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‘Nothing can be done until everything is done’: the use of complexity arguments by food, beverage, alcohol and gambling industries
  1. Mark Petticrew1,
  2. Srinivasa Vittal Katikireddi2,
  3. Cécile Knai1,
  4. Rebecca Cassidy3,
  5. Nason Maani Hessari1,
  6. James Thomas4,
  7. Heide Weishaar2,5
  1. 1 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  2. 2 MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
  3. 3 Department of Anthropology, Goldsmiths University of London, London, UK
  4. 4 EPPI-Centre, SSRU, Department of Social Science, UCL Institute of Education, University College London, London, UK
  5. 5 Hertie School of Governance, Berlin, Germany
  1. Correspondence to Dr Mark Petticrew, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine (LSHTM), 15-17 Tavistock Place, London WC1H 9SH, UK; Mark.Petticrew{at}


Background Corporations use a range of strategies to dispute their role in causing public health harms and to limit the scope of effective public health interventions. This is well documented in relation to the activities of the tobacco industry, but research on other industries is less well developed. We therefore analysed public statements and documents from four unhealthy commodity industries to investigate whether and how they used arguments about complexity in this way.

Methods We analysed alcohol, food, soda and gambling industry documents and websites and minutes of reports of relevant health select committees, using standard document analysis methods.

Results Two main framings were identified: (i) these industries argue that aetiology is complex, so individual products cannot be blamed; and (ii) they argue that population health measures are ‘too simple’ to address complex public health problems. However, in this second framing, there are inherent contradictions in how industry used ‘complexity’, as their alternative solutions are generally not, in themselves, complex.

Conclusion The concept of complexity, as commonly used in public health, is also widely employed by unhealthy commodity industries to influence how the public and policymakers understand health issues. It is frequently used in response to policy announcements and in response to new scientific evidence (particularly evidence on obesity and alcohol harms). The arguments and language may reflect the existence of a cross-industry ‘playbook’, whose use results in the undermining of effective public health policies – in particular the undermining of effective regulation of profitable industry activities that are harmful to the public’s health.

  • alcohol
  • epidemiology
  • obesity
  • public health policy

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  • Contributors The authors (MP, SVK, CK, RC, NMH, JT, HW) discussed the paper at a meeting in February 2016; the paper was drafted by MP, and each of individual authors (MP, SVK, CK, RC, NMH, JT, HW) contributed to the searches for relevant examples and case studies. The writing of subsequent drafts of the manuscript was then undertaken, with all authors (MP, SVK, CK, RC, NMH, JT, HW) contributing.

  • Funding This project was part-funded through a Wellcome Trust grant in Humanities and Social Science. The funder had no role in the design, interpretation or reporting of the study. SVK is funded by an NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_12017/13 & MC_UU_12017/15) and the Scottish Government Chief Scientist Office (SPHSU13 & SPHSU15).

  • Competing interests SVK is a member of the steering group of Obesity Action Scotland, to whom he provides unpaid advice on the evidence base for public health actions to tackle obesity.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data are already available on the web, via the links provided, and additional data are provided in the supplementary file.