- Gerard Hastings, director
- 1Institute for Social Marketing, University of Stirling and the Open University, Stirling FK9 4LA, UK
The work of Professor Richard Doll provides two key lessons for public health. The first, that we must do all we can to eradicate the use of tobacco, has been well learnt and is being energetically acted upon. The second, more subtle learning—that our economic system has deep flaws—remains largely ignored. And yet, lethal though tobacco is, the harm being done to public health by our economic system is far greater.
Furthermore, the two are intimately connected: tobacco has remained such an intractable problem only because our economic system allows free ranging corporations to market it. The same applies to the other two “industrial epidemics”1 that constitute such a large share of the public health burden: alcohol misuse and obesity. In each case evocative promotion, ubiquitous distribution, perpetual new product development, and seductive pricing strategies are used to encourage unhealthy consumption. And in each case painstaking research and review have shown the obvious truth that this marketing effort succeeds, especially with the young.2 3 4 The consequence has been the inevitable escalation of lifestyle illnesses such as cancer, heart disease, cirrhosis, and diabetes.
However, the impact of marketing on public health goes much deeper than this. Marketing textbooks lionise the consumer: our complete satisfaction is the essence of successful business (provided we can afford to pay). The result is an unstinting hunt for new needs and wants (or, increasingly, whims) to satisfy, and a population that has a burgeoning sense of entitlement. The damaging effect of this favouritism is shown in the pharmaceutical business, which pays more attention to the trivial complaints of the rich than the life threatening sicknesses of the poor. As …