Last month I wrote about how pragmatic discourse is often sacrificed at the altar of fake statistics. Misleading figures, however, are merely one cog in a far greater pro-interventionist machine, all of which serves the oldest trick in the public health playbook: the ratchet effect.

It was Ronald Coase who famously said, “If you torture the data enough, it will confess to anything.” Professional public health fanatics have taken this a step further — not only twisting data to fit their narratives but also employing an insidious strategy to ensure their true goals are kept concealed. The ratchet effect is a deliberate method used to disguise the true intentions of extremist campaigners. Knowing that their ultimate objective is too radical to be accepted outright, they break it down into incremental, seemingly reasonable measures — slowly eroding opposition along the way. Policymakers, often naïve or short-sighted, rarely stop to ask what will be demanded next, but they ought to. With £3.9 billion of ring-fenced public health grant money for 2025-26 announced last month, can we really afford to continue this charade?

Consider the case of tobacco regulations. First, smoking was banned in public places. Then, cigarettes were moved to higher, more obscure shelves, followed by the introduction of plain packaging.

Each step was presented as a logical progression, justified by appealing to public health concerns. Yet, despite a dramatic decline in smoking rates over this period, the ultimate goal has remained unchanged: the complete prohibition of cigarette sales. Along the way, many of the foundational arguments for these policies — such as the exaggerated dangers of second-hand smoke — have been debunked, but the interventionists march forward undeterred.

Smoking regulation is one the zealots habitually gravitate towards, because even the most libertarian among us have to acknowledge that smoking is indiscriminately harmful. Tobacco is the case study these radical organisations use in their efforts to sound sensible – until you arrive at baby formula. With generic advertising and promotional activities such as discounts banned under the Infant Formula and Follow-on Formula Regulations 2007, Baby Milk Action piggybacked on this legislation to call for a total ban on formula marketing. There are now campaign groups calling for baby formula to be made prescription only. I breastfed all three of my children, and the scientific benefits are clearly undeniable, but there is nothing to be gained by forcing all women to feed their children naturally. It is the moral equivalent of banning caesareans.

What makes the ratchet effect deeply undemocratic is that each policy, when viewed in isolation, appears reasonable. The public is reassured that no further steps will be taken, but history shows otherwise. Once a restriction is implemented, another soon follows, always framed as the next logical step. By the time people recognise the full extent of the agenda, the battle is already lost. It is a calculated manipulation of public trust.

Moreover, this strategy lowers the burden of proof for new interventions. By normalising each incremental policy as an unquestionable necessity, virtually anything can be elevated to a public health issue. I recently discovered an entry in the American Journal of Psychiatry called “school avoidance syndrome“, otherwise known as truancy. It seems deeply ironic that those who advocate a greater remit of the state are also those who routinely acknowledge how overstretched our health systems are. But when you learn that the Public Health Grant money increases in its millions year on year, all becomes clear.

With such a seismic amount of taxpayer money, there is no incentive for resolution. It is no surprise that public health has become a juggernaut akin to the Industrial Revolution — a self-sustaining machine that absorbs endless funding to justify each successive measure, even when the previous ones have already achieved their stated objectives. In Scotland, deaths by alcohol fell from 1,399 in 2008 to 1,020 in 2019 through better training of staff and education of the dangers of excessive alcohol intake. That was not enough for the nanny statists. Their insatiable desire to push through the prohibitionist goals led to the introduction of minimum alcohol pricing, and arguably as a result, death by alcohol in Scotland is now at a 14 year high.

We should be able to demand the same level of transparency from institutions and charities involved in policymaking as we do from elected politicians. The only problem is there are hardly any avenues to do so. According to analysis by Regulus Partners, between December 16th 2024 and February 14th 2025 Britain’s gambling market regulator wrote to just two publications to ask for articles to be corrected, despite receiving notification of at least 18 instances of misuse by media organisations, campaign groups and politicians in that period. This is what allows the rachet to keep moving in a forwardly direction, and one campaigners have already primed to advance their nanny state assault.

Anti-gambling fanatic and former aide to Jeremy Corbyn Matt Zarb Cousin has, in his bid to make placing a bet a near impossible endeavour through excessive regulation, recently strategically chosen to target slot machines rather than horse racing. He has inferred that the latter is subject to more robust defences from MPs, eager to protect the rural economies of their constituencies, and is now advantageously making useful idiots of them.

His argument hinges on the claim that slot machines, rather than sports betting, are the most addictive form of gambling. This is, of course, a gross oversimplification and a flawed portrayal of addiction — one that wrongly suggests addiction is a static condition tethered to a particular product rather than an individual’s predisposed brain chemistry.

The reality is that if slot machines are banned or heavily restricted, compulsive gamblers will simply migrate to other forms of betting, including sports gambling. This will artificially inflate the number of people supposedly ‘harmed’ by sports betting, but this is exactly what they want. It is the means to justify further regulatory interventions. Worse still, this line of argument forces even reasonable opponents into a rhetorical trap: by conceding that slot machines are more harmful than sports betting, they inadvertently accept the flawed premise that addiction is caused by the product rather than individual vulnerabilities.

The ratchet effect is not just a theoretical concept; it is a demonstrable strategy employed by activists who understand that outright prohibition or draconian regulations will never be accepted in one fell swoop. Instead, they chip away at freedoms incrementally, ensuring that each new restriction becomes the baseline for the next demand. This is why vigilance is crucial. Without scepticism and resistance of their dishonest methods, we risk sleepwalking into a world where personal responsibility is eroded, and every aspect of life is subject to bureaucratic control, all in the name of public health.

Abbie MacGregor is the Head of Communications at the Gamblers Consumer Forum.