Putting the country’s health first on the route to Covid-19 recovery
This week marks Global Week for Action on Non-Communicable Diseases (NCDs).
NCDs, such as cancer, heart disease, stroke, diabetes and chronic respiratory diseases, are estimated to account for 89% of all deaths in the UK1.
The main preventable causes of NCDs include consumption of products such as tobacco, alcohol or foods high in fat, salt and/or sugar. Their impact is keenly felt in the UK’s most deprived areas, where rates of tobacco use, harmful alcohol intake and obesity are higher, widening health and social inequalities.
The pandemic has diverted focus from these particular health issues over the last 18 months. However, with recognised links between NCDs and Covid-19 disease severity, and the emerging information on how Covid-19 measures have affected people’s health and wellbeing, it is clear that action in this area is needed.
Impact of the pandemic
Figures from across the UK indicate concerning behaviour changes related to tobacco use and the intake of alcohol and unhealthy foods during the pandemic.
Research commissioned by Alcohol Change UK found that more than a quarter (28%) of people who have ever drunk alcohol thought they had been drinking more during lockdown2. In England, the first Covid-19 lockdown was associated with a rise in smoking among young adults, and figures from the 2020 Scottish Health Survey found that more than a third (36%) of people who smoke, reported smoking more during lockdown3,4. Similarly, a survey commissioned by Obesity Action Scotland in May 2020 noted increases in the consumption of foods high in fat, salt and/or sugar5.
Alongside these modified behaviours, Covid-19 restrictions have disrupted the provision of essential support, such as stop smoking and alcohol treatment services. These changes have particularly affected deprived communities where rates of NCDs are highest.
As we look ahead to Covid-19 recovery, it will be important to deliver effective public health policies to prevent NCDs, reduce inequalities and support a healthier and resilient population.
Supporting public health action
Low prices and easy availability, combined with attractive advertising and other marketing, create an environment that makes it difficult for consumers to avoid or reduce their intake of these unhealthy products.
Government action can help by regulating their price, availability and marketing, which alongside direct support, enables people to reduce their consumption. However, such action is often delayed or prevented due to powerful lobbying from the large companies who produce these products.
Together, SPECTRUM colleagues provide a unique overview of NCD prevention strategies including action on price, availability and marketing of tobacco, alcohol and unhealthy food products, and industry influence on health policy. Some examples of recent and ongoing work include:
- An initiative to map and analyse corporate responses to the Covid-19 pandemic, in collaboration with the NCD Alliance. This project culminated in a report, Signalling Virtue, Promoting Harm, detailing hundreds of international examples of companies leveraging the pandemic for commercial gain and to influence policy.
- Expanding an existing informative data source in England – the Smoking and Alcohol Toolkit Study (www.smokinginengland.info and www.alcoholinengland.info) – to Scotland and Wales. In response to the Covid-19 pandemic, studies were also updated to include a question with the coronavirus outbreak as a motive to stop smoking. The Scottish and Welsh components of the Smoking and Alcohol Toolkit Study are now live with headline smoking estimates available online (see www.smokinginscotland.info and www.smokinginwales.info). Drinking estimates are to be released in autumn 2021.
- The development of a Healthy Weight Strategy with partner organisation the Obesity Health Alliance, due to launch in the autumn of 2021. The strategy aims to provide a longer term plan for action to reduce obesity prevalence, with a set of ambitious and comprehensive recommendations that address the systemic drivers of obesity including the promotion of foods high in fat, salt and/or sugar.
- Ongoing research will use electronic till data to consider whether patterns of alcohol purchasing in Scotland changed during the Covid-19 pandemic. The study will examine whether there were changes in: the proportion of shopping baskets containing alcohol; the size and value of alcohol baskets the types of alcohol products purchased; and the price paid for alcohol products. It will also look at how these purchasing patterns vary by region of the country, neighbourhood deprivation, rurality, and retail outlet density.
Considering the direct and indirect impact of commercial actions and policy interventions is crucial as we seek to push the prevention agenda, and take action on NCDs to Build Back Better. We look forward to contributing to the conversation.
1. World Health Organization. 2014. Noncommunicable Diseases (NCD) Country Profiles – United Kingdom. https://www.who.int/nmh/countries/gbr_en.pdf
2. Alcohol Change UK. 2020. Research: drinking in the UK during lockdown and beyond. https://alcoholchange.org.uk/blog/2020/drinking-in-the-uk-during-lockdown-and-beyond
3. Jackson, SE, Beard, E, Angus, C, Field, M, Brown, J. Moderators of changes in smoking, drinking and quitting behaviour associated with the first COVID-19 lockdown in England. Addiction. 2021; 1– 13. https://doi.org/10.1111/add.15656
4. Scottish Government. 2021. Scottish Health Survey – telephone survey – August/September 2020: main report. https://www.gov.scot/publications/scottish-health-survey-telephone-survey-august-september-2020-main-report/pages/11/
5. Obesity Action Scotland. 2020. Lifestyle of Scotland’s People Since the Coronavirus Outbreak. https://www.obesityactionscotland.org/media/1467/polling-summary-report-2805.pdf