Smoking and Obesity — Uncle Sam to the Rescue?

Smoking and unnecessary eating have in common the pitch used to sell them: “You Deserve This.” Because you are an exceptional person, because you work hard without complaint, and endure what Shakespeare called the “slings and arrows of outrageous fortune,” you are entitled to a whiskey, a steak, a baked potato with sour cream, and a cigar. But here is a hot tip backed up by centuries of philosophy: Thinking about what is deserved is not a healthful path, and has potent consequences.

In tackling the childhood obesity epidemic, Dr. Pretlow sees two main needs: 1) get obese kids un-addicted from highly palatable foods, and 2) prevent healthy kids from becoming addicted to start with. It is useful to examine the methods that have been used to decrease cigarette smoking, to see if they might be transferable. But first, what is the rationale for government involvement in either smoking or the eating patterns that lead to obesity?

As the theory goes, everyone is potentially affected by secondhand smoke, which is especially bad for babies, the elderly, sick people, and anyone whose breathing apparatus is already compromised. Smoking is harmful to the individual, no question. It is also hazardous, in less obvious and less immediate ways, for everyone. This would include peripheral dangers like forest fires, and houses burning down.

It is harder to make a case for any universal harm caused by some people being obese. The demonstrable damage to the common good is mostly financial, which counts for a lot — but, at least, gas station storage tanks don’t blow up when they walk by.

One report on the food industry’s social responsibility said,

Not everyone has the same nutritional needs; there is no food-related equivalent to the harm people may encounter from secondhand smoke; no research has shown that foods have physically addictive properties, much less that food companies manipulate their addictive content to encourage dependence, as was the case with the tobacco companies.

Not much there to work with. Some analysts feel the strongest parallel between smoking and obesity is probably the corporate exposure to liability litigation and legislative actions. Government-imposed fines, and compensation awarded to the families of dead victims, are both expensive.

While the food industry does not mind paying for the services of high-powered lawyers it would still, like anyone else, prefer not to. The authors of this paper noted that consequently, in the United States,

Some of the most important advances in public health in recent times (e.g., the reduction in smoking) have resulted from new legislation, heightened regulatory enforcement, litigation, or a combination of these three factors.

Within living memory, people could smoke in hospitals, college classrooms, and restaurants. Intensive media attention began to shape public opinion. The government stepped in very heavy-handedly, banning the advertising of tobacco in many contexts. A gradual dawn of awareness let to a smoking ban inside virtually all buildings, and in entire sections of cities.

What would it take to get such decisive action on problem foods? That is, as the old saying goes, a whole different kettle of fish. Tobacco is, after all, just one plant, and nicotine is just one chemical. By focusing efforts on the science of one plant and its most prominent toxin, parameters were neatly drawn.

Food, on the other hand, comes in thousands of varieties and combinations. Every attempt to regulate a basic substance like, for instance, sugar, has always faced numerous and vociferous objections. When the debate turns to more complicated ingredients, the logistical problems multiply exponentially.

Is there a path through the wilderness?

Your responses and feedback are welcome!

Source: “The Foodservice Industry’s Social Responsibility Regarding the Obesity Epidemic, Part I:,”, 2010
Photo credit: Hello Turkey Toe on Visualhunt/CC BY

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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