No more business as usual: enticing companies to sharply lower the public health costs of the products they sell

Public Health. 2009 Mar;123(3):275-9. doi: 10.1016/j.puhe.2008.12.020.


Cigarettes, alcohol, junk food and motor vehicles cause a staggeringly high level of death, injury and disease. Business leaders from the industries that make these products currently try to frame these negative outcomes as 'collateral damage' that is someone else's problem. That framing is not only morally objectionable, but also overlooks the possibility that, with proper prodding, industry could substantially mitigate these public health disasters. A promising regulatory tool called 'performance-based regulation' is a new approach to combating the problem. Simply put, performance-based regulation would impose a legal obligation on manufacturers to reduce their negative social costs. Rather than suing the firms for damages, or telling them how they should run their businesses differently (as typical 'command and control' regimes do), performance-based regulation allows the firms to determine how best to decrease today's negative public health consequences. Like other public health strategies, performance-based regulation shifts the focus away from individual consumers on to those who are far more likely to achieve real public health gains. Analogous to a tax on causing harm that exceeds a threshold level, performance-based regulation seeks to harness private initiative in pursuit of the public good.

MeSH terms

  • Accidents, Traffic / economics
  • Accidents, Traffic / prevention & control
  • Alcohol Drinking / economics
  • Alcohol Drinking / prevention & control
  • Automobiles / economics
  • Developed Countries
  • Food Industry / economics
  • Health Policy / economics*
  • Health Policy / legislation & jurisprudence
  • Health Promotion / economics*
  • Health Promotion / legislation & jurisprudence
  • Humans
  • Smoking / economics
  • Smoking Prevention
  • Taxes*