General Health Friday May 4, 2012

Can you really fight bad habits with financial disincentives?

The debate surrounding quitting smoking is something we have covered in some detail here on the HealthExpress blog. Over the last few months alone, we have looked into the various methods employed by governments, the most effective stop smoking methods and the high figures of new, young smokers. What becomes clear when considering all the sides to the debate is that there is very little consensus in what actually constitutes an effective way of lowering the number of smokers in the UK.

The most obvious trend amongst the various campaigns that have been implemented with this goal in mind is that they tend to be very negative. The overwhelming focus is on the costs of smoking, both in terms of finances and health, rather than the positive benefits of quitting. For example, stop smoking television adverts often use images of children and smoke to illustrate the negative effects of secondhand smoke. Cigarette packets are now, by law, adorned with blunt warnings of the smokers' impending smoking-related doom. While I don't personally think there is anything wrong with these campaigns, there is surely an argument to be made that they would be more successful if more emphasis were to be given to the positive outcome, rather than the negative present. Simply, is it better to encourage positive behaviour or discourage negative behaviour?

The New Zealand Ministry of Health has taken the idea of discouraging smoking further than most by allegedly considering whether the price of cigarette packets should increase sharply to around $100 New Zealand dollars per packet. This is the equivalent to about £50 in the UK. As far as financial disincentives go, they don't get more discouraging than this.

It would be difficult to argue that such a policy would not be effective in achieving the desired outcome. Charging $100 for a packet of cigarettes will simply price out the vast majority of smokers. But at what cost? Why not simply outlaw smoking if the desired result - fewer smokers - is the same? Making a habit prohibitively expensive does not seem a particularly principled method of tackling a genuine problem. It does nothing to address why people smoke, nor does it offer any kind of positive incentive to help smokers deal with the difficulties of actually quitting smoking, such as the often debilitating withdrawal symptoms.

Positive campaigns could be extremely effective if they were introduced alongside the current more negative methods. There doesn't seem to be much logic in championing one over the other. For example, healthy eating campaigns seem to emphasise a more active approach towards a healthier lifestyle, suggesting ways in which we can change our diets for the better. Anti-smoking propaganda, on the other hand, seems to be limited to one strict "stop smoking" message, even as statistics show that many smokers remain undeterred. Maybe it's time for a more positive approach? One thing's for sure - it certainly can't hurt.

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