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Title page 1

Contents 4

ABOUT THE AUTHOR 8

ACKNOWLEDGMENT 9

FOREWORD 10

SUMMARY 14

PART ONE. EVIDENCE 18

1. EVIDENCE-BASED POLICY 19

From medicine to policy 21

Disseminating research 27

2. POLICYMAKING IN THE REAL WORLD 34

The science of muddling through 35

The public health perspective 38

The public choice perspective 43

PART TWO. THE CASE STUDIES 50

METHODOLOGY 51

3. FIRST CASE STUDY: PLAIN PACKAGING FOR TOBACCO 55

Background 55

The policy 61

Timeline 61

The evidence 64

The Stirling Reviews (2012 and 2013) 66

The Chantler Review (April 2014) 69

Wakefield et al. (2013) 72

Discussion 73

4. SECOND CASE STUDY: THE SOFT DRINKS INDUSTRY LEVY 83

Background 83

The policy 86

Timeline 87

The evidence 89

Colchero et al. (2016a) 90

Public Health England's evidence review (October 2015) 91

Briggs et al. (2013) 95

Discussion 95

5. THIRD CASE STUDY: MINIMUM UNIT PRICING 108

Background 108

The policy 113

Timeline 113

The evidence 115

The Sheffield Alcohol Research Group (2008-16) 116

Zhao et al. (2013) and Stockwell et al. (2012a, 2012b) 116

Discussion 118

6. FOURTH CASE STUDY: FIXED ODDS BETTING TERMINALS 129

Background 129

The policy 135

Timeline 135

The evidence 137

DCMS (January 2016) 138

Responsible Gambling Strategy Board report (January 2017) 139

Gambling Commission (March 2018) 143

Discussion 147

7. PACKAGES OF EVIDENCE 163

Plain packaging 165

In theory: The Stirling Reviews 165

In practice: Wakefield et al. (2013) 167

In practice: Australian smoking rates and tobacco sales 172

Expert opinion: The Chantler Review 174

Sugar tax 179

In theory: Briggs et al. (2013) 179

In practice: Colchero et al. (2016a) 182

Expert opinion: Public Health England review 183

Minimum pricing 186

In theory: The Sheffield studies 186

In practice: The Canadian experience - Zhao et al (2013) 194

Expert opinion: Public Health England 199

FOBTs 199

In theory: Gambling Commission (2018a) 200

In practice: DCMS (2016) 200

Expert opinion: Gambling Commission (2018a)/Responsible Gambling and Strategy Board (2017) 201

8. EVALUATION 205

Plain packaging 206

Sugar tax 208

Minimum pricing 211

FOBTs 216

Summary 218

PART THREE. PRESSURE 221

9. EVIDENCE-BASED POLICY OR POLICY-BASED EVIDENCE? 222

Plain packaging 238

Sugar tax 241

Minimum pricing 243

FOBTs 245

Summary 247

10. GETTING THE BARNACLES OFF THE BOAT 249

Public approval 250

Plain packaging 250

Sugar tax 250

Minimum pricing 251

FOBTs 253

Risks of failure 255

Risks of inaction 257

Plain packaging 258

Minimum pricing 260

FOBTs 264

Sugar tax 265

11. A PUBLIC CHOICE PERSPECTIVE 267

Activism 270

Policymaking under pressure 275

Interest groups 276

Bureaucrats 287

Industry 290

The public 292

Politicians 297

The value of evidence 300

CONCLUSION 309

REFERENCES 324

ABOUT THE IEA 348

Tables 164

Table 1. Packages of evidence 164

Table 2. Gambling machine session losses in UK betting shops (2015-16) 202

Table 3. Primary and secondary objectives of each policy 205

Table 4. UK adult smoking prevalence, 2011-19 (DHSC 2022: 19) 207

Table 5. Child obesity prevalence (England) 209

Table 6. Gross Gambling Yields, UK 216

Table 7. Evidence gathering before and after implementation 228

Table 8. Support/oppose plain packaging 250

Table 9. Support/oppose soft drinks levy 251

Table 10. Support/oppose minimum unit pricing (UK) 252

Table 11. Support/oppose FOBT stake limit of £2 254

Table 12. Public opinion before the policy decision was taken 254

Table 13. Prevalence of use and public support for the related policy 297

Table 14. Intuitive arguments for and against each policy 302

Figures 65

Figure 1. Number of references to evidence in the media and House of Commons 65

Figure 2. Type of evidence cited (by number of references) 74

Figure 3. Methodology of peer-reviewed studies 74

Figure 4. Type of peer-reviewed study cited (by number of references) 76

Figure 5. References to evidence by media outlet 79

Figure 6. Number of references to evidence in the media and House of Commons 90

Figure 7. References to evidence by media outlet 95

Figure 8. Type of evidence cited (by number of publications) 96

Figure 9. Type of evidence cited (by number of references) 97

Figure 10. Number of references to evidence in the media and House of Commons 117

Figure 11. Type of evidence cited (by number of references) 119

Figure 12. References to evidence by media outlet 121

Figure 13. Number of references to evidence in the media and House of Commons 151

Figure 14. Type of evidence cited (by number of references) 152

Figure 15. References to evidence by media outlet 157

Figure 16. Daily and overall smoking prevalence in Australia 1995-2013 173

Figure 17. Seasonally adjusted tobacco sales in Australia: December 2009-March 2014 173

Figure 18. Wholly alcohol-attributable deaths, British Columbia 2002-2011 196

Figure 19. Problem gambling prevalence Great Britain/England 1999-23 218

Figure 20. Media references to evidence related to plain packaging 305

Figure 21. Media references to evidence related to the sugar tax 305

Figure 22. Media references to evidence related to plain packaging/Lynton Crosby 306

Figure 23. Media references to evidence related to the sugar tax/Jamie Oliver 307

Boxes 81

3. FIRST CASE STUDY: PLAIN PACKAGING FOR TOBACCO 81

Box 1. Typical headlines 81

Box 2. Excerpts from the House of Commons 82

4. SECOND CASE STUDY: THE SOFT DRINKS INDUSTRY LEVY 106

Box 1. Typical headlines 106

Box 2. Excerpts from the House of Commons 107

5. THIRD CASE STUDY: MINIMUM UNIT PRICING 127

Box 1. Typical headlines 127

Box 2. Excerpts from the House of Commons 128

6. FOURTH CASE STUDY: FIXED ODDS BETTING TERMINALS 161

Box 1. Typical headlines 161

Box 2. Excerpts from the House of Commons 162

출판사 책소개

알라딘제공

'Laws are like sausages. It is better not to see them being made.' - Otto von Bismarck

The 21st-century public is endlessly bombarded with calls for restrictions on unhealthy or sinful behaviour. Whether it's sugar taxes, plain packaging on cigarettes, or minimum alcohol prices, we're often told that these policies are for our own good - the evidence says so.

But what is the evidence for evidence-based policymaking?

Inside the Sausage Factory looks under the bonnet of four campaigns for public health policies in Britain to discover what kind of evidence was influential and whether it made any difference.

The findings will disappoint anyone who expects rational decision-making and sound legislation. It is a story of shallow politicians, state-funded campaigners, activist-academics, junk science and bad laws.

Evidence was used, but only as window dressing. Applying insights from public choice theory, Dr Christopher Snowdon argues that all the players in these policy campaigns - activists, politicians, academics, industry and voters - were acting in their self-interest and that the decisive factor was political pressure, not science.

Read this book, and let it ruin your appetite for politics.

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