Illness, disease and death can be the result of bad luck, genetic factors or people’s lifestyles – whether someone smokes, drinks a lot or consumes a lot of junk food, for example.
The role of lifestyle in explaining why the UK is an increasingly sick country, and the growing pressures on the NHS, is often underappreciated. Experts tend to cite the growing and, especially, ageing population, which are both key factors.
But lifestyles do produce a significant amount of arguably avoidable ill health. For instance, skin cancer is one of the few forms of the disease where the incidence of it – the proportion of people getting it – is growing, and that is largely because of UV exposure during holidays in hot, sunny places. Cancer specialists estimate that about 40% of all cases of the disease are avoidable.
In human terms that means that about 184,000 people in Britain will be diagnosed with cancer this year as a direct result of their obesity, smoking, drinking or history of sunburn, at a cost of £78bn, including £3.7bn of the NHS’s precious budget. No wonder Keir Starmer wants to make lighting up even more difficult.
A recent World Health Organization (WHO) report estimated that across Europe’s 53 states a total of 2.7 million people a year die as a consequence of consumption of or exposure to four products: tobacco, alcohol, ultra-processed food and fossil fuels. That is 7,400 a day – or almost one in four of everyone who dies in Europe.
The UN’s health agency pulled no punches when it launched its findings in June. The title of its report was not snappy: “Commercial determinants of noncommunicable diseases in the WHO European region”. But it did make completely clear that, in simple terms, some big businesses and their products are causing misery and mortality on a colossal scale.
It sounded the alarm about “the wide range of tactics [these] industries employ to maximise profits and undermine public health. Those practices fuel inequality and rates of cancer, cardiovascular and chronic respiratory diseases, and diabetes, and create a major barrier to prevention policies.”
They could have added dementia and mental illness. The WHO warned that “a small number of transnational corporations … wield significant power over the political and legal contexts in which they operate, and obstruct public interest regulations which could impact their profit margins”.
The new joint report from the Obesity Health Alliance, Alcohol Health Alliance and Action on Smoking and Health is on the same subject: the polluters and poisoners of public health. But it uses simpler language. It identifies these industries’ “killer tactics”, including the wooing of MPs. These are tactics that are intended to delay, water down or derail altogether government efforts to improve the health of the nation; policies which would, if successful, hit the profits of these corporations.
It cites, for example, the Scotch Whisky Association’s legal challenges to the Holyrood government’s decision to bring in minimum unit pricing of alcohol, which delayed its introduction – and potentially protected drinks producers’ profits – for six years. It references, too, the again legal manoeuvres deployed by tobacco firms to impede the arrival of plain packaging of cigarettes. Will the hospitality trade do the same if Starmer pursues a ban on some outdoor smoking? Will parliamentary friends of the tobacco and alcohol trades prove helpful allies?
Obesity costs the UK an estimated £95bn a year, alcohol harm £27bn and smoking in England alone £46bn. And, as the new report says: “the poor health caused by and exacerbated by consumption of tobacco, alcohol and unhealthy food and drink is responsible for the majority of premature death in the UK.”
The new government is committed to tough action to improve public health and also to restoring standards of integrity to public life. Taking on vested interests whose products and behaviour are disastrous for health, and ending their influence on and interference with the political process, is an acid test of both these aims.