The nanny statists lack evidence for their campaigns

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In my new book, Inside the Sausage Factory, I examine four campaigns for ‘public health’ policies in the 2010s and examined all the evidence that was marshalled for and against them. It turns out that the evidence for them wasn’t very good and there wasn’t much evidence marshalled against them, but that isn’t really the point. Nor does it matter that all the policies failed. A bad policy introduced on the basis of poor evidence is still an evidence-based policy. The question – or my question at any rate – was whether the four policies were evidence-based at all. 

My case studies were plain packaging for tobacco, minimum pricing for alcohol, the sugary drinks tax and the clampdown on fixed-odds betting terminals (FOBTs). You may recall that there was a lot of noise made about these policies by campaigners at the time, along the lines of ‘if the government doesn’t do this, thousands will die’. I would argue that the noise was more important than the evidence in getting the government to go along with them. Politicians had not devised any of the policies themselves and most of them didn’t much care about them. They had been thrust upon the government by single-issue pressure groups who moulded public opinion to the point where the political benefits of capitulating were greater than the political costs of maintaining the status quo. The sole exception was minimum pricing in England where surveys showed that half the population were opposed to it. But even minimum pricing was adopted in Scotland where it was less unpopular and where the SNP was keen to flex the muscles of the Scottish government.  

Along the way, there were so many departures from the classic model of evidence-based policymaking that it is hard to believe that politicians were diligently following the science. David Cameron was committed to minimum pricing before suddenly turning against it and was firmly opposed to the sugar tax before suddenly supporting it. Labour and the Liberal Democrats opposed minimum pricing in Scotland but supported it in England. The SNP supported minimum pricing before there was any evidence to support it whatsoever. There was hardly evidence presented for the FOBT reform and the government ignored what little evidence there was. On plain packaging, the government said it would wait for evidence from Australia but then proceeded with the policy before the evidence could emerge. Speeches in the House of Commons largely ignored evidence in favour of personal anecdotes and ad hominem arguments. The media were far more interested in reporting Jamie Oliver’s opinions of the sugar tax than in covering the academic evidence and they were more interested in one of David Cameron’s advisor’s alleged links to the tobacco industry than in all the evidence on plain packaging combined.

I could go on (hence the book). It may not surprise you that politicians make political decisions rather than evidence-based decisions, but it is worth keeping the receipts, not least because all the campaign groups involved are still at work lobbying for new lifestyle regulations. If we look at what really led to each of the policies being introduced, we can see that everybody was acting in their own rational self-interest. Most of the politicians didn’t care about the price of sugary drinks or what people get up to in betting shops, but they did want to get re-elected and they didn’t want to be on the wrong side of history. So long as they were confident that the policy wouldn’t backfire spectacularly, lose the government a lot of tax revenue or be very unpopular, siding with the nanny statists was the path of least resistance. The decisions to introduce plain packaging and effectively ban FOBTs were particularly easy because only a small minority smoked, an even smaller minority played machines in bookmakers and there was limited public opposition. 

The people who told pollsters that they supported these policies were acting in their own self-interest too. For those who didn’t consume the products in question, the rational response was either apathy or mild support for the nanny state cause. The sugar tax effectively transferred money from those who consumed sugary drinks to those who did not. A reduction in smoking and heavy drinking was widely assumed to cut NHS costs, thereby lowering taxes or providing better treatment to those who do not drink heavily or smoke. Cutting the stake on FOBTs was assumed to reduce the number of high street betting shops, thereby freeing up commercial property for shops that might be of more benefit to non-gamblers and, in the opinion of many, lifting the character of the high street.

Whether or not these assumptions were realistic is beside the point. The vast majority of the public were not actively involved in campaigning for or against any of the policies and their ‘support’ amounted to no more than expressing an opinion in a survey. The putative benefits of the policies to individuals who did not consume the products may have been negligible, but the cost of agreeing with the policies was zero (and since all the campaigns involved alleged social evils, social desirability bias encouraged support). Like the politicians, the public did not need to be convinced that the policy would work so long as they had no reason to believe that they would be adversely affected if the policy failed. So long as there was some chance that they would benefit, however indirectly, from fewer people using a product that they themselves did not consume, they could be persuaded that the policy was in their interest.

As for those who did consume the products, they mostly did nothing to defend themselves, but the was rational too. As Mancur Olson explained in The Logic of Collective Action, individuals know that their participation in an organised protest group will make virtually no difference to the outcome. The cost of taking action is typically greater than the cost that the policy will impose on them and so they do nothing. In my case studies, some consumers were prepared to voice their opposition in low-cost ways (more than 100,000 people signed a petition against plain packaging, for example), but they otherwise had little option but to free ride on whatever campaign the affected industry could muster up (the industry was also acting in its own self-interest, as the “public health” groups never failed to point out). As a result, there was no grassroots opposition to the nanny state campaigns.

But there was no grassroots activism for the campaigns either. All of the single-issue pressure groups were small, highly professional lobbying outfits funded either by the government or by a wealthy benefactor. It was completely rational for them to campaign for changes to the law because it was their job. Similarly, it was perfectly rational for activist-academics funded by the state to produce impactful, partisan research in high profile journals. The UK’s Research Excellence Framework (REF) defines impact as “the effect on, change or benefit to the economy, society, culture, public policy or services, health, the environment or quality of life, beyond academia.” Such a system positively encourages academics to engage in high profile, winnable policy campaigns in fields such as “public health” which are awash with money. Academics from Oxford University later filed a case study with the REF taking credit for ‘Creating a favourable policy environment for new sugary drinks taxes’ while academics from Cambridge University boasted about ‘Making the case for the sugar levy’ and ‘Fuelling sustained government action on sugary drinks’. 

Everyone was acting in their rational self-interest and yet it led to a succession of policy duds. In politics, everyone acting rationally can lead to irrational policies being introduced. None of the policy decisions I studied were evidence-based. At best, they were evidence-decorated. 

All the campaigns were remarkably similar, with the only defeat for the “public health” groups coming in Westminster with minimum pricing. And the cycle has played out again and again in the years since, with Boris Johnson bringing in bans on the marketing of ‘less healthy’ food and Rishi Sunak announcing a generational tobacco sales ban. Since the single-issue pressure groups are paid to campaign, rather than to solve the problems they talk about, this cycle will go on and on until they are defunded or the public get sick of it. Neither looks likely any time soon.

‘Inside the Sausage Factory’ is published by the IEA.

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