Gaping holes in a patchwork of policy proposals: what do the manifestos say on tobacco, alcohol and junk food?

Tobacco, alcohol and obesity remain the leading causes of ill health and early death in the UK. Together they cause an estimated 2.5m hospital admissions a year in England, with UK costs from lost productivity alone running at over £31bn. Yet despite this, the three major party manifestos leave some gaping holes in the patchwork of policy proposals aimed at tackling these risk factors.

Over the past decade, national policy aimed at tackling tobacco, alcohol and obesity has focused on individual behaviour change – providing services for people already addicted to tobacco, living with obesity, or are impacted by alcohol-related harm. While these services have a vital role, far less has been done to create healthy places that can help protect communities from these risk factors in the first place. These policies are often less expensive, can have a bigger impact on overall population health and are more likely to reduce health inequalities. 

As such, at the Health Foundation we’ve long called for government to take much bolder action to protect people from the harms of alcohol, tobacco and unhealthy food, including a greater use of taxation and regulation.

What do the manifestos say?

The flagship piece of public health legislation for the Conservative party in 2024 was the Tobacco and Vapes Bill which would have created a ‘smokefree generation’, making it illegal for anyone born after 1 January 2009 to ever be sold tobacco. This was a potentially transformative piece of public health policy that would have protected the health of generations to come but it didn’t get to Royal Assent before parliament dissolved for the election. Commitment to a smokefree generation has made it into both Conservative and Labour manifestos but is notably absent from the Liberal Democrat manifesto, who instead plan to implement a welcome, but less-transformational, ‘polluter-pays’ levy on tobacco companies to fund ‘health care and stop smoking services.

On unhealthy food, all three parties promise to finally introduce a version of the long-promised advertising ban on junk food to children. The Labour manifesto is also proposing a ban on sales of high-caffeine energy drinks to children under 16 – another previous Conservative policy promise that wasn’t implemented – and the Liberal Democrats have said they’ll correct a long-standing anomaly in the soft drinks industry levy and include juice and milk-based drinks.

And on alcohol, there’s nothing.

What else would help?

The public clearly think that national government has responsibility for protecting people from harms of tobacco, alcohol, and unhealthy food. Our most recent Ipsos polling shows there is more support than opposition for bold policies that go further than the manifestos promise, often with greater support among Labour voters.

The Department of Health and Social Care estimates that the smokefree generation policy could reduce the number of 14–30 year olds who smoke from 13% to closer to 0% by 2050. And there’s potential for government to help further by banning tobacco sales in supermarkets and online – as suggested in the Khan Review.  

There is also plenty more that could be done on unhealthy food. For example, by introducing the National Food Strategy recommendation to extend the Soft Drinks Industry Levy to foods high in sugar and salt, and using the revenue to expand programmes such as Healthy Start and free school meals aimed at supporting low income families get fresh and healthy food. 

And despite year-on-year increases in deaths from alcohol in England, the silence on alcohol policy gets louder. England hasn’t had an alcohol strategy since 2012, when David Cameron promised to review a range of policies, including minimum-unit alcohol pricing. Since then, Scotland have led by introducing minimum-unit pricing and demonstrating that it can improve health and narrow inequalities without harming the alcohol trade. With the policy also now adopted in both Wales and the Republic of Ireland, it is time for a new government in England to grasp the nettle.

How can local government help take action?

There is also plenty that could be done post-election to help local councils address harms from tobacco, alcohol and unhealthy food. We’ve previously written about these in detail, with several key opportunities available.

• Councils should be able to include public health as an objective when making alcohol licensing decisions. This would allow public health and licensing teams to work together to help reduce alcohol-related harm in communities most affected.
• A nationally coordinated and locally run tobacco licensing scheme for retailers could help local trading standards teams enforce the smokefree generation policy, as well as provide some local flexibility for councils to adopt local licensing conditions (such as requiring stores to provide information on stop smoking services). Local areas could also limit the number of licenses they provide in a given area.
• The Liberal Democrat manifesto mentions supporting local authorities to restrict outdoor junk food advertising –  we argue, more specifically, that councils should be given clear powers to restrict alcohol and unhealthy food advertising in public spaces on privately owned billboards and advertising spaces.
• Finally, closer integration between planning and public health – including in the National Planning Policy Framework, the government guide for how to apply planning policy – could help ensure that planning authorities are confident that decisions made on the basis of local health needs, such as takeaways near schools, won’t be overturned if the business appeals.

What’s next?

While the manifesto commitments on tobacco and junk food are welcome, large holes in the policy patchwork remain – particularly on alcohol. As NHS pressures continue to rise and ill health keeps thousands off work, a healthy population will be critical to future government ambitions to health improvement and economic growth. Thankfully there are policies that can help, as outlined in our prevention briefing, the next government will need to decide just how seriously it steps up to the challenge.

On Thursday 19 September 2024, Adam Briggs will be chairing a webinar exploring what local government in England can do to tackle the leading risk factors for ill health.