Evidence map›Paper›PMID 33593757›Full record

ArticleBMJ global health2021

The case for developing a cohesive systems approach to research across unhealthy commodity industries.

Cécile Knai, Mark Petticrew, Simon Capewell, Rebecca Cassidy, Jeff Collin, Steven Cummins, Elizabeth Eastmure, Patrick Fafard, Niamh Fitzgerald, Anna B Gilmore and 12 more

Abstract read
In one paragraph

Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  7. United Nations Partnerships With the Alcohol Industry.International journal of health policy and management · 2026
    Article
  8. Do ESG Frameworks Capture Corporate Health Impacts? An Analysis of the Food and Beverage Industry.International journal of environmental research and public health · 2025
    Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Cécile KnaiFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK cecile.knai@lshtm.ac.uk.ORCID 0000-0001-6663-7379
Mark PetticrewFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Simon CapewellDepartment of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK.
Rebecca CassidyDepartment of Anthropology, Goldsmiths University of London, London, UK.
Jeff CollinSPECTRUM Consortium, UK.
Steven CumminsPopulation Health Innovation Lab, Department of Public Health, Environments & Society, London School of Hygiene & Tropical Medicine, London, UK.
Elizabeth EastmureFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Patrick FafardFaculty of Social Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Niamh FitzgeraldSPECTRUM Consortium, UK.
Anna B GilmoreSPECTRUM Consortium, UK.
Ben HawkinsFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Jørgen Dejgård JensenInstitute of Food and Resource Economics, University of Copenhagen, Frederiksberg, Denmark.
Srinivasa Vittal KatikireddiMRC/CSO Social and Public Health Sciences Unit, University of Glasgow School of Life Sciences, Glasgow, UK.
Nason MaaniFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.ORCID 0000-0002-3398-0688
Nicholas MaysFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Modi MwatsamaOur Planet Our Health, Wellcome Trust, London, UK.
Rima NakkashHealth Promotion and Community Health, American University of Beirut, Beirut, Lebanon.
Jim F OrfordSchool of Psychology, University of Birmingham, Birmingham, UK.
Harry RutterDepartment of Social and Policy Sciences, University of Bath, Bath, Bath and North East Somer, UK.
Natalie SavonaFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
May C I van SchalkwykFaculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK.
Heide WeishaarCenter for International Health Protection, Robert Koch Institute, Berlin, Germany.

Funding

British Heart FoundationCancer Research UKChief Scientist Office SPHSU13Chief Scientist Office SPHSU17Department of Health NIHR300156Medical Research Council MC_UU_00022/2Medical Research Council MC_UU_12017/13Medical Research Council MR/S037519/1Wellcome Trust
6 · The paper itself

Abstract

objectivesMost non-communicable diseases are preventable and largely driven by the consumption of harmful products, such as tobacco, alcohol, gambling and ultra-processed food and drink products, collectively termed unhealthy commodities. This paper explores the links between unhealthy commodity industries (UCIs), analyses the extent of alignment across their corporate political strategies, and proposes a cohesive systems approach to research across UCIs.

methodsWe held an expert consultation on analysing the involvement of UCIs in public health policy, conducted an analysis of business links across UCIs, and employed taxonomies of corporate political activity to collate, compare and illustrate strategies employed by the alcohol, ultra-processed food and drink products, tobacco and gambling industries.

resultsThere are clear commonalities across UCIs' strategies in shaping evidence, employing narratives and framing techniques, constituency building and policy substitution. There is also consistent evidence of business links between UCIs, as well as complex relationships with government agencies, often allowing UCIs to engage in policy-making forums. This knowledge indicates that the role of all UCIs in public health policy would benefit from a common approach to analysis. This enables the development of a theoretical framework for understanding how UCIs influence the policy process. It highlights the need for a deeper and broader understanding of conflicts of interests and how to avoid them; and a broader conception of what constitutes strong evidence generated by a wider range of research types.

conclusionUCIs employ shared strategies to shape public health policy, protecting business interests, and thereby contributing to the perpetuation of non-communicable diseases. A cohesive systems approach to research across UCIs is required to deepen shared understanding of this complex and interconnected area and also to inform a more effective and coherent response.

Indexed as

Health PolicyPolicy MakingCommerceHumansPoliticsSystems Analysispublic healthqualitative study

Identifiers

PMID33593757
PMCPMC7888371

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.