After flirting with Nudge a couple of years ago, the penny has now dropped amongst public health pro's that their agenda of limiting choice, raising prices and restricting availability cannot be dressed up as a friendly nudge. To highlight this, they show a table of nudges versus shoves (or velvet gloves versus iron fists, if you prefer). [Click to zoom]
Most of the so-called nudges would actually require regulation. Pubs are not going to, for example, serve drinks in smaller glasses because there is no demand for it. Others, such as "reduce cues for smoking by keeping cigarettes, lighters and ashtrays out of sight" would be enforceable even if regulated. And still others, such as "designate sections of supermarket trolleys for fruit and vegetables" are just stupid. Still, it gives you an idea of what these people would do if they could.
As for the shoves (regulations), most of them are already in place. Minimum pricing, a ban on trans-fats and raising the minimum age of alcohol purchase are the only policies to which the government has not yet capitulated. The rest would have to go under any government that took Nudge seriously.
The authors would like to see "regulations to limit the availability of alcohol" and "pricing interventions" on food. Since the desire to make it more expensive and inconvenient to eat and drink is at odds with
Evidence to support the effectiveness of nudging as a means to improve population health and reduce health inequalities is, however, weak.
That's a bit rich coming from people who are still clinging to the belief that...
...increasing the price of tobacco may be more effective in reducing smoking among adults on lower incomes and in manual occupations than among those with higher incomes
There is a vast amount of evidence taken over decades to show that people on low incomes are the least responsive to prices increases. And there is increasing evidence that taxes in places like Ireland, Britain and Canada have already reached the tipping point at which smuggling and contraband make further tax hikes counterproductive.
It looks as if the attack on individual rights will be dressed up as an attack on the straw men of the drinks/food/tobacco industries in the future. And why not? It's a tactic that's been working ever since the Prohibition Party targeted the largely fictitious 'liquor trust' in the 19th century.
Without regulation to limit the potent effects of unhealthy nudges in existing environments shaped largely by industry, nudging towards healthier behaviour may struggle to make much impression on the scale and distribution of behaviour change needed to improve population health to the level required to reduce the burden of chronic disease in the UK and beyond.
This sounds to me like a door slamming. Farewell Nudge, we barely knew thee.
