The latest issue of the Royal College of Physicians’ Future Healthcare Journal (FHJ) warns that preventable illness and widening health inequalities in the UK are being driven by the profit-driven actions of global corporations.
Guest edited by Professor Chris van Tulleken, consultant physician, academic and broadcaster, the June 2025 issue of FHJ brings together leading voices in public health to explore how the tobacco, alcohol, food, pharmaceutical and gambling industries actively create conflicts of interest with scientists, clinicians, academics, regulators and charities.
This issue of FHJ calls on decision-makers to recognise and act on the systemic harm caused by commercial industries – particularly tobacco, alcohol, food, gambling and parts of the pharmaceutical sector – where profit-driven tactics are contributing to ill health.
FHJ is an RCP journal. It has editorial independence and the views expressed by journal article authors are not necessarily the views of the RCP.
‘If commercial incentives are the engine of public health harm, then conflicts of interest are the lubricant,’ writes Professor Chris van Tulleken in his editorial. ‘There are solutions to these problems, but as long as industry are in the room when policies that affect them are being written, rates of commerciogenic disease will continue to grow unchecked.’
Contributors argue that:
- tactics first pioneered by Big Tobacco are now common in food, alcohol and gambling – including the denial or dilution of evidence or regulation
- conflicts of interest must be tackled head-on with a mandatory national register of doctors’ financial interests, statutory limits on industry influence in health policy-making and the removal of harmful industry-led education campaigns from schools
- local authorities are beginning to act on junk food and gambling, and now national policy and resources must follow
- the externalised costs of the harms created by these industries shrink the economy – this is not an anti-growth agenda. Improved regulation is compatible with, and would stimulate, economic growth
- the medical community, especially doctors, must speak out to challenge industry narratives and protect their professional integrity.
Introducing this issue of FHJ, Professor Chris van Tulleken says:
‘Every single article in this issue gives examples that will shock and horrify you.
‘Conflicts of interest have been used by the tobacco industry to evade effective regulation for decades, when in reality, these companies knowingly sell an addictive product that kills people. And the practices for which tobacco has become famous – corrupting science, buying policymakers, denying harms, delaying regulation – have been adopted by all of the industrial sectors discussed in this issue.
‘We forget at our peril that the primary motivation of corporations is to maximise profits. The interests of the alcohol industry, for example, are to sell as much alcohol as possible. The same goes for food, gambling, tobacco and many other sectors.’
FHJ editor-in-chief, Dr Andrew Duncombe says:
‘This issue of FHJ focuses on the impact of commercial organisations on public health and their role in influencing government policy through a covert network. Four industries (tobacco, unhealthy food, fossil fuel and alcohol) are responsible for at least a third of global deaths per year.
‘This appalling statistic, together with the costs of associated healthcare exceeding tax revenues from these industries, show that action is urgently needed.’
In an article on the industry promotion of harmful products, Association of Directors of Public Health vice president, Dr Alice Wiseman, says:
‘Non-communicable diseases (NCDs) account for nearly 90% of deaths in England and 74% worldwide and contribute significantly to disabilities and poor health, including heart disease, stroke, cancer, diabetes and a range of mental health issues. The increasing prevalence of NCDs is caused, in large part, by the consumption and use of harmful products such as tobacco, alcohol, unhealthy food and drink and gambling.
‘The harm caused by use and consumption of these products not only impacts individuals and their families but costs the UK economy over £30 billion and leads to nearly half a million people being out of work through ill health. They also drive inequality, with people living in the most disadvantaged areas experiencing greater levels of harm than those in the least deprived.’
This issue of FHJ includes a number of contributions from young people, including a representative of Bite Back, a youth-led activist movement focused on improving child health by transforming the food system.
In her article, Annabelle Marie (Derin) Elegbede explains:
‘What we perceive as autonomous choice is, in reality, the product of relentless marketing tactics – ultimately, we are far more likely to consume the options most aggressively pushed upon us. Young people are being targeted by big food businesses and bombarded with junk food marketing, and it poses a severe threat to our health.’
Describing first-hand how young people perceive the alcohol, tobacco, vaping and fast food industries, Joseph Dickenson and Sean Devlin of Wimbledon College in London say:
’Social media gives us an insight into other people’s lives, anywhere in the world. As young people, we often hold celebrities and influencers up as role models, seeking to emulate them. Vaping, smoking and drinking are rarely outright promoted, but they often feature subtly in posts [and] add to the sense of rebellious glamour that already surrounds alcohol and nicotine.’
Other contributors to this issue of FHJ include:
· Mark Sullivan on a not-for-profit pharmaceutical development model
· Dr Margaret McCartney on the NHS and the pharmaceutical industry
· Professor Chris van Tulleken on ultra-processed foods and public health
· Dr Bartosz Helfer, Dr Katarzyna Henke-Ciążyńska and Dr Robert J. Boyle on commercial influences on infant and young child feeding
· Dr May CI van Schalkwyk and Prof Rebecca Cassidy on the gambling industry
· Dr Waterston et al on sponsorship by the commercial milk formula industry
· Prof Anna B Gilmore, Dr Rachel A Barry and Dr Alice Fabbri on the tobacco industry
· Prof Mark Petticrew, Dr May CI van Schalkwyk and Prof Cécile Knai on the alcohol industry
· Dr James Larkin on why we need a mandatory register of interests for UK doctors
· Lord James Bethell on the junk food industry.
Professor Chris van Tulleken adds:
‘There is not a single instance where voluntary self-regulation by any industry to improve public health has proven effective. Food and drink is one of the UK’s largest industrial sectors, but tax revenues are dwarfed by the cost to our economy of diet-related disease in terms of public health costs, reduced productivity and lost human capital.
‘Contributors to this issue of FHJ offer many and varied solutions to this growing public health crisis – all of which involve ending the conflicts of interest between those who create policy and those with a financial interest in the subject of the policy.’