Is it right? Or left

Saving the public from themselves is a difficult job and since the dawn of democracy there has always been one never ending conflict. One side believes that one’s status is entirely due to their actions.  Therefore if you are unhealthy, it’s your fault because it’s your personal responsibility to keep yourself in a good health. On the other side of the coin there is the belief that we have no control over our own lives. If you are unhealthy, it’s more to do with the system than your own actions. We are just flotsam carried to and fro by the tides of power. If you believe in the first narrative, then your political views a probably to the right and your world views will be reflective of that. For example people are poor because they don’t try hard enough at school or the have bad genes. If however you believe the second narrative you probably have leftish or socialist views. Poor people are poor because they haven’t had the same opportunities as wealthier people and go to poorly resourced schools. However, the vast majority of our views sit somewhere in the middle. It’s ludicrous to suggest that global obesity is due to millions of individual food choices and has nothing to do with our environment. Similarly, it is absurd to suggest that people are completely powerless and do not have the ability to make personal choices.

The problem with personal responsibility narrative is it tends to put blame on populations who are essentially victims of a systemic issue. Expecting low income people to utilise self-control when on every corner of their neighbourhood there is cheap, energy dense flavoursome food is ridiculous. There is always ‘that guy’ on national radio who says “people just need to eat less unhealthy food and be more active”. And of course the food industries and tobacco industries will be heard saying it’s all about personal responsibility and practicing self-control. Their giant revenue stream depends on that doctrine and any move towards policy or restriction of their product will be opposed. Even to the point of lobbying governments, nowhere is this more apparent that the highly legal practice as seen in the USA. And when companies want to protect their patch, they sing the same old tired rhetoric. “It’s about informed choice”. “People a responsible for their health”. “We don’t need a nanny state “we need less government interference in our lives”.

At the same time we should never distance ourselves from personal responsibility. We are lucky that in NZ if you want to make change, if you want to make a healthy choice, you can. If you are low income, its not going to be easy. The system is working against you, but if you truly wanted to be a non-smoker, if you truly wanted to eat healthier food; you can. If you really wanted to quit, you could. If you wanted to be more active, it’s possible.

But what we really need is a system that supports personal responsibility. That makes it easier for people to adhere to healthier lifestyles. How difficult is it for a young person to be smoke free when their parents smoke, siblings smoke, and there are dairies on every corner that sell tobacco? If however, a child is born into a family where both parents were compelled to quit because of associated costs, and none of the siblings smoke, this is an entirely different dynamic. Now we have a scenario where personal choice and personal responsibility is more likely to be the healthier choice. And as we all know, the first few smokes may have been personal choice, but the next 20 years is all about addiction, so personal choice goes down the toilet.

This is why tobacco control is about utilising a diverse bag of tricks that is multi-layered, and multi-dimensional so that they all combine to make it easier for our people to exert personal choice and personal responsibility. Self-control and self-determination works best when the environment is in their favour.  Willpower is a finite resource that can become fatigued when constantly called upon . If you are trying to eat more healthy, it doesn’t help seeing images of yummy foods all of the time. It doesn’t help smokers trying to quit when they see people smoking wherever they look.

Human nature is fragile. It is irrationally predictable.  Call it a nanny state, say its meddling in peoples lives, however, when health compromising services or products are on every street corner, are cheaply available, are socially acceptable, universally accessible and physiologically desirable the outcome not that surprising. We need to create the supportive environment that creates a level playing field so that personal responsibility is actually ‘a thing’.