United States to Shift from Longstanding 'Lost Pleasure' Public Health Approach

March 18, 2015|5:44 p.m.| ASTHO Staff

The United States may move away from a longstanding regulatory approach to public health issues that stresses the idea that regulations may cause individuals to experience “lost pleasure.” This possible switch stems from a disagreement about the way that FDA economists considered the lost pleasure principle when it proposed new regulations last year for e-cigarettes and required calorie posting on certain restaurant menus.

Although FDA claims that it was necessary to consider individuals’ possible lost enjoyment to balance those regulations, many public health experts believe that FDA weighted the principle too heavily in those cases, making for ineffective regulations that undermined projected public health benefits. In the case of e-cigarette and other tobacco regulations, using the lost pleasure approach reduced the regulations’ projected benefits by 70 percent.

As a result of this dispute, HHS and FDA senior leadership asked public health experts for feedback on how the government can produce robust recommendations that still consider the impact of reducing access to enjoyable but unhealthy behaviors. A working group convened by HHS Assistant Secretary Richard Frank plans to issue a white paper with guidelines that FDA should use going forward. The white paper is expected to recommend reducing use of the lost pleasure approach, rather than eliminating it altogether.   

The concept of lost pleasure reflects the idea that individuals’ inability to experience an enjoyable activity (like smoking) can be assigned a dollar amount. When considering new tobacco and e-cigarette regulations last year, for example, FDA initially claimed that lost pleasure would cost consumers tens of billions of dollars. However, some experts claim that the lost pleasure concept does not consider the positives that individuals experience when they reduce unhealthy behaviors from smoking, like lower rates of chronic disease or cancer. Further, they claim that it’s not appropriate to consider enjoyment loss for an addictive and dangerous behavior like smoking because many smokers took up the habit in their youth and regret it now. There is also concern that FDA’s use of the lost enjoyment principle opens its regulations up to court challenges, since U.S. law requires that FDA regulations provide a net benefits for consumers.

FDA plans to finalize its updated tobacco and e-cigarette regulations this June.

For more information, see this article from Reuters.