Intended for healthcare professionals

Rapid response to:

Head To Head

Can we leave industry to lead efforts to improve population health? No

BMJ 2013; 346 doi: (Published 17 April 2013) Cite this as: BMJ 2013;346:f2426

Rapid Response:

Re: Can we leave industry to lead efforts to improve population health? No

There is no such thing as population. Consumption is a matter of personal preferences.

Ultimately, the obligation to maintain and improve one's health lie with the individual. The proof is obvious: despite what the author sees as "market manipulation" millions of ordinary people consciously eat reasonably healthy food and conduct reasonably active lifestyle taking care of their bodies and minds in parks, recreational and fitness centers.

Industry is well positioned to cater to these people.

Apart from rare genetic differences, the chief reasons why many people in developed countries are unhealthy are their individual preferences. Whether these preferences can be improved, or whether an objectively "better" set of preferences even exists, is a philosophical or an anthropological question, certainly a better one than "can we allow the industry to serve its customers?".

The author writes "...around 90% of lung cancer can be attributed to smoking. Why should manufacturers be allowed to produce and market (at all) a product with such predictable consequences and wash their hands of any responsibility". Perhaps its because, as every smoker can attest, cigarettes serve other useful purposes in the smoker's life, for example, improving his or her concentration, or saving him or her from depression. If the smoker is prepared to take the risks - why should anybody else be allowed to deny him or her this choice, considering the fact that the majority of smokers are likely to die early and their net burden on the society is therefore near zero?

Moreover, why should we trust the government to decide which product should be allowed to be produced and marketed? Is government somehow magically protected from incentives to manipulate and be manipulated, to deceive and be deceived, and to mislead and be misled? How do we know that government-approved choices are better for individuals - considering all the costs, benefits and risks arising from the centralized choice-making?

Competing interests: No competing interests

21 April 2013
Vacslav Glukhov
Abingdon Villas, London W8 6BS