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Public Health Success?

May 16th, 2012 Posted in health by

If, as some campaigners would have us believe, obesity is more of a health risk than smoking, the data suggest that 50 years of massive investment in the public health industry have yielded very little in the way of overall risk reduction.

Source: Centers for Disease Control and Prevention – USA

I do not believe that the relationship between smoking and obesity rates is simple but this graph suggests that as a society we should at least consider taking a more holistic look at health issues.

For far too long now, health policy has been dictated by a dangerous combination of single issue campaigning and statistics based “evidence”.

People are not numbers, they do not conform to the rigid norms dictated by the public health industry and many will choose to accept certain health risks in pursuit of what they consider a more enjoyable if potentially shorter life.

I have no idea how much of the rise in obesity in the USA was fuelled by ex-smokers displacing one potentially harmful activity with another.  Similarly, campaigners have no idea whether trying to reduce young people’s access to tobacco and alcohol might lead to increased uptake of other substances that are potentially more acutely threatening to their health.

One thing that we do know, or should if we bothered to learn the lessons of history is that many public health interventions have had unintended negative consequences and the more illiberal and draconian the intervention then the greater the risk and impact of such consequences.

Chris Snowdon deals with this subject in some depth in his book The Art of Suppression. It is an informative well researched read for anyone interested in the reality behind the rhetoric.  Until I read it, amongst other things I was unaware that Heroin was originally promoted by the pharmaceutical industry as a non-addictive alternative to morphine.  Snowdon covers a range of issues including the disaster of alcohol prohibition in the 1920s, the EUs illogical ban on oral tobacco and the growth in designer drugs as a consequence of Ecstasy prohibition.

He questions why prohibitionist policies remain attractive to many in the light of their historic failure and concludes that “in the end, fear is more intoxicating than hope.”

By Chris Oakley. Chris has previously posted on Liberal Vision:  Smokers-State Aprroved hate and Intolerance is UK policy,   Alcohol is Old News – Minimum Pricing for Digestives is the “Next Logical Step” , Soviet Style Alcohol Suppression Campaign Called for By Public Health Activists , Alcohol Taxation: The truth, the whole truth and nothing but the truth , A Liberal Tolerant nation? and  What hope is there for liberty if truth becomes the plaything of political lobbyists.

5 Responses to “Public Health Success?”

  1. Anthony G Says:

    There is much evidence to suggest that the decline in smoking rates in recent decades may have contributed to the increase in overweight and obesity.

    Wasn’t there a BMJ article a while ago reporting nonsmokers are twice as likely to be obese than smokers and three times as likely to be SEVERELY obese than smokers?

    I wonder why then why that the health lobby have long urged for a ban on nicotine products like e-cigs and snus? These reduce harm of smoking and control their weight as well.


  2. Anthony G Says:

    Just goes to show that health campaigners are almost certainly one of the main causes of todays public health problems. Well meaning they may be – but the unintended consequences of many health-lobby led policies are truly terrifying.

    If government had gone down the “harm reduction” route on smoking rather than the “quit or die” route, the UK’s health would almost certainly be considerably better.

    Andrew Lansley take note.


  3. Angela Harbutt Says:

    Excellent article Chris. I have read Art of Suppression and would recommend to all. It is a cracking read.


  4. Chris Oakley Says:

    Anthony, I am not sure about the link between smoking and obesity but it does seem to be widely accepted that smokers tend to be less likely to be overweight or obese than non-smokers and this is factored in to some of the better epidemiology studies. It is not mentioned in the “fact” sheets produced by the public health industry as far as I can tell.

    Every activist group pushes its own agenda not based on thoughtful analysis of the facts and certainly not on the science but on how well it can spin the available data, how much it can exaggerate its case and how well it can manipulate government. The expansion of knowledge and truly informed choice has been usurped by a closed minded adherence to dogma and a constant clamour for coercive legislation.

    If more people actually thought about the unintended consequences of these single issue campaigns and read well researched books like Snowdon’s then perhaps we might see a healthier attitude evolve in our society. Sadly I don’t think that Lansley is listening and I doubt that he reads this kind of “off message” material.

    As for harm reduction, the government are not interested because they bought into the “quit or die” approach pushed by CRUK /ASH years ago. Interestingly, it is the big bad tobacco companies who are investing in harm reduction whilst our Department of Health consults on “glitzy” packaging.

    And they wonder why people don’t turn out to vote.


  5. Dave Atherton Says:

    Firstly it is medically ‘better’ to be obese than an active smoker. The obese live 3-4 years more than smokers. Smoking is also a hunger suppressant.

    However there is some reasonable evidence that there maybe a correlation between the decline in smoking and a rise in obesity. Identical twins, if one of the smoked then he/she would weigh 1.5 kgs less than the non smoker.

    The American Nation Bureau of Economic Research has a paper which states:

    “…30% of Americans are currently obese, which is roughly a 100% increase from 25 years ago….we find that cigarette smoking has the largest effect: the decline in cigarette smoking explains about 2% of the increase in the weight measures. The other significant factors explain less. ”

    You pay your money and you take your choice.

    http://www.nber.org/papers/w17423


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