Four Types of Killjoy: #5 Conclusion

So, what have we learned?

In this series of posts, the IEA’s Christopher Snowdon explains the background and beliefs of the anti-smoking, anti-alcohol, anti-obesity and anti-gambling movements in the UK.

This is the conclusion, available early to paid Insider subscribers.

Read part 4 on anti-gambling here, part 3 on anti-obesity here, part 2 on anti-alcohol here, and part 1 on anti-smoking here.

There are some striking similarities between the interest groups in this series: anti-tobacco, anti-alcohol, anti-obesity and anti-gambling. They have all built formal coalitions, three of which use the term ‘Health Alliance’ in their name. They all have All-Party Parliamentary Groups pushing their message to MPs and the media. They all focus on supply-side measures to reduce the consumption of products which, to a greater or lesser extent, involve risk. They all view the industries which produce the goods and services they object to as their main opposition and downplay the role of individuals in making decisions for themselves. Several policy options, such as advertising bans, feature in the prospectus of all four.

In terms of policy wins, tobacco control has been the most successful of the four enterprises, largely because cigarettes are an exceptionally dangerous consumer product and because smokers are an increasingly small minority. By contrast, alcohol, sugary drinks and gambling are all consumed by a majority of Britons at least occasionally. Anti-smoking campaigners have set many precedents, such as graphic warnings and the only international WHO treaty (the Framework Convention on Tobacco Control), and have blazed a trail for other activist groups to follow. At times, emulation of tobacco control is done quite explicitly, with activist-academics framing their issue as ‘the new tobacco’ or ‘the new smoking’ and wondering aloud why policy-makers do not take their issue as seriously.

But there are also many dissimilarities. Organised opposition to sugary drinks, ‘junk food’ and gambling in Britain is a relatively recent development whereas professional tobacco control emerged in the early 1970s. After fifty years, tobacco control is a mature movement with a set of values and aims that have solidified into orthodoxy. It is largely homogenous in its outlook, notwithstanding the debate about tobacco harm reduction. Activism and academia merge seamlessly, with academics supplying the ammunition for the activists. Total abstinence from tobacco is the goal and coercion in some form is regarded as necessary to reach it. In a society that is broadly anti-smoking, especially in its upper echelons, its basic premise is no longer controversial. The youthful anti-smoking activists of the 1970s and 1980s have become part of the public health establishment. Groups such as Action on Smoking and Health are funded by the state and work closely with the Department of Health. ASH is, as Virginia Berridge puts it, an ‘insider/outsider organisation’.

Organised opposition to alcohol has an even longer history and the flame of gospel temperance still burns, in a modified form, among some of the interest groups in the alcohol policy debate today. But by no means everybody who agitates for anti-alcohol policies is inspired by traditional temperance beliefs, nor by the neo-temperance agenda of the Purple Book. Some of them see total abstinence as the ultimate goal, but many do not (and those who do are usually politically astute enough to not say so publicly). Some are concerned with specific policy areas, such as drink-driving, public order and underage drinking, rather than tackling drinking per se, but they find common cause on certain issues, such as tax rises and minimum pricing, with those who espouse the whole population approach.

Policy entrepreneurs in the food and gambling spaces are even more diverse. Total abstinence from food is clearly not a desirable goal, although abstinence from sugary drinks and ‘ultra-processed food’ is increasingly seen by some players as achievable. Total abstinence from gambling is seen as both desirable and realistic by some of the religious anti-gambling activists and it is the implicit goal of the new generation of ‘public health’ academics, but it is clearly not the aim of the gambling companies that joined the coalition to push for specific policies, such as the FOBT reform. Both interest groups are relatively immature and the academic literature is only able to give partial support, at best, to their policy objectives. Until very recently, the anti-gambling coalition has had to rely on commissioned research and the ‘grey’ literature while the anti-obesity coalition relies as much on celebrities to drive its advocacy as it does on academics. Although the ‘public health’ literature on food policy is gradually becoming more ideological and gambling is increasingly seen as a ‘public health’ problem, public debate on both issues remains heavily influenced by non-academics.

But while the political coalitions fighting for each of these causes may have different interests and agendas, the policies they lobby for are remarkably similar and the ‘public health’ literature portrays all four issues as being almost inter-changeable. Each issue is gradually being ‘tobacconised’ with conscious and open emulation of the anti-smoking movement by campaigners against alcohol, ‘ultra-processed food’ and gambling. The four pillars of tobacconisation are (1) incremental and endless regulation of the product, (2) demonisation and ostracisation of industry, (3) rejection of individual choice and personal responsibility, and (4) total abstinence as the goal, backed up with claims about there being ‘no safe level’ and all consumers being at risk.

As I show in a new IEA paper, ‘public health’ academics have created a narrative in which every industry they oppose (and the list is long and growing) use the ‘tobacco playbook’. It seems likely that there is an element of what psychologists call projection in this claim. When Ulucanlar et al. complain that ‘corporations position themselves as representing and speaking for the public interest while they position those proposing the policy as damaging the public interest’ they could easily be writing about themselves. Similarly, their claim that ‘corporate actors’ have created a narrative in which ‘everything they represent and do is good and everything opponents represent and do are bad’ is arguably a better description of public health ‘advocates’ than industry ‘lobbyists’. Above all, the claim that all ‘health-harming industries’ emulate the ‘tobacco playbook’ diverts attention from the existence of a more specific anti-tobacco playbook that is being explicitly deployed against a wide range of industries, despite assurances in previous decades that there would be no ‘slippery slope’.

The differences between these four interest groups have narrowed over time and will narrow further. Coercive paternalists in ‘public health’ have found a winning formula in tobacco control and are consciously following a longterm plan of gradually chipping away at liberties until the activity has been ‘denormalised’ and prohibition can be contemplated. It will take many years and they will face political and public opposition, but time is on their side and they have plenty of resources.