Despite efforts to regulate the industry, payday loans are still being taken out by customers who use them for essentials such as food, fuel or rent.

Glaswegians alone rack up more than £57m annually in high-priced debt from payday lenders, home credit deals, pawn-brokers and rent-to-own schemes according to the Glasgow Centre for Population Health (GCPH) which says it should be viewed as a public health problem.

The stress of managing repayments contributes to mental health problems and can even exacerbate physical illness, the report suggests. One expert describes the effect of payday loans as corrosive and notes that 78 per cent of payday loan borrowers use their loan to buy food.

The most important finding of the report is that efforts to limit the damage of payday lending - by trying to prevent people taking out multiple loans, for instance, and putting a ceiling on interest rates - may not be helping.

Regulation has helped some customers, and forced some payday lenders out of business. But it hasn't stopped people needing short term credit, the authors say. Instead the report says they may in some cases be driving people into the arms of loan sharks and other illegal lenders.

Many would see credit unions as the best alternative. Indeed, credit unions themselves position their services as an antidote to other more toxic forms of debt.

But the report pours considerable cold water on these hopes. Credit unions struggle to offer the immediacy of payday loans.

Yet urgency is often the primary need of the (overwhelmingly poor) clients of payday lenders.

And isn't just that. The minority of CUs which do provide payday loan-type products cannot offer them at much cheaper rates than the existing lenders, given the risk of default.

They also tend to place more restrictions on them, and any default is considerably more likely to affect the borrower's credit rating. Finally branches are harder to reach and less likely to be open.

Mitigating the public health impacts of debt is a laudable goal, but the underlying problem is one of poverty. Some people feel they need to get payday loans simply to survive.

Longer term solutions will only be found by tackling key factors that cause people to be chronically poor - such as unemployment, zero hours working and the threadbare social safety net of the benefits system.

GCPH recommends some alternatives, such as continuing to promote the Living Wage. Giving people access to better financial products at times of crisis is vital, but there are challenges to achieving this. Likewise to tackling under-employment.

Health services need to do more to understand debt and financial insecurity and offer support, and direct people to other sources of assistance, the report says. An initiative to encourage saving among Glasgow secondary pupils by opening credit union accounts for them is impressive, but its impact can only be long-term.

With the increased adoption of the living wage, new powers coming to the Scottish Government over welfare, and pressure on for better fairer terms of employment, there are signs of hope.

But the overall message of the report is clear - high cost lending is far from fixed, and it is costing us all.