Behavioural Science Can Empower People to Make Healthy Choices

Health communication is very closely linked to behavioural science as it is the basis for the development of effective behaviour change communication. The Rīga Stradiņš University (RSU) Health Communication programme is collaborating with University College London Centre for Behaviour Change in both teaching and research.

What are some jobs one can do after studying behavioural science?

Obviously, there are academic positions as a behavioural scientist. But in addition, I think there are loads of opportunities in applying behavioural science. It depends on the country, but many governments are setting up behavioural science units, as are companies. Even if they don't have one they often want advice on behavioural science. Behavioural science is becoming embedded in all sectors, including NGO's. Even if you're not a behavioural scientist, if you're a company director, or you work in marketing, it doesn't matter what area you're making decisions in, having some understanding of behavioural science helps you do your job.

Can you describe what the profession is like?

What I would say is that applying behavioural science is a bit like being an engineer. As an engineer you're a practitioner; you're not generally discovering new things. What you're doing is implementing what's been discovered and finding innovative ways of improving the technology, but the basic science is undertaken by physicists and chemists etc.

How does this interact with public health?

Working as a behavioural science practitioner on a large scale means creating a social and physical environment for the population that supports them moving away from addictions or other problems, like drugs, alcohol, smoking, or addressing behavioural problems such as overeating, risky driving, not exercising, or whatever it might be. It also involves attempting to prevent these behaviour patterns from becoming established in the first place.

Can you break down what that can look like in practice?

What that means is, in terms of government policies, is to create a multi-component strategy. This is the big lesson we learned in the UK at the turn of the century with smoking. If you do one little thing at a time, you don't have much effect, but if you put them all together into a multi-component strategy, then you can really make a difference.

Running communications campaigns is very important. Almost no policies that you could imagine are going to work without an effective communications campaign, because whatever it might be, if you don't run a communications campaign around it, then how are people going to know? A communications campaign is really the glue that holds everything together.

Back in the day I thought we'd never see smoking bans, or smoke free environments. It didn't seem possible, but it was possible. Ireland started the process, and I think a lot of people saw that as a good example of what was possible. It only worked because it had a good communications campaign alongside it.

To sum up, creating a good physical and social environment goes hand in hand with offering support for people who need it on a personal level. It's no use having a situation where people are motivated to try to change their behaviour and all you get is that the people who find it easy do it, and the people who find it hard don't. This exacerbates health inequalities.

These are quite straightforward public health messages. Why is it still necessary to repeat them?

You need to tackle the root causes of these public health problems, which are the commercial drivers, the alcohol industry, the tobacco industry and so on. The tobacco industry and the alcohol industry are still very, very active globally. They try to undermine public health policies by trying to sell their products. It's their job. So, we have to recognise that everything we think of to try to stop people smoking, or drink so much, or whatever it might be, these companies are trying to counter that.

How do you try to get your message noticed by policy makers?

It is really important for policy makers to know that the evidence for what you are proposing is really strong. But this is not enough. It has to fit with their values and personal wants and needs. That is the tricky part because in many countries, politicians running them do not prioritise creating healthier and longer-lived populations over commercial interests. And the public is not well-enough informed to put pressure on politicians so that their complacency becomes a vote loser.

Occasionally, we get politicians who do care and we have to be ready to support them with the evidence and a very clear plan. That is what happened in the UK in 1998 when the comprehensive tobacco control strategy was introduced and in Ireland when the smoking ban was put in place. And more recently in New Zealand which in my view is the only country that is currently taking the drive to eliminate tobacco use seriously.

What do you think about the new tobacco policy in New Zealand?

I know the policy very well and I know the people who are behind the policy. The one thing that everyone knows about is this policy is that they’re raising the age of sale, year on year, so that eventually only 80-year-old people will be able to buy cigarettes, but that's only part of the policy. They have a comprehensive policy where not only are they progressively raising the age of sale, but they're also improving the treatment that they provide to help smokers stop. They're also, and I know this is controversial in some countries, although it's not controversial in New Zealand or Britain, they're also proponents of using less harmful forms of nicotine, like patches, gum, or even the dreaded e-cigarettes.

I think it will be effective in achieving their goal of getting smoking prevalence below 5% within the next decade. I may be wrong, but my prediction is that this policy will be like Ireland was for smoking bans. I think other countries will see what is happening in New Zealand and consider it as something that could work for them too. I think it will drive smoking prevalence down quite considerably.

What are some misconceptions about the field?

With the COVID-19 pandemic, behavioural science has become more prominent in the public eye. This has led a very small but vocal number of people to characterise us as puppet masters pulling the strings of government to manipulate the public. 

This is demonstrably false. The advice that the Westminster government received is in reports that are available on the internet and clearly show that the behavioural scientists were very concerned for government not to go down an authoritarian path and instead to ensure that people had an accurate perception of the risks of COVID and the benefits of remedial action such as quarantine and vaccination, and crucially that people should be adequately supported to enable them to take the steps necessary to protect themselves and others. Unfortunately, the Westminster government did not follow that advice.

What do you see as being the future for behavioural science?

I would like to be optimistic and believe that we will see a golden age of behavioural science, where people are more informed and more empowered. Currently, commercial and political vested interests are manipulating people to do things that are against their own interests. It would be good if behavioural science were able to empower people to become more resistant to this manipulation.

Are there risks in the growing application of behavioural science?

Yes. Behavioural science is not a "deterministic" science like mechanics. It's a "probabilistic" science more like meteorology. That is because there are always so many factors in play that we usually can’t be absolutely certain what will happen – but we can make predictions with varying degrees of confidence.

Now, unfortunately, the human brain wants certainty and it wants simplicity. It's attractive for people to hear so-called behavioural scientists giving them simple solutions and easy answers, their own great solution to the problem, whether it's losing weight or stopping smoking. 

Humans find easy answers very attractive, so we have to be very cautious when people do that. If anyone claims to be a behavioural scientist and says 'I have the guaranteed solution to your problem' then I think you can just stop listening at that point and go and find someone else. If they say 'I think X is true with Y level of confidence, based on Z evidence' then it’s worth paying attention.