Liekuut |The right to good health is at least as important as individual freedom of choice

In ‘Liekuut’, which is the Groningen dialect for straight ahead or straightforward, we share the perspective of one of our academics on a topical issue. This is how we show that UG researchers contribute to the societal debate.

During ‘Stoptober’ people are encouraged to quit smoking. While it is nice to motivate people individually, legislation and regulations are indispensable when it comes to combating smoking behaviour, says Brigit Toebes, Professor of Health Law at the Faculty of Law of the University of Groningen and scientific director of the Aletta Jacobs School of Public Health. She argues that the right to good health is at least as important as personal freedom of choice and that the government should absolutely continue to intervene. While we’re at it: we should also talk about alcohol.

Important to intervene

‘Smoking kills. It has been directly linked to cancer, diabetes, and cardiovascular disease. Over the course of the twentieth century, tobacco has caused more than 200 million deaths. Moreover, in the Netherlands 20,000 people die every year from the consequences of smoking – about as many people as the population of a town like Haren. Yet the people who are dying are usually not the wealthy inhabitants of Haren, but primarily those who live in poorer areas. There are significant health disparities in the Netherlands, and particularly those with lower incomes and lower levels of education have less healthy lifestyles, so it's incredibly important we continue to make an effort to change this.’

No right to make the wrong choices

‘Ten years ago, there was a lot of talk about kind of having ‘the right to smoke’, but I’m glad to see that this narrative is turning around. The right to good health is, just like individual freedom, a requirement for human dignity, and if you were to get COPD and would no longer be able to climb the stairs, this could severely affect your dignity. I think this outweighs freedom of choice. It may perhaps feel like the small pleasures are being taken away, but, in my opinion, that’s exactly what it means to protect people’s wellbeing. In principle, people are free to make their own wrong choices, but it’s also genuinely important that we help people to make healthy choices. Sometimes, this means resolutely removing the unhealthy choice, especially when it concerns products that have proved deadly. In addition, in the context of children’s rights, it’s essential to protect children and ensure they don’t start smoking.’

Efficient interventions

‘The legal measures that we’ve taken really do work: In the past few years, the number of adult smokers has dropped with about five percent. Interventions are done according to the four p’s: price, product, place, and promotion. Cigarettes become a lot less appealing when they cost a lot more, when the product packaging shows distasteful pictures, when you can no longer buy them at the supermarket, and when they are no longer promoted. These are all great interventions that significantly reduce smoking. It's clear, however, that we should remain alert as young people in particular are now collectively reaching for vapes.’

Alcohol, the great unifier

‘If we’re discussing health matters, we should also talk about alcohol. Alcohol is the oil of our society, the great binding agent — Where there’s a good time, there has to be alcohol. In my opinion, we've become a little too comfortable with that, as there’s a large group of people in the Netherlands who drink daily, and there’s a lot of excessive drinking among adolescents. Recently, the WHO has taken up a new vision, which states that there’s no safe level of alcohol consumption. So if we want to focus on the right to good health we have to do something with that.’

No lobbyists at the table

‘So, what should we do? To some extent we can do the same as we are currently doing with regards to smoking and follow the four p’s again: remove alcohol from supermarkets, change the packaging, or restrict marketing so we link alcohol consumption less to having a good time. It’s even more important, however, that the policy is made independently, which means alcohol lobbyists shouldn’t have a seat at the table. We’ve achieved this with an international anti-tobacco treaty, which ensures that representatives of the tobacco industry are no longer welcome when the government discusses new tobacco policies. I believe we should maintain the same approach for alcohol. After all, if you want to encourage healthy consumption habits within society, these representatives shouldn't have a say in it.’

Not a fun message

‘I understand that this isn’t a fun message, but it is a vital one if we want to safeguard the right to good health, wellbeing and dignity. If we want to achieve a broader societal shift, we need broader legislation, and, above all, we have to protect young people from being exposed to things that have proven harmful. Only then can we bring about a healthy transformation for the future.’

Overview of all 'Liekuut' opinion pieces.