A report released on November 20, 2023, by a coalition of health charities has laid bare the £31bn productivity cost to the economy from alcohol, tobacco and unhealthy foods.

Action on Smoking and Health (ASH), the Obesity Health Alliance (OHA) and the Alcohol Health Alliance (AHA), have joined forces to outline the scale of harm caused collectively by tobacco, alcohol and unhealthy food and drinks, which are major causes of death and chronic disease.

The charities say big businesses are currently profiting from ill-health caused by smoking, drinking alcohol and eating unhealthy foods, while the public pay the price in poor health, higher taxes and an under-performing economy.

The wage penalty, unemployment and economic inactivity caused by tobacco, alcohol and obesity costs the UK economy an eye-watering £31bn and has led to an estimated 459,000 people out of work.

Meanwhile each year, the industries which sell these products make an estimated £53bn of combined industry revenue from sales at levels harmful to health.

The coalition is calling on the government to put in place a comprehensive strategy to prevent ill health from commercially driven risk factors and redress the balance between industry influence and the public’s health.

Linda Bauld, a professor of public health at the University of Edinburgh and chair of the report steering group, said, “There is a clear role for government in reducing the consumption of products which harm health and the economy, and this fits with the government’s own vision for improving public health. However, in practice with the exception of tobacco, action has been slow and concentrated not on what businesses do to increase consumption but on what individuals can do to resist temptation. This balance needs to be reset, and industry activity must be regulated to protect the health of the public.”

Key findings in the report include:

  • Overall, 13 per cent of adults in England smoke, 21 per cent drink above the recommended drinking guidelines, and 64 per cent are overweight or living with obesity, which is a key consequence of consuming too many unhealthy foods.
  • This is putting a great strain on NHS services, with millions of hospital admissions in England each year due to diseases caused by these products (506,000 tobacco-related admissions, 980,000 alcohol-related and 1,020,000 weight-related).
  • Continuous exposure to these products drives consumption at levels damaging to health. While any level of smoking is harmful (100 per cent of tobacco usage), analysis for the report found that 43.4 per cent of alcohol purchased by UK households, and 28.8 per cent of food purchased, were over government guidelines on safe consumption of alcohol and saturated fat, free sugars or salt. This equates to £81.5bn being spent by consumers on products which harm them while businesses take home £53bn in revenue.
  • Health-harming commodity industries use similar tactics to avoid regulation. This lobbying by health-harming industries has held back regulations to reduce the harm from these products.

Public support for action is high in all areas, including:

  • Around seven in 10 of the public supports protecting health policy from the influence of industries that make tobacco, alcohol or unhealthy food and drinks. (75 per cent support this for the tobacco industry, 70 per cent for the alcohol industry and 68 per cent support this for unhealthy food and drinks manufacturers)
  • The majority of the public supports the idea of levies on industries to reduce and/or prevent harm from the products those industries produce. Seventy-seven per cent support a tobacco industry levy, 61 per cent support an alcohol levy and 59 per cent support a levy on unhealthy food and drink manufacturers.

ASH, OHA and AHA say policymakers’ current approach to tackling health inequalities is fragmented, with the introduction of piecemeal national policy preventing strategies from realising their full potential.

Ian Gilmore, president of the BMA and chair of the Alcohol Health Alliance, said, “Tobacco, alcohol and unhealthy food are the three leading causes of preventable death and ill health in England and are key drivers of health inequalities. The results of these place huge pressure on our already stretched health services.

“We know that people want the opportunity to lead healthy lives and make healthy choices. But the current lack of legislation around these harmful products makes it difficult when industry invests millions of pounds into strategies to coerce us into consuming them.

“For too long, the government has prioritised industry profits over public health. If the government is serious about tackling preventable diseases, protecting people and the NHS, a comprehensive strategy addressing price, availability and promotion – developed without the interference of big industry – is urgently needed.”

The organisations want the government to build on the progress made on tobacco and further regulate unhealthy foods and alcohol as part of a coherent cross-government health strategy, with a key focus on the prevention of illness caused by these three product groups.

Alice Wiseman, policy lead for addiction for the Association of Directors of Public Health, said, “This report highlights the frighteningly high level of influence industry has over our health. The government must learn from the lessons of tobacco control and regulate all harmful products so that our society promotes good health, instead of constantly pushing us to consume products that actively harm our health. Directors of Public Health work in partnership to address these issues on a local level, but to tackle them consistently across the country, we need bold, national action that enables communities to put health at the heart of their decision-making.”

The report does not call for an identical approach to tackling these harms, recognising there are differences in the risks to health and the nature of industries. But it does call for far greater coherence and for regulations to be proportionate to the harms products cause.

The report recommends:

  1. The government should take a coherent policy approach to tobacco, alcohol and high fat, salt and/or sugar foods, with a focus on primary prevention.
  2. Health should be prioritised through a cross-government approach to prevention.
  3. Public health policymaking must be protected from the vested interest of health-harming industry stakeholders.
  4. Spending on prevention should be treated as an investment.

Five key actions:

  • Regulate advertising to limit harm through restrictions on advertising, promotion and sponsorship of harmful products.
  • Regulate product use and environment by raising the age of sale of some products appropriately to limit harms, removing products from prominent positions in shops, and using licencing to further regulate the sale of alcohol and tobacco.
  • Raise the price of harmful products through appropriate taxation with automatic uprating mechanism, minimum unit pricing, and restrictions on alcohol promotions and multi-buy deals.
  • Fund treatment services and ensure equitable access, focusing efforts on communities and individuals who experience the worst harms.
  • Inform the public about the risks linked to health-harming products through evidence-based mass marketing health campaigns and product labelling.

Owen Jackson, director of Policy for Cancer Research UK, the funders of the report, said, "The UK has a proud history of leading the way in public health. From the Soft Drinks Industry Levy, which has resulted in over 50 per cent of manufacturers reducing the sugar content of drinks, to the recently announced landmark plans to raise the age of sale of tobacco products, what is shown time and again is that sustained, bold political leadership on public health is supported by the public. I hope this report helps us to set a clear narrative on prevention not just for this parliamentary term but for future parliaments too."

For more information visit https://ash.org.uk/uploads/Exec-Summary-Holding-us-back-report.pdf