Lessons from Our Cigarette Policy for Obesity

Obesity has passed smoking as the country's biggest health burden. This is partly because Americans are getting fatter, and partly because more smokers are quitting. Is it time for the US to have a more serious anti-obesity policy?

The Atlantic's Megan McArdle, James Fallows and Marc Ambinder debated this very topic last year, and their thoughts are well worth reading. To sum up with criminal briefness: Megan thinks the common interventions don't work; Marc thinks good policy starts with the kids; and James basically agrees with Marc.

I'd like to try a thought experiment. How are we turning the tide against the smoking epidemic (smokers have fallen from 22.7 percent of the population in 1993 to 18.5 percent in 2008)? I can brainstorm three big fronts against tobacco: (1) new laws (2) new prices and (3) widespread public relations. In the 1970s we banned TV and radio ads with cigarettes, and forced cigarettes to print warnings from the surgeon general. We later banned all tobacco ads in the 1980s. Recently the federal government forced tobacco companies to print even bigger, scarier-looking warnings on their products. Locally, big cities like Chicago and New York have made it hell for smokers to indulge in public spaces, and smokeless apartments and hotel rooms have proliferated throughout the last thirty years. Meanwhile, many state taxes have pushed cigarette prices through the roof, an anti-smoking advocacy groups have raised hell behind the scenes, waging wars in state legislatures and Congress, raging against movie studios and ad companies and standing behind PSAs.

Could US obesity policy benefit from a similar three-pronged attack? The overlap is imperfect, but we can still look for analogs. An obesity policy cut from our cigarette-policy mold might include national laws to ax corn subsidies and local incentives as small as tax breaks for companies who provide wellness programs. It might include national or state taxes on junk food and soda. It might include the emergence of obesity groups that offer sympathy for obese Americans -- since obesity has a more significant genetic component than a smoking addiction, it would be foolish and unfair to merely demonize them -- but also advertises non-faddish methods for fighting obesity with sustainable life choices. Whenever you start thinking about ways to change American habits, the first step is to accept the reality that it's very, very difficult. But the fact that cigarette smoking has fallen about 20 percent in the last 15 years is reason to think that the effort is not futile.