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Carrots and sticks: Can governments do without public health regulation?

This is the first of three papers exploring tobacco, alcohol, obesity and gambling policy. It compares different types of policy approach, and concludes that more ‘interventionist’ and apparently politically challenging measures, such as strict regulations on availability and taxes, tend to be more effective.

KEY POINTS:

  • In general, more ‘interventionist’ policies (such as bans, taxes and regulations) tend to be more effective – though the story is nuanced.
  • Individual-level interventions (eg incentive payments, treatment) are more amenable to experimentation, and so have stronger evidence behind them.
  • However, the evidence that we have on measures that affect whole populations suggests they have bigger effects, and are cheaper (and so more cost-effective).
  • The evidence – particularly from tobacco control – suggests that a range of policies, implemented together, should reinforce one another and make each policy more effective.
  • Yet the most impactful measures may be those that appear most politically difficult because they involve raising prices or restricting availability.

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