Cheaper chocolate and alcohol are a public health setback

Cheaper chocolate and alcohol are a public health setback
It is well documented that higher prices for alcohol, tobacco and sugar products result in lower consumption. Credit: NTB / Shutterstock

Norway's budget settlement between the government and the Progress Party resulted in getting rid of the sugar tax for chocolate and sweets, halving the tax on soft drinks, cutting the taxes on snuff by 25 percent and on beer and wine by 10 percent.

Steinar Krokstad, who has headed HUNT—the Trøndelag Health Study—for many years, knows most everything about Trøndelag county residents' and living habits. The professor is very disappointed with the state budget settlement.

Sad, says Krokstad

"This is just sad. So much time and effort has been put into preparing the ground for a good health policy. Then we watch as important measures are removed with the stroke of a pen to get the state budget passed. The entire scientific basis is ignored," says Krokstad.

"It's a well-documented fact that high taxes on these products are beneficial for . Higher prices mean less consumption. The public health field is about influencing behavior, making it easy for people to make good choices and harder to make bad choices," he says.

Price is higher than the gain

"The boundary between and is an important balancing act, but I can't believe that the possible positive effects we think we'll get from more jobs in Norway and less trade leakage to Sweden will outweigh the benefits of lower sugar intake and lower alcohol consumption," Krokstad says.

"I don't see higher taxes on these harmful goods as a threat to individual freedom. For , this matter is also about freedom from experiencing insecurity related to alcohol in the home and weight problems," he says.

Science and politics

As a researcher, Krokstad finds that sticking your neck out on such a politicized topic poses a dilemma.

"As public health physicians, it's easy to be regarded as being too political. But we can't get away from the fact that politics is the most important driver in public health work. So we have to get involved, at the same time as we depend on trust among politicians and on their help to get things done in public health work," he says.

"If this is about considering cross-border trade and jobs, politicians have other effective tools in their toolbox. Cross-border trade can easily be regulated by adjusting quotas. The issue has been presented as if reduced taxes are the only solution," says Krokstad.

Obesity and intoxication

Krokstad points out that in general, economic growth has been beneficial for public health. But when prosperity reaches a certain level, it also creates public health problems.

"Not all economic growth and increased consumption are good for public health. We need to stimulate the growth we want, and not what's undesirable and harmful to our health. Obesity and intoxication are perhaps the most critical threats to public health," he says.

"During this corona pandemic, we've observed particularly great concern for children in difficult home situations. We know that child welfare cases are strongly associated with drug use. The costs to society of health damage and reduced ability to work due to alcohol are huge," says Krokstad.

Getting heavier

The HUNT studies show that men in Trøndelag county were on average 10 kilos heavier in 2018 than in the 1980s, and women 7 kilos heavier. In the 80s, eight percent of men were within the obese range, compared to 23 percent in 2018. For women, the obesity level increased from 13 percent to 23 percent in the same period.

Among young people, the proportion within the overweight and obese range increased from 16 percent to 24 percent between 1996 and 2017, and from 16 percent to 25 percent among girls. Obesity is most prevalent in rural areas and in groups with low socioeconomic status. Even though the curve has flattened out a bit, people in Trøndelag are still gaining weight.

In violation of the WHO

The social health physician believes that the government is acting in violation of clear advice from the WHO and Norway's obligations to help reduce non-communicable diseases. The World Health Organization calls obesity the fastest growing health threat, and it is becoming a bigger problem than malnutrition and infectious diseases as the main cause of poor health.

Obesity is associated with heart disease, high blood pressure, stroke, some types of cancer, diabetes and a number of other diseases. In addition, people with obesity face prejudice and discrimination—including from health professionals.

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