence shows that financial links can create an ‘implicit demand’ for researchers’ work to benefit the funder, and those in receipt of funds can respond to such pressures unintentionally and subconsciously.143 Further, although all researchers rely on personal interests and experiences to shape their research, financial COIs, specifically, act as a ‘megaphone, amplifying a set of interests that align with the sponsor’s’.144 Despite FSFW claiming a ‘confluence’ rather than ‘conflict’ of interest exists (with funder and researchers similarly striving for reduced harm from tobacco),145 the WHO’s FCTC asserts there is an ‘irreconcilable conflict’ between the tobacco industry’s interests and public health.146
Similarly, it was not the function of this paper to draw conclusions on any potential role (or otherwise) of the industry’s newer products in reducing tobacco harms. Rather, with our case study adding to growing evidence that corporate involvement in science continues to bring deleterious effects, we reiterate the standpoint147 that a distinction must be made between products (some of which may play a role in tackling the tobacco epidemic) and producers (who should play no role in tobacco control science and policymaking).
Where we did not find evidence of a strategy, this may be because FSFW is not engaging in such activities, or because our analysis mainly relied on publicly available documents (and was therefore unlikely to find evidence of covert activity). Such ‘gaps’ also indicate areas (including funding of medical education148 and links with authors of clinical practice guidelines149) where ongoing monitoring could be focused. Conversely, we found evidence of a relatively new150 scientific communication route not identified in the SPM—dissemination of industry-funded science through preprint platforms (and later citation of such without mention of its non-peer-reviewed status). This echoes historical tobacco industry activity—funding symposia in order to create scientific outputs and subsequently cite them as if peer reviewed.2 16
Implications for research, policy and practice
The SPM needs to be applied to additional investigations of industry involvement in science, in order to further test and develop the model. Future research could also focus on the SPM’s strategy D (‘Create industry-friendly policymaking environments which shape the use of science in policy decision-making in industry’s favour’). While this was not the focus of the current study, we did note FSFW’s espousal of a risk-based (rather than precautionary) approach to policymaking.73 FSFW frames such an approach as ‘science based’151–155 arguing governments should ‘shift away from prohibitionist policies to more empathetic and science-based policies’.151 This mirrors previous tobacco industry pushes for so-called ‘science-based’ policymaking, which in the 1990s included covert attempts to inhibit policymakers’ abilities to use whole evidence bases in regulatory decision-making on corporate products.16 FSFW’s denigration of precautionary approaches to policymaking indicates the potential for the organisation to be used as a conduit for similar attempts.
PMI’s funding of FSFW endangers progress made in protecting science from tobacco industry influence in several significant ways. First, FSFW undermines proposed standards6 for using tobacco industry funding for research. By claiming to meet these standards, it disingenuously positions itself, an industry-funded scientific organisation founded with no external oversight, as the solution to industry influence on science.
Second, PMI channelling research funds through FSFW sidesteps—and thus renders ineffective—policies adopted by a growing number of academic journals which intend to prohibit publication of tobacco industry-funded science and/or mandate declaration of author COIs.7 8 156 157 Such policies require industry-funded researchers to be fully compliant in their disclosures (we show this was rarely the case in FSFW-funded science and research) or require journal editors to be fully informed of scientific organisations’ connections to the tobacco industry (which is virtually impossible given our finding of the growing network of grantees and subgrantees).
Further, FSFW circumvents norms about the unacceptability of collaborating with the tobacco industry, jeopardising the industry denormalisation achieved since the forced closure of the historical industry-funded scientific organisations. The American Journal of Public Health’s invitation to FSFW staff to comment on tobacco regulatory issues,60 the University of California’s approval of grant funding from FSFW158 and the Conrad Foundation’s acceptance of FSFW funds for its children’s science competition159 are unlikely to have occurred had the funding come directly from a tobacco company: equivalent relationships with PMI would not have been deemed normatively appropriate. Such decisions augment PMI’s recent direct attempts to normalise its presence in science and policy spheres.160 161
It is crucial that decision-makers in research, education, academia, policy and practice are aware of the role third-party organisations such as FSFW play in corporate influence on science. Beyond this, our findings indicate that over 70 years since the tobacco industry began to manipulate science, efforts to protect science from tobacco industry interference remain inadequate. The development of more robust systems to better protect scientific integrity is urgently needed.
Data availability statement
All data relevant to the study are included in the article or uploaded as supplemental information.
Ethics statements
Patient consent for publication
Ethics approval
Not applicable.
Acknowledgments
We thank other members of the Tobacco Control Research Group at the University of Bath, the STOP team and the wider tobacco control community for sharing data with us. We are also grateful for the constructive feedback provided by the four reviewers.
References
Footnotes
X @bathtr
Contributors All three authors conceived of the paper. TL collected, read and analysed the documents. TL drafted the paper, to which substantial contributions were then made by AG and BC. All authors revised the paper. All authors take responsibility for the content of the paper. TL is responsible for the overall content as guarantor
Funding The majority of TL’s time spent on this research was supported by the South West Doctoral Training Partnership (SWDTP). TL and AG also acknowledge the support of Bloomberg Philanthropies’ Stopping Tobacco Organizations and Products project funding (www.bloomberg.org).
Disclaimer The opinions expressed are those of the authors alone. The funders had no role in study design, data collection, analysis, decision to publish or preparation of the manuscript.
Competing interests In this paper’s section on ‘Influence on the interpretation of science’, we refer to a report on FSFW and PMI which FSFW described as containing 'false narratives' about FSFW. TL and AG are coauthors of this report.
Provenance and peer review Not commissioned; externally peer reviewed.