Premium
Understanding the Influence of Evidence in Public Health Policy: What Can We Learn from the ‘Tobacco Wars’?
Author(s) -
Smith K. E.
Publication year - 2013
Publication title -
social policy and administration
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 63
eISSN - 1467-9515
pISSN - 0144-5596
DOI - 10.1111/spol.12025
Subject(s) - tobacco control , centrality , policy advocacy , evidence based policy , public policy , politics , public relations , political science , health policy , public health , value (mathematics) , tobacco industry , sociology , health care , law , medicine , nursing , mathematics , alternative medicine , pathology , combinatorics , machine learning , computer science
Abstract Public health is overtly policy‐orientated and there is widespread support for the notion that health policies should be strongly informed by evidence. Despite this, studies consistently find that public health policies are not evidence‐based. This is often explained by reference to popular theories about research‐policy relations which highlight, amongst other things, the communicative gaps between academics and policymakers, the centrality of values (or politics) to decision‐making and the efforts by external interests to influence policy outcomes. Employing the ‘tobacco wars’ as a case study, with a particular focus on the UK , this article explores how tobacco control advocates and tobacco industry interests have attempted to influence policy and how, in so doing, each has sought to enrol evidence. Whilst accepting that evidence has played an important role in tobacco policy development, the article challenges claims that the implementation of tobacco control policies can be attributed to evidence. Turning to value‐orientated and network‐based approaches to conceptualizing policy development, the article demonstrates both the importance of values and the complex nature of coalitions. However, it argues that this approach needs to be supplemented by an ideational understanding of policy change, which pays attention to the ways in which arguments and evidence are constructed and framed. The article also suggests there are signs that the two ‘coalitions’ involved in the ‘tobacco wars’ may be unravelling. Overall, the ‘tobacco wars’ serve to highlight the complex relationship between evidence and policy, offering some insights for those interested in studying or improving the use of evidence in policy.