Profit Before People: The commercial determinants of health and lessons from the tobacco epidemic (2023)
Key recommendations
This report has examined the tactics employed by the tobacco industry to normalise use of a product that kills more than half of its long term users. We've seen how its disinformation, marketing and a misleading narrative about 'individual choice' overlap to create a culture that cut millions of lives short - an epidemic that must have seemed endless to our public health predecessors.
But today, with continued ambition and perseverance, the end may well be in sight. We know that there is much more to do to achieve a smokefree Gateshead and North-East but we have also seen how, through a co-ordinated, multi-strand approach, smoking prevalence has reduced significantly.
This is important not just because it reduces suffering, poverty and health inequalities, but it also provides valuable lessons for tackling other key commercial determinants of health. The tactics we see from the alcohol, gambling and ultra-processed food and drink industries are horribly familiar, and whilst taking these industries on can seem daunting, we must keep our tobacco control successes in mind as we work steadily towards ensuring people always come before profit.
Tobacco | |
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Recommendation 1 - Support and advocate for proposed age of sale legislation | In October 2023, the Government announced proposed legislation which will stop children turning 14 or younger this year from ever legally being sold tobacco products - raising the smoking age by a year each year until it applies to the whole population. As most smokers start in childhood and regret it, we need to ensure this recommendation is passed along with proposals to reduce youth vaping and additional funding committed to improve smoking cessation support. |
Recommendation 2 - Advocate for a 'polluter pays' levy | Hundreds of Gateshead residents die each year because of smoking, with thousands more living with smoking related diseases while the TI makes billions. The government alone cannot provide the level of funding required to achieve a smokefree future. Gateshead supports the 'polluter pays' levy in which tobacco companies fund support to help people quit smoking. |
Recommendation 3 - Support and enforce vape regulation | We need to ensure adult access to all available options for stop smoking support, including vapes. It is important to reduce their appeal to children while also ensuring they remain available to adults who want to quit. We support better regulation of disposable vapes to reduce appeal and accessibility to children, to reduce environmental impact, and ensure the costs of collecting and recycling vapes is met by industry. |
Recommendation 4 - Creating a system approach to quitting | Our ambition is to normalise quitting and create an environment where smokers make quit attempts regularly until successful. This will require a change to the current model of stop smoking support. We want to develop an approach that targets our limited resources to those smokers who need most support, whilst working with Fresh and NHS partners to create a system that puts smokers' needs at the centre and encourages all smokers to make at least one quit attempt annually. |
Recommendation 5 - Prevention is key | Prevention must become a key part of our strategy to end smoking, as well as to inform our approach on many other Public Health issues. Smokers should be offered advice and support to quit at every opportunity whether that is through GPs, hospitals, midwives, pharmacists, dentists, or other partners. Systems must change to recognise that prevention is better than cure and the required investment should be made to ensure savings further down the road. |
Recommendation 6 - Commit to the long-term, multi-strand approach to tobacco control | Smoking prevalence continues to decline, but evidence both here and internationally has shown that smoking rates could plateau and even start to rise again if we do not continue to fight against the TI. Gateshead, in partnership with Fresh, must continue to develop and deliver on our multi-strand tobacco control action plan. Effective partnership working through our Smokefree Alliance will continue to address inequalities and drive down levels of smoking to achieve our goal of 5% smoking prevalence by 2030. |
Alcohol | |
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Recommendation 1 | The alcohol industry and the organisations it funds should not influence health policy, health services or education/awareness raising initiatives aimed at young people. |
Recommendation 2 | We need to strengthen the current system for governing alcohol marketing to ensure alcohol is not normalised, and to protect children and vulnerable adults from exposure to these products. |
Recommendation 3 | We need to challenge the narrative of the alcohol industry, which focuses on personal responsibility and blames "poor choices" for alcohol harms. Establishing alcohol as a harmful product is a legitimate intervention. |
Ultra processed foods and drink | |
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Recommendation 1 | Learning from the 'food advertising policies' in other local authority areas, advertising of HFSS products should be restricted on council owned sites. Businesses can continue to advertise as long as they promote a healthier product. |
Recommendation 2 | Social movements have long campaigned against commercial products and practices that cause health and other social harms. Harnessing a social movement in Gateshead can build upon previous work in reducing health-harming commercial determinants of health and create healthier communities. |
Recommendation 3 | We need to use practice-based evidence to inform local strategies. This will involve reviewing experiences to identify what works and what does not, to create a body of practice-based evidence and ultimately reduce the harmful influences of HFSS products within our communities. |
Gambling | |
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Recommendation 1 | Recognise the importance of the harm caused by gambling and the way that the gambling industry operates as a pressing public health and wellbeing issue, and an important driver of inequity. |
Recommendation 2 | Advocate for a comprehensive public health approach to gambling harm prevention, building on the learning from Tobacco Control, and recognising the industry as the key vector of harm. |
Recommendation 3 | This would include independent (for example, free from gambling industry influence) policies and strategies based on precautionary principles that prioritise health and wellbeing, and protect individuals, their communities, and families from being harmed by the gambling industry, its products, and practices. |