Intended for healthcare professionals

Feature Investigation

Big tobacco, the new politics, and the threat to public health

BMJ 2019; 365 doi: (Published 15 May 2019) Cite this as: BMJ 2019;365:l2164

Read all The BMJ's investigations

  1. Jonathan Gornall, freelance journalist
  1. Suffolk
  1. jgornall{at}

With several Tory leadership contenders sympathetic to its ideology, the Institute of Economic Affairs is closer to power than it has been for decades. In an exclusive investigation, Jonathan Gornall reveals how the organisation is funded by British American Tobacco and has links with senior conservative ministers. After orchestrating a series of attacks on public health initiatives, the IEA may now hold the key to No 10

Whatever the eventual consequences of Brexit for the NHS,12 an article published in the Daily Telegraph in March made it clear that an even greater threat to public health in the UK may emerge from the battle for control of the Conservative Party.

In an essay published on 31 March, titled “The next Tory leader must be a bullish libertarian,” the director general of the free market think tank the Institute of Economic Affairs (IEA) set out what amounted to a manifesto for the new party leader.

The leadership election, wrote Mark Littlewood, was a chance “to rediscover an agenda supportive of . . . free markets and a smaller state.” Theresa May’s successor should ensure that “the plethora of censorious and hectoring measures over what British adults choose to eat, drink and smoke must come to an end.”3

What the IEA says matters. Credited by Margaret Thatcher in 1979 for having “created the climate of opinion which made our victory possible,”4 its free market fundamentalism is now back in vogue. “Bullish libertarianism” appeals to a significant faction of the Conservative Party, and, as the showcasing of Littlewood’s prescription in the Telegraph attests, any prospective leader is likely to emerge from the ranks of those who subscribe to the IEA’s ideology.

The institute has a longstanding commitment to dismissing public health initiatives as “nanny state” interventions.56 Its …

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