Deadly Choices

1. What it is

Deadly Choices is a government-funded public health campaign.

One visible element is outdoor advertising, including billboards on buses, depicting a pregnant woman addressing the baby in her womb and stating that she is quitting smoking because it is good for both of them.

The stated objective is to reduce smoking during pregnancy.

That objective is legitimate.

2. How programs like this are typically justified

Government campaigns of this type are usually justified using proxy measures such as:

• Impressions
• Reach
• Awareness
• Visibility
• Engagement metrics

These are easy to count.
They are politically legible.
They are not the outcome.

The outcome is behavioural change:

fewer pregnant women smoking.

If that outcome is not directly measured, the program cannot demonstrate success.

3. The targeting problem

Outdoor advertising targets the general population to reach a very narrow group.

The actual target audience is:

• Pregnant women
• Who smoke
• Who are undecided
• Who are receptive to messaging

This is a tiny fraction of viewers.

As a result:

• Most impressions are irrelevant
• Cost per relevant exposure is extremely high
• Attribution to behaviour change is weak or impossible

High-precision channels already exist:

• GP clinics
• Antenatal clinics
• Hospitals
• Pharmacies
• Baby stores

These environments contain the exact audience at the exact moment decisions are made, at far lower cost per relevant exposure.

Choosing mass advertising over point-of-care intervention prioritises visibility over efficiency.

4. Why this is moral theatre

Moral theatre has three characteristics:

• High public visibility
• Low accountability for outcomes
• Emotional signalling in place of measurement

This campaign fits that pattern.

That does not make it evil.
It does make it an immoral waste of taxpayer money.

Spending public funds without a credible mechanism to measure behavioural impact diverts resources from interventions that could actually work.

5. The incentive failure

Public programs are structurally rewarded for:

• Spending their allocated budget
• Being seen to act
• Avoiding political risk

They are not rewarded for:

• Solving the problem permanently
• Making themselves unnecessary
• Demonstrating that a cheaper approach worked better

If a program truly eliminated the problem it exists to address, it would undermine its own future funding.

This creates a perverse but rational outcome:

• Activity is safer than effectiveness
• Continuity is safer than success
• Spending is safer than solving

No malice is required.
Only incentives.

6. Why some problems are chosen and others avoided

Certain behaviours are safer to campaign against than others.

They:

• Have clear moral framing
• Involve a visually sympathetic subject
• Do not provoke strong political backlash
• Allow public virtue signalling at low risk

Other health problems with larger population impact but higher political sensitivity are quietly avoided.

This is not a health optimisation strategy.
It is a risk management strategy.

7. What a serious approach would look like

A serious approach would:

• Treat behaviour change as an optimisation problem
• Fund multiple competing interventions
• Measure outcomes, not impressions
• Rapidly kill what does not work
• Scale what does

An open competition for effective interventions, with the rights to test and deploy all submitted ideas, would outperform a single centrally designed campaign at a fraction of the cost.

8. Why this matters

Taxes are not high only because needs are great.

They are high because large amounts of spending are protected by moral cover rather than evidence.

When programs cannot be questioned without being framed as uncaring, waste becomes untouchable.

That is the real damage of moral theatre.

9. Final question

If the goal is to save lives, could this money have been spent in ways that actually saved some?