Let’s not be unreasonable: governments can’t control everything. Systems fail. Events creep up. But it’s a matter of legitimate concern when risks are known, quantified and still inadequately addressed.
As a society we have a complex relationship with risk, straddling the law, politics and commerce. Many will say the risks taken by individuals with their own health and safety is their own affair; indeed, that the right to take risks is our liberal, democratic birthright. But one might argue just as reasonably that when an individual gambles unsuccessfully, it is society that suffers the repercussions – the health costs, the opportunity costs, the resources expended – and that communities, represented by government, have the right to limit their exposure.
That explains today’s expressed desire to “fix” obese people – why wouldn’t we send them on healthy eating and exercise courses if we can help end a condition that costs the NHS £8.8bn a year?
The easiest answer is that it won’t work. What we know, not least from research undertaken by the behaviour and health research unit at Cambridge University, is that the least effective way to deter people from taking risks is to warn them off, and encourage forbearance. Those issuing the warning may be disbelieved. Those being warned may be unwilling to sacrifice immediate and known pleasure for the distant, theoretical prospect of better health, or delayed death.
Knowing that over-eating or under-exercising is risky will not in itself induce those engaged in such activities to stop. But awareness of that limitation – the knowledge that people cannot and will not address the risks themselves – can move them towards participation and advocacy for solutions that actually work. Changing the environment, research suggests, can limit the scale of risk-taking. Knowing what doesn’t work may lead us to focus on what does.
Theresa Marteau, director of the Cambridge unit, says this is the point to impress on policymakers. Not least because they already know it to be true. In 1974, over 50% of men and 40% of women in Britain were smokers. Now, less than 17% of the UK population smokes. Smoking was in long-term decline already, but after years spent prioritising individual risk, the ban on smoking in public places greatly accelerated the process. Environmental change continues with the removal of cigarette packets from view in shops and the ongoing effort to make the packaging undesirable, a new measure it is hoped may deter another 300,000 smokers.