A bitter taste? Exploring the political constraints on public health policies

This is the second of three papers exploring tobacco, alcohol, obesity and gambling policy. It explores the political opportunities and constraints around action on these issues, based on a review of polling evidence and interviews with policymakers involved in implementing major public health policies.


  • Public opinion does not appear to be the main obstacle to interventionist public health policies:
    • More people were in favour of than opposed to the vast majority of policies polled.
    • Advertising restrictions and policies to benefit children are particularly popular.
  • Taxes, especially new taxes, tend to be relatively unpopular – but public health taxes are seen more favourably than other forms of tax.
  • Expert interviews suggest resistance from the media, industry and party colleagues is a bigger barrier than voter opposition.
  • That means politicians seeking to take action on public health need to be prepared for a long-term project requiring political capital and stamina.
  • There are at least two strategic approaches they might take:
    • Building ‘scoreboard momentum’: carefully picking battles, proposing measures that are likely to pass and consolidating.
    • ‘Two steps forward, one step back’: recognising almost anything proposed will meet resistance, take a maximalist approach fighting on multiple fronts, expecting to lose on some.


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