 Second, continua like the Nuffield Ladder oversimplify the complex impact of interventions on choice and liberty and on relations between citizens and the state. When public health authorities do nothing, it does not follow that choice and liberty are necessarily the winners. For example, with no government intervention to serve as a counter ballast, private sector actors in the pharmaceutical, food, and energy sectors may undermine both individual choice and health through misinformation, manipulative advertising, or anti-competitive practices. Similarly, incentives are not always less restrictive of choice than disincentives, and some object to both because they are manipulative and autonomy-undermining (Quong 2011). Nudges and health promotion campaigns also raise concerns about unwarranted state intrusion, depending on the context. For example, ad campaigns that are transparently sponsored by public health agencies, such as those to prevent transmission of influenza by promoting personal infection control practices or reduce obesity by encouraging exercise and healthy eating, do not raise the same moral issues as the embedding of anti-drug or food messages in the storylines of entertainment television programming by these same authorities (FCC 2000; Forbes 2000 (Other Internet Resources); Goodman 2006; Krauthammer 2000; Kurtz and Waxman 2000). Much like corporate advertising, these embedded messages, as well as some nudges, may succeed in shaping people’s preferences without their awareness. These undetected effects lead to questions about whether such interventions constitute insidious manipulation by government and, as a consequence whether they are really less objectionable than more overt interventions like taxing or restricting liberty.