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NEW YORK -- Several public heath experts believe that many Americans are trading smoking for the lesser evil of eating too much, according to the New York Times.
The story of this trade-off can be seen in the data. From 1973 until 1983, Americans were actually growing thinner. During that period, the average weight of middle-aged men fell about two pounds, while that of middle-aged women fell nearly three pounds.
Then the trend reversed: From 1980 to 2000, the average weight of Americans rose by nearly 20 pounds. Everyone got heavier, said Dr. David Williamson, a statistician at the Centers for Disease Control and Prevention, to the New York Times. "Competitive cyclists weigh more than they did 20, 30 years ago; HIV patients weigh more."
Yet the nation also is healthier. Life expectancy has gone up by more than six years over the past three decades, and heart disease, long the major killer, is on the wane.
A big reason Americans are fatter and healthier, Dr. Williamson believes, may be the steep decline in cigarette smoking. If he is right, the rise in obesity is a classic case of unintended consequences - one of a long list of medical and public health interventions whose full effects could not be foreseen.
The connection between smoking and obesity is not yet proven, but the statistical correlations are there. From 1980 to 2000, smoking rates fell by 27 percent in the nation as a whole and by 38 percent among middle-aged Americans.
"There is no question that smoking affects the epidemic" of obesity, said Dr. Neil Grunberg, a psychologist and neuroscientist at the Uniformed Services University in Bethesda, Md.
Smokers who quit, he noted, gain about 10 to 12 pounds on average, in part because they crave sweet foods and carbohydrates. In addition, Dr. Grunberg said, smokers' metabolism slows down after they quit.
Dr. Michael Grossman, an economist, and his colleagues at the Graduate Center of the City University of New York have analyzed the economic causes of obesity. They have calculated, based on cigarette tax receipts, that for every 10 percent increase in the price of cigarettes, the number of obese people rises 2 percent. Smoking cessation, they estimate, accounted for 20 percent of the obesity increase in this country.
Dr. Katherine Flegal, a statistician at the National Center for Health Statistics, said the effect may be even bigger, once scientists add the upward effect on average weight of the growth in the number of Americans who, because of the success of the antismoking movement, never smoked in the first place.