Budget day rarely brings huge victories for public health like last week’s bombshell – a sugar tax on fizzy drinks. The myriad medical, public health, children’s and anti-obesity organisations that have campaigned so long for just such a levy were entitled to their euphoria. “This is a moment to celebrate”, said the Obesity Health Alliance, capturing the mood. They fell over themselves to praise George Osborne for being so bold and radical.
The surcharge on Coca Cola, Capri Sun, Irn Bru and the rest offers other potential benefits beyond the expected cut in consumption. It is the first time any government has decided to use fiscal measures to tackle the scourge of bad diet.
Already some health experts want ministers to follow the logic of that move and impose the tax on any food that contains dangerously high levels of sugar. And the tax, when it starts in 2018 – barring threatened legal action by a self-interested industry – could help focus people’s minds on the healthiness of what they consume.
For Duncan Selbie, the chief executive of Public Health England, the chancellor’s move was “a stunning early indication of the government’s commitment to reducing child obesity”. Maybe, maybe not. Only the childhood obesity strategy will vindicate (or not) such optimism. And it has been delayed by many months until the summer, as ministers try to reconcile the urgent need for decisive action with the fear of being seen as nanny state diet bullies.
Obesity is a worsening disaster – for individuals and their children, the NHS, productivity levels and people’s personal happiness. This escalating situation requires that when the childhood obesity masterplan comes, it is infused with unprecedented robustness, similar to Osborne’s sugar tax announcement last week, and that its implementation ignores fierce resistance from those who profit from promoting our chronic national sugar rush. A sustained programme of mandatory reformulation of foodstuffs to strip out excess amounts of fat, salt and sugar, encompassing all food producers, is an absolute bare minimum.
But those at No 10 and the Department of Health involved in producing what ministers insist will be a game-changing document would do well to bear in mind NHS England boss Simon Stevens’s view that “obesity is the new smoking” and be guided by lessons from the decades-long but ultimately successful fight against tobacco.
First, obesity is the new smoking. In the 1960s 70% of men smoked, though that is down to around 20% now. Today, two-thirds of adults are either overweight or actually obese. So the government must embrace sustained action, and always be doing something new to disrupt the industry, using a changing array of tactics.
While one burger is not bad for you in the same way that one cigarette is, producers of bad food must be made ashamed for poisoning our bodies.
Why not modify the shock tactic TV adverts previously used to tell and show people what tobacco does to arteries, to do the same for the bodily impact of disgusting amounts of fat, salt and sugar? Why not fund an information campaign that warns the public that being dangerously overweight increases the risk of 10 forms of cancer – including breast, bowel and prostate cancer?
Adverts could also mention the links with common killers such as heart disease and stroke. “I never knew that…” would see sales fall. And why not insist that cereals or biscuits that are stuffed full of sugar have to carry graphic health warnings about tooth decay, weight gain and the rest, as packets of cigarettes do about lung disease.
Just as banning the marketing of cigarettes helped to ostracise them, shouldn’t the promotion of foods high in fat, salt or sugar be outlawed as part of a process of deliberate denormalisation? “But everyone eats some of this stuff” is not a reason to hold off pushing them to the bounds of a new definition of social acceptability.
With luck the sugar tax will show that a government that vacillated over plain packaging of cigarettes and minimum unit pricing of alcohol has jettisoned the flawed, failed Responsibility Deal approach and accepted that – for the greater good – intervention is what works best in public health.
guardian.co.uk © Guardian News and Media Limited 2010