How can we deal with problem lifestyles?
In July, the outgoing prime minister, Theresa May, published a green paper proposing far-reaching health measures, including the aim of making the UK ‘smoke free’ by 2030 and a ban on the sale of energy drinks to children. But the new prime minister, Boris Johnson, has signalled that he would review the effectiveness of sin taxes. That was welcome news for those who support personal choice and see such measures as a further restriction on our freedom to live our lives in the way we see fit.
However, while the claim that we now live in a ‘nanny state’ has become widespread, it remains the case that there are number of lifestyle choices – ‘bad habits’, as it were – that can have a negative impact both on the individuals who indulge in those habits and on the people around them. For example, heavy drinking increases the risks of liver disease, heart disease and cancer, among other problems. But it also reduces family incomes and can increase the risk of violence, including domestic violence.
Those who oppose government intervention frequently quote John Stuart Mill’s ‘harm principle’, set out in his famous essay, On Liberty: ‘The only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others.’ But even if Mill is right, no man or woman is an island, and almost anything we do will impact on others, whether it is the irritation of other people’s cigarette smoke, fellow employees missing work due to sickness caused by overindulgence in food or drink, or even paying extra tax to fund NHS treatment of smokers, drinkers and obese people.
If the government doesn’t step in, who should? One argument is that those who profit from products that cause harm, like drinks companies or food manufacturers, need to take more responsibility about the formulation and marketing of their products. Could that beer be a little bit weaker? Could that chocolate bar be slightly smaller and have less sugar in it? Do we need to see these products advertised so widely?
Others might see intervention by manufacturers as just as irritating and illiberal as interference from government. For example, in response to the sugary drinks tax, the makers of Irn Bru and Lucozade both reformulated their products to avoid the tax, substituting artificial sweeteners for sugar. The result was a backlash from many fans of the original recipes. Gambling adverts that constantly remind us to ‘bet responsibly’ quickly grate and appear patronising to many.
Those who defend personal autonomy would argue that these choices are about personal responsibility. Surely we are the best people to decide how we spend our money or how we should we eat or drink? Yet it is clear that a sizeable proportion of the population struggles with these issues. Hence, we have alcoholics, compulsive gamblers, morbidly obese people and smokers with cancer, bronchitis and emphysema.
Should we simply leave those with chronic, lifestyle-related problems to their own devices in the name of autonomy and moral responsibility? Would that be ‘throwing people under the bus’ in the name of an ideological attachment to trivial freedoms? Is it up to others, whether it is corporations, NGOs and family members to solve problems when individuals make the ‘wrong’ choices? Or should we accept that only the state can intervene with the force and scale necessary to solve these problems, even if it is at the expense of personal freedom?