Why hospitals hire tobacco lobbyists: conflicts of interest among lobbyists’ clients

Abstract Lobbyists sometimes represent clients with seemingly adversarial policy interests. We seek to explain the occurrence of such ostensible conflicts of interest. In hiring lobbyists, interests encounter a tradeoff between access and agency. Although some lobbyists promise access to lawmakers, they may not lobby as contracted. Interests hire seemingly conflicted lobbyists more often when access is costlier and reputational risks are smaller. We examine the hiring of tobacco lobbyists by health interests, given the possibilities for shirking and reputational damage. We find that institutions such as hospitals hire tobacco lobbyists regularly and more often than membership-based health groups. Intergroup competition for access and lobby laws, especially anti-conflict laws, affect the use of tobacco lobbyists independent of rates of multi-client lobbying. Conflicts are more common today than ever but interests can protect themselves somewhat from opportunistic agents. Our findings also suggest that reforms can improve the representation of client interests.