Commentary on Morris et al .: Shifting consumption from unhealthy to healthy commodities

While reducing the consumption of unhealthy commodities benefits the economy through spending reallocation, public health policies aimed at reducing these behaviours must also incentivise reallocation to commodities that improve individuals' health, benefiting not only the wider economy but also population health. In their recent study, Morris et al. [1] simulate the economic impact of a 10% reduction in total consumer expenditure on alcohol, tobacco, confectionery and gambling in the United Kingdom. When policies to reduce the consumption of unhealthy commodities are evaluated for implementation, industries that produce such goods usually claim that these policies will harm the economy by reducing consumption and jobs [2]. This is not necessarily true, as the resources individuals would have used to buy those goods would be reallocated to other goods. The net effect will depend on how this reallocated spending ripples through domestic supply chains and intersectoral linkages. To better design public policies that reduce the consumption of harmful goods, reliable estimations of the net economic impact of such reductions are needed. The study contributes to addressing this gap by providing estimates of these macroeconomic effects in the United Kingdom [1]. Using the Commercial Determinants of Health Input–Output (CDOHIO) model, the authors estimate that reducing consumption of tobacco, confectionery and gambling yields a positive effect on gross value added (GVA). Alcohol, however, reports a net negative effect on GVA, which results from a negative economic impact of reduced on-trade alcohol consumption, which outweighs the positive effects in the off-trade sector. Because on-trade alcohol is classified within the food and beverage services sector, which is more labour-intensive than the off-trade retail sector, it generates a larger economic impact. These results suggest that policies that reduce the consumption of unhealthy goods not only improve population health [3], but also benefit the economy by reallocating consumption to other goods. In their simulation, Morris et al. [1] assume that reallocated expenditure from unhealthy commodities replicates the existing aggregate consumption distribution proportionally. However, this assumption can be relaxed to account for heterogeneous reallocation patterns, as empirical evidence indicates that consumption of unhealthy goods is correlated with other commodities in different ways. For instance, studies find that tobacco-consuming households exhibit lower expenditure shares for health, education, clothing, housing and quality nutrition [4-7]. Reduced consumption of unhealthy goods may redirect spending toward goods that enhance human capital, potentially amplifying macroeconomic benefits beyond the model's baseline. However, as the consumption of unhealthy products often correlates [4, 8], individuals could simply shift toward alternative harmful commodities. Because different commodities affect the economy in varied ways, future research incorporating these non-proportional reallocation patterns can provide a more precise picture of the economic impact of these policies. More interestingly, public policies can actively shift reallocation patterns toward healthier commodities. Although reducing the intake of unhealthy goods is a primary public health goal, promoting the consumption of health-enhancing alternatives is a parallel objective. For instance, increasing prices through taxation is established as the most cost-effective policy to reduce tobacco consumption while increasing government revenue [9, 10]. These additional resources can be used to support policies that aim to promote health behaviours. By simultaneously adopting policies that make healthier options more affordable, displaced expenditure can be reallocated toward goods that both stimulate the economy and improve population health. The study by Morris et al. [1] provides evidence that reducing the consumption of tobacco, off-trade alcohol, confectionery and gambling does not harm the economy, but rather improves it. However, because the net effect on the economy depends on how displaced resources are redirected, these findings raise interesting questions about how health policies can influence this reallocation. Health policy must anticipate these spending shifts and actively promote the reallocation of expenditure toward healthier commodities rather than substituting one harmful commodity for another. By relaxing the assumption of proportional reallocation, future simulations can estimate the net economic effects of these divergent behavioural scenarios. Daniel Araya-Ríos: Conceptualization (equal); writing—original draft (equal); writing—review and editing (equal). No specific funding was received for this commentary. The author is supported by the Health Research Board grant APA-2024-024. The author is supported by the Health Research Board grant APA-2024-024. None.