Economic incentives such as paying people not to smoke should be incorporated into public health strategy, a government policy group has said.

Health England, a cross departmental body set up by the Department of Health, has published a report saying that offering immediate rewards to encourage people to undertake healthy activities could be particularly effective.

It used the example of a local authority scheme in Dundee that pays smokers £12.50 a week if they can prove with a carbon monoxide test that they have not smoked. 


Researchers also found that, contrary to popular wisdom, taxes on unhealthy behaviours do work, as people consume less alcohol and tobacco when prices are raised.

The report’s co-author and Health England chair, Julian Le Grand, said policy makers must deal with the problem that the costs of unhealthy activities were generally reaped in the future, whereas the pleasures were immediate.

He said: “Policies have to be developed either that bring some of the costs from unhealthy activities - or the benefits from healthy ones - back from the future.

“Equally we need to reduce some of the benefits from unhealthy activities - or reduce the costs of healthy ones - in the present.”

Government investment

Health England also proposed incentivising primary care trusts to invest in disease prevention by matching funding spent on specific preventative programmes pound for pound with central government investment.

It said in a survey of PCTs, less than 10 per cent used their public health allocation for the purpose for which it was intended, with most axing public health programmes to pay for “more apparently immediate needs” such as paying for overspend on trust budgets for hospitals and GPs.

Health England has published a separate report on public health spending, which has found that spending on public health in the UK doubled between 1999 and 2007, growing from 1.8 per cent of total health expenditure to 3.6 per cent.

Liberal Democrat health spokesman Norman Lamb said: “Incentive schemes could be an important part of tackling health inequalities, provided that they are well thought out and evidence based.”