Light me up: power and expertise in risk communication and policy-making in the e-cigarette health debates

Abstract

This paper presents a detailed account of policy-making in a contemporary risk communication arena, where strong power dynamics are at play that have hitherto lacked theoretical analysis and empirical validation. Specifically, it expands on the understanding of how public health policy decisions are made when there is a weak evidential base and where multiple interpretations, power dynamics and values are brought to bear on issues of risk and uncertainty. The aim of the paper is to understand the role that power and expertise play in shaping public health risk communication within policy-related debates. By drawing on insight from a range of literatures, the paper argues that there several interacting factors that shape how a particular narrative gains prominence within a wider set of perspectives and how the arguments and findings associated with that perspective become amplified within the context of policy choices. These findings are conceptualised into a new model – a policy evaluation risk communication (PERC) framework – and are then tested using the Electronic cigarette debate as a case study.