title: Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.
abstract: BACKGROUND
  Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers.
  
  
  METHODS
  Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method.
  
  
  RESULTS
  Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour.
  
  
  CONCLUSIONS
  The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation.
authors.affiliation: 1 Institut de Hautes Etudes Internationales et du Développement, Global Health Programme and Programme for Gender and Global Change, Graduate Institute of International and Development Studies, Geneva, Switzerland tm388@cam.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Somerville
authors.affiliation: 2 Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Theresa M
authors.initials: TM
authors.lastname: Marteau
authors.affiliation: 2 Behaviour and Health Research Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
authors.forename: Ann Louise
authors.initials: AL
authors.lastname: Kinmonth
authors.affiliation: 3 Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Cohn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000517:prevention & control; D003365:Costs and Cost Analysis / Q000331:legislation & jurisprudence*; D004032:Diet; D035082:Federal Government; D005260:Female; D017144:Focus Groups; D015438:Health Behavior; D006291:Health Policy / Q000191:economics* / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011639:Public Opinion; D012737:Sex Factors; D000074606:Smoking Prevention; D012959:Socioeconomic Factors; D013660:Taxes; D035502:Trust; D014479:United Arab Emirates