In the midst of a political discussion, a friend of mine gave her own definition of socialism. "It means the state looks after us, and tells us what to do," she said, in typically iconoclastic fashion. I ignored the fact that this seemed to me to be a definition of totalitarianism, and I resisted the temptation to tell her that she might be happier living in North Korea, but the news, reported on i's front page yesterday, that almost half of Britain's cancer cases are preventable made me reflect a little deeper on the relationship between the individual and the state.
The finding that the biggest preventable cause of cancer is smoking was not exactly a stunning revelation, but the report, published by Cancer Research UK, identified 13 other risk factors, which included sun exposure (also well known) and eating too much salt. Excessive drinking was linked to a number of different cancers – very handy to know at this time of year – and another danger was a lack of physical exercise.
The message seemed to be: don't smoke or drink, eat your greens, don't sunbathe, and make sure you go to the gym, and you'll considerably reduce your chances of getting cancer.
It seems pretty sensible, straightforward advice, and, as i's health guru Jeremy Laurance wrote yesterday, we know what to do, and now we just have to do it. So can the state make us?
Should we have warnings on packets of salt like we do on cigarettes? A ban on sunbeds? Tax incentives for gym membership? Now, I speak as someone who has suffered from cancer and, when I discovered I had the disease, I immediately regretted every cigarette I had smoked, every glass of claret that had passed my lips, and every opportunity to get on the treadmill that I had spurned.
Public health messages are very effective, and while yesterday's report was something of a statement of the obvious, it does no harm at all to reinforce the links between illness and lifestyle. In the end, however, the state can do only so much. We are not under the leadership of a regime that interferes in every area of our lives. It is our own choice to smoke, drink and eat too much. But I don't think we should underestimate the work that has been done by the (often unfairly derided) nanny-like inclinations of the state.
For instance, by making obesity a public health issue, some sandwich chains – and even a few restaurants – put the calories on their offerings. This is a welcome development – my shop of choice sells a sandwich which weighs in at a whopping 762 calories, which should be enough to put anyone off. And the push to drive smokers out into the cold – literally – has led to a dramatic cut in tobacco consumption. Jeremy Laurance is right: it is a matter of individual choice. I don't blame the state for my cancer – but neither do I want it to stop telling where I'm going wrong!