Nudge towards effective harm reduction

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Second, these “soft” approaches tend to be cheaper to implement that rigid regulatory regimes, so it is hardly surprising governments have welcomed them so warmly.

President Barack Obama in the USA and Prime Minister David Cameron in the UK have both encouraged government agencies to draw on behavioural and social sciences. Nudging is fast becoming a global policy phenomenon.

Integration

There are dangers, however. Behaviourally-informed tactics, including default rules and disclosure requirements, raise important legal concerns about the rights of citizens vis-à-vis the regulatory state. What is the legal position when nudging preserves and compromises freedom at the same time?

More importantly, with no rational framework for integrating behavioural research into policy-making, the application of this science will remain haphazard and the impact small and anecdotal. A framework would help to make public health decision-making more transparent and accountable.

The USA has already set the precedent, imposing a general requirement on public administrations to adopt principled and consistent procedures for using behavioural science in policy-making. Clear processes should also help to protect policies and people from possible abuses. An emphasis on thorough regulatory impact assessments should also policy-makers to “test” a range of regulatory options and allow citizens to have a say too.

Tobacco: new regulations missing a trick

Let’s take the example of policies towards the prevention of tobacco addiction. In Europe, the revised tobacco products Directive, for instance, embraces behaviourally-informed approaches. To its credit, newly-adopted approaches-such as combined graphic and health warnings-no longer inform the public about the adverse effects of smoking. Instead they seek to change social norms by “denormalising” tobacco. However, the Directive fails to use behavioural insights to promote harm reduction approaches.

Electronic and herbal cigarettes also fall under the legislation. Consequently, their marketing material must now also carry health warnings. In addition, e-cigarettes might become subject to the same authorisation required for medicinal products.

The overall stance on both conventional and alternative tobacco products favours an abstinence-only policy. And, it de facto rejects a risk-reduction approach, which would encourage smokers to switch to less damaging nicotine-delivery. The rules are understandable because people fear that e-cigarettes might encourage smoking. Nonetheless, millions of addicted smokers are left with only one choice: to get their nicotine by smoking or quit.

The Commission’s abstinence-only approach is questionable; it makes much more sense to nudge smokers towards less hazardous alternatives. We certainly need to build up the evidence about “safer” alternatives. But it is shameful that the ideological imperative to “denormalise” smoking could deprive society of the potential gains from harm-reduction through switching.

Indeed, this policy flaw highlights the major contribution that behavioural science has to make. It is time to shift policy discussion away from the morals of harm reduction to where it belongs: rooted in science.

Alberto Alemanno

Alberto is Jean Monnet professor of EU Law and Risk Regulation at the HEC Paris and global clinical professor at NYU School of Law HEC Paris as well as global clinical professor at NYU School of Law.

This article is the edited version of a piece that was first published in Science in the Public Interest vol. 1: Harm Reduction, published by SciCom– Making Sense of Science.

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