The Institute for Public Policy Research (IPPR) has published what it calls “the most ambitious blueprint for the nation’s health since Beveridge”. I wouldn’t get too excited. Their previous contributions to the debate about the nation’s health include demanding plain packaging for crisps and sweets. Surprisingly, that doesn’t get a mention this time around but the report does include 20 recommendations, many of which don’t have much to do with health but are things that left-wing think tanks always want, including “a full restart of Sure Start”, a legal “Right to Disconnect” at work, abolition of the two child benefit cap, more spending on research, more work for quangos, even more “free” school meals, etc.

But the IPPR also wants a “healthy industrial strategy” based on the “polluter pays principle”. Their thinking is rooted in two absurd beliefs that have become the orthodoxy in “public health” through repetition. The first is that if you drink yourself to death, it has nothing to do with you and is instead the fault of Heineken or the French wine industry or some other commercial entity. The second is that the greatest public health win of the last ten years was Lucozade putting more artificial sweeteners in their drinks. Despite the sugar tax having no effect on childhood obesity, the IPPR reckons it was “among the most successful government policies of the last decade” (to be fair, it hasn’t been a great decade for government policies) and wants it to be “expanded”, not just to food and drink but to a bunch of products and services that are already heavily taxed.

They start with food:

This expansion could draw from international precedent. Both Hungary and Mexico have implemented non-essential food taxes. The former introduced an excise tax on packaged products high in fat, salt or sugar – justified by the cost of poor diet to the nation’s health service. In Mexico, an 8 per cent tax applies to non-essential, energy-dense food exceeding 275 kcal/100g. Both countries have had positive results in improving diet and increasing government revenue (Illescas-Zarate, Pineda et al 2024).

Eager to learn more about the success of these policies, I looked up the references. One of them is a theoretical modelling study. The other is a review of 20 studies, only two of which looked at the impact on obesity. These produced “mixed findings” and the authors say that the kind of tax proposed by the IPPR (10 per cent on various ‘junk foods’) “could yield substantial revenues to governments” but “is unlikely [to] significantly contribute to decreased obesity levels”.

To be fair to the IPPR, they don’t explicitly claim that such taxes reduce obesity, but since that is the outcome most people are interested in, it is worth noting that obesity rates in Hungary have risen from 21 per cent to 24 per cent since 2014 and have risen in Mexico from 32 per cent to 37 per cent since 2012.

Still, good news about the substantial revenues to government!

Having proposed a futile and regressive tax grab that will increase everyone’s cost of living, the IPPR gives us a handy reminder that modern “public health” is actually a moral reform movement by focusing on something that isn’t really a health issue but does give people a little bit of joy from time to time: gambling.

The sophistication and accessibility of gambling has increased substantially in the last 20 years — as have gambling companies’ profits. This is partly down to technological change: the internet and innovation in online gambling platforms have given every phone, laptop and device the potential to be a 24/7 casino. But it is also down to policy choices. The Gambling Act (2005) chose to treat gambling as akin to any other leisure activity, in contrast to other international approaches.

As a result, gambling harms are increasing.

There is no evidence that “gambling harms” are increasing. Problem gambling prevalence hasn’t budged in 25 years.

The rise of online casinos has led to a much higher prevalence of gambling across the UK population (eg Gambling Commission 2022).

Not true. The number of people who gamble has fallen in the last ten years (see page 10).

Last year, a new methodology for testing gambling harm found 2.5 per cent of the adult British population may be suffering from problem gambling – far higher than previous estimates of around 0.3 per cent (Gambling Commission 2023a).

The IPPR is implying that there has been a sudden rise in problem gambling prevalence. In fact, the Gambling Commission started using a much weaker survey design that attracts problem gamblers. The Commission has explicitly warned people not to compare the two surveys, but the IPPR is doing it anyway.

And the NHS has begun opening (at its own cost) gambling clinics, to increase its own capacity to meet demand caused by gambling harms.

The only reason the NHS is doing it “at its own cost” is because an activist-bureaucrat started turning away the money from industry that previously paid for these services.

This includes harm to children. The Gambling Commission’s 2022 audit found that a fifth of young people had spent their own money on gambling, and 0.7 per cent of those aged 11–16 were already classed as problem gamblers in Britain, with 1.3 per cent ‘at risk’ (Gambling Commission 2022). The number who are already problem gamblers is a notable increase on 2017 figures, when the rate was 0.4 per cent (Gambling Commission 2017).

This, again, was due to methodological changes. First, the definition of “children” was expanded to include 16 year olds who (at the time) could legally play the lottery. Then the survey was moved online and then 17 year olds were included.

Technology has made gambling significantly more accessible, but much harder for parents and guardians to monitor.

The Gambling Commission data shows that only 1 per cent of 11-17 year olds use gambling websites. The majority of 11-17 year olds who gamble play machines in arcades or bet with friends, as they are legally allowed to do.

Given these risks, we propose increasing gambling duties as follows to raise an estimated £2.9billion in 2025/26, rising to £3.4 billion by the end of this parliament.

How would this make any difference to underage gambling or problem gambling? It wouldn’t. It is just another shakedown on top of the forthcoming gambling industry levy (which the IPPR doesn’t seem to be aware of).

Next up, tobacco:

Tobacco continues to pose a substantial public health threat to the UK. There are 6.4 million adults who still smoke, despite nearly 80 years of conclusive evidence on the link between smoking and cancer. And despite the severe harm caused by tobacco, tobacco firm profits can still be remarkably high. One study estimated that profit margins can be as high as 70 per cent (Branston 2015).

At least 80 per cent of the price of a pack of cigarettes is tax, so that can’t be true on a per-unit basis. The reality is that the industry gets a few pence per pack after the venal government has filled its boots. Cigarette manufacturers are basically unpaid tax collectors.

Tobacco manufacturers would be subject to a cap on their wholesale prices, ensuring that their profits are controlled at around 10 per cent.

To achieve this, government would require tobacco companies to submit detailed Annual Financial Returns (AFRs) audited by independent parties. This would enable DHSC to determine the cost of production for each of these firms.

Another make-work scheme for bureaucrats and, given the unnecessary complexity of this idea, no doubt for lawyers and accountants too.

The difference between the capped price and the current wholesale price would be collected as a levy or through increases in excise duties. This would ensure that consumer prices remain unaffected.

I’m no fan of sin taxes, but isn’t the point of them to increase consumer prices to reduce demand? Is reducing industry profits an end in itself now?

Apparently so, for the analogy with the sugar tax has already fallen apart (as it did with gambling, above). The IPPR doesn’t want to nudge the industry into reformulating cigarettes, it just wants its cash.

There is, of course, one way for the tobacco industry to help its customers make healthier choices and that is through the production and promotion of reduced-risk nicotine products, but the IPPR wants to tax them too.

We also propose that the vape excise tax – consulted on by government in summer 2024 – goes ahead.

Then you don’t really care about health then, do you? Short of subsidising cigarettes, taxing vapes is about the worst thing you could do.

While vaping is evidently safer than smoking, the recent rise in youth vaping suggests its use now goes beyond its use as a stop-smoking device. Studies have shown teenagers are relatively sensitive to e-cigarette price changes, particularly if they do not already use nicotine (Corrigan et al 2021). Given this, the duty may help support lower adolescent vaping rates without undermining the potential value of vapes as a stop-smoking device.

What is this, Schrödinger’s tax? Logic dictates that a price rise that deters non-smoking adolescents from using e-cigarettes will have a very similar effect on adult smokers. Sure enough, that is what the evidence shows.

And finally, alcohol:

Alcohol mortality has reached historic highs in the UK – and is up 30 per cent on 2019 levels (ONS 2024l).

Indeed it is, all thanks to something that happened in 2020 which showed the importance of face-to-face treatment for alcoholics and the irrelevance of modern “public health” orthodoxy.

Despite this, alcohol duties have been frozen in recent fiscal events.

Wine taxes rose by 20 per cent last year while beer and spirits duty rose by 10 per cent.

We propose this is set at RPI + 3 per cent and left in place until alcohol harms fall to at least pre-2019 levels.

No thanks. The UK already has some of the highest alcohol taxes in Europe, if not the world.

This will serve as an incentive to the alcohol industry to take other measures to support public health and reduce tax liability more quickly.

Yeah, if I worked in the alcohol industry I would simply stop selling alcohol.

Idiots.

They also want plain packaging for vapes, cancer warnings for alcohol and various other things that are too depressing to mention. The fun police are on a roll right now, aren’t they?