Intended for healthcare professionals

Editor's Choice

Public health or research—money matters

BMJ 2018; 361 doi: (Published 12 April 2018) Cite this as: BMJ 2018;361:k1607
  1. Cat Chatfield, quality improvement editor
  1. The BMJ
  1. cchatfield{at}

The UK introduced its first sugar tax this week. Soft drink manufacturers will now have to pay tax linked to a product’s sugar content, and some companies are already taking action.1 Whether it will have any impact on the obesity crisis remains to be seen,2 but growing evidence shows that taxes on alcohol, tobacco, and soft drinks have been effective in reducing non-communicable diseases, as found in a new Lancet taskforce report (doi:10.1136/bmj.k1524).

These findings are consistent with research by the Global Tobacco Economics Consortium, which modelled the consequences of a 50% price increase on cigarettes among 500 million male smokers in 13 middle income countries. An increase in cigarette taxation would most benefit the poorest segment of a population, not only in life years saved but also by avoiding catastrophic health expenditure, the study finds (doi:10.1136/bmj.k1162. McCord and Novotny describe the additional economic benefits of higher cigarette taxation at a societal level (doi:10.1136/bmj.k1433).

But tackling financial motives is not sufficient. In our head to head debate, Miriam Wiersma and colleagues argue that we all have non-financial motives that must be managed, since they exert a “powerful influence on human behaviour” (doi:10.1136/bmj.k1240). Marc Rodwin, however, disagrees: financial conflicts of interest are a practical legal tool, he says, and redefining them to include intellectual conflicts would reduce their usefulness, “making it merely another phrase for bias.”

Tim Schwab also tackles non-financial competing interests when considering Coca-Cola’s influence on obesity research and whether nutrition researchers should declare their dietary preferences (doi:10.1136/bmj.k1451).

The NHS, the world’s most prominent example of universal health coverage, will have its 70th anniversary in July. It is loved, valued, and unaffordable.3 In their editorial, Appleby and Abbasi pose a series of questions about the uncertain affordability and sustainability of the NHS (doi:10.1136/bmj.k1540), and we will attempt to answer these in The BMJ over the course of this year.

On a brighter note, we seek your nominations for the NHS’s greatest achievement. We will announce the results at the time of the 70th anniversary (doi:10.1136/bmj.k1562).

View Abstract