Data from: Dynamics of combatting market-driven epidemics: Insights from U.S. reduction of cigarette, sugar, and prescription opioid consumption

Misuse and overconsumption of certain consumer products have become major
global risk factors for premature deaths, with their total costs in
trillions of dollars. Progress in reducing such deaths has been slow and
difficult. To address this challenge, this review introduces the
definition of market-driven epidemics (MDEs), which arise when companies
aggressively market products with proven harms, deny these harms, and
resist mitigation efforts. MDEs are a specific within the broader
landscape of commercial determinants of health. We selected three
illustrative MDE products reflecting different consumer experiences:
cigarettes (nicotine delivery product), sugar (food product), and
prescription opioids (medical product). Each met the MDE case definition
with proven adverse health impacts, well-documented histories,
longitudinal product consumption and health impact data, and sustained
reduction in product consumption. Based on these epidemics, we describe
five MDE phases: market expansion, evidence of harm, corporate resistance,
mitigation, and market adaptation. From the peak of consumption to the
most recent data, U.S. cigarette sales fell by 82%, sugar consumption by
15%, and prescription opioid prescriptions by 62%. For each, the
consumption tipping point occurred when compelling evidence of harm,
professional alarm, and an authoritative public health voice and/or public
mobilization overcame corporate marketing and resistance efforts. The gap
between suspicion of harm and the consumption tipping point ranged from
one to five decades–much of which was attributable to the time required to
generate sufficient evidence of harm. Market adaptation to the reduced
consumption of target products had both negative and positive impacts. To
our knowledge, this is the first comparative analysis of three successful
efforts to change the product consumption patterns and the associated
adverse health impacts of these products. The MDE epidemiological approach
of shortening the latent time to effective mitigation provides a new
method to reduce the impacts of harmful products.

部分消费品的滥用与过度消费已成为全球范围内导致过早死亡的主要风险因素，其相关总成本高达数万亿美元。降低此类死亡案例的进展始终缓慢且艰难。为应对这一挑战，本综述介绍了市场驱动型流行病（market-driven epidemics, MDEs）的定义：当企业大肆推广已被证实存在健康危害的产品、否认其危害性并抵制减害干预举措时，便会催生此类流行病。市场驱动型流行病是健康的商业决定因素这一更广泛研究范畴内的特定类型。本研究选取三款具有代表性的市场驱动型流行病相关产品，覆盖不同消费场景：香烟（cigarettes，尼古丁递送产品）、食糖（sugar，食品）与处方阿片类药物（prescription opioids，医疗产品）。这三款产品均符合市场驱动型流行病的案例判定标准：均已被证实存在有害健康影响，拥有详实可考的发展历史，具备纵向的产品消费与健康影响数据，且实现了产品消费量的持续下降。基于上述三类市场驱动型流行病，本文归纳出五个典型阶段：市场扩张期、危害证据显现期、企业抵制期、减害干预期与市场适应期。从消费峰值至最新统计数据来看，美国香烟销量下降了82%，食糖消费量下降了15%，处方阿片类药物处方量下降了62%。针对每一类产品，其消费转折点均出现在以下时刻：关于危害的确凿证据、专业领域的警示，以及权威公共卫生发声和/或公众动员，成功抵消了企业的营销与抵制举措。从公众对危害的质疑到消费转折点的时间跨度为10至50年，其中大部分时间可归因于获取足够危害证据所需的周期。针对目标产品消费量下降的市场适应举措，同时存在消极与积极影响。据我们所知，本研究首次针对三款产品的消费模式改变及相关有害健康影响开展比较分析，且上述改变均已取得成功。市场驱动型流行病的流行病学研究方法可缩短有效减害干预的潜伏期，为降低有害产品的健康影响提供了全新路径。