The true extent of commercialism at Christmas – and beyond

January is here again and now the Happy New Years have been said, it is time to knuckle down and stick to the resolutions and for many, that means embracing sobriety as part of Alcohol Change UK’s ‘Dry January’ campaign.

Last year, 175,000 people joined in, with research indicating an increase to wellbeing for all participants. However, while the campaign is clearly helpful to thousands of people, the key to significantly reducing alcohol harm is tackling the commercial determinants of health rather than individual responsibility.

With this in mind, and as we also debate whether or not to wade through the leftover pickings from too many boxes of chocolates and ready-made party treats, I want to highlight the role of industry versus that which individual choice plays – not just in our collective overindulgence over the festive fortnight but also in our ongoing consumption.

Go into any supermarket and the impact of the food and drink industry’s marketing machine is all too evident. There is wall to wall promotion of alcohol and food high in fat, sugar or salt, all of which is backed up by multi-media campaigns designed to drive sales of harmful products, many of which are unashamedly aimed at children and young people.

At no point during our supermarket visits do we have real freedom of choice. How can we have when we are constantly subjected to extremely clever and powerful advertising campaigns specifically designed to increase sales of products that we know cause illness, disease, and for some, death.

For example, we know that alcohol causes more than 200 different diseases and injuries including mouth, throat, stomach, liver and breast cancers; high blood pressure, cirrhosis of the liver; and depression. Abuse is also usually more severe when alcohol is involved and, in the UK, one in five children live in a household where at least one parent has an alcohol use disorder.

Meanwhile, we also know that the UK has the fourth highest level of people living with obesity in Europe with obesity being directly responsible for at least 200,000 new cancer cases annually. Around a quarter of adults and a third of children in their final year of primary school are overweight or living with obesity, with the cost to the UK economy at estimated £58 billion.

Yet, despite this knowledge, industry continues to manufacture, market and sell products which directly contribute to these figures. Not only that, but they do so at a price point almost three times lower than healthier alternatives, overriding any freedom of choice we may have had by making them accessible and affordable to all.

When the true scale of tobacco harm was realised, the world’s leaders took action. Strict rules and regulations were gradually introduced and, as a result, disease, illness and death caused by tobacco began to decline. We aren’t there yet of course, and all of us in the public health community – along with majority of the public – hope to see the proposed new ‘stopping the start’ legislation become reality and get us even closer to a smokefree UK.

Given the success of tobacco regulation then, why are we not doing the same with other harm-causing products? This extends far beyond alcohol and food – for example, the industries behind gambling and fossil fuels are also determining our health outcomes as are a whole host of other commercial interests.

So often, we hear cries of “nanny state” when we talk about the need for Governments to intervene and introduce restrictions and regulations, but the nanny state has actually given us a number of welcome freedoms.

For example, it has eradicated cholera and other nasty, water borne diseases and substantially reduced the likelihood of death from a car crash by making us wear seatbelts. It also introduced legislation to put a cap on rocketing energy bills and dramatically reduced our risk of cancer by banning smoking in enclosed spaces.

All of these interventions could be termed “nanny state” and some were controversial at the time, but far from taking away our freedoms, as a direct result of these (and other) measures brought in by the state, disease and accident incidence has fallen, life expectancy has risen, and we’ve been given the freedom to live and enjoy our lives for longer.

By the time Christmas and all its excesses comes round again, the country is likely to have decided who the next Government will be. I sincerely hope that whoever that may be, they are able to work together with all parties and public health experts to understand the impact of commercial determinants of health and introduce policies that will give us more of those freedoms.

Let us push our trolleys down an aisle which has a range of affordable, healthy alternatives in view, alongside the chocolates, sweets and ready meals. Let us also be able to live in an environment where we can choose not to drink if we want to, without the need for such an emphasis on supporting individual behaviour change – support which is often inaccessible to those especially vulnerable to harm.

Ultimately, let us live in a society where big business puts health before profit in communities that promote good health, as opposed to one that constantly pushes us to consume products that actively harm our health. Far from being restrictive, such a society, with policy to regulate harmful products, would give us the freedom we need to enjoy living longer, healthier lives.