Parallels in Tobacco, Alcohol, and Food Control

A previous post established that there are 18 major clusters of ways where obesity intervention seems possible. Some, like parental education and portion control, are familiar elements of Dr. Pretlow’s W8Loss2Go program.

Childhood Obesity News has of course mentioned many items on the list, such as active transport and reduced availability of calorically dense junk food. In Great Britain, one of the things that reformers consistently fight for is the limitation of price promotions, like “buy one get one” deals, on the theory that if junk food costs more, people will buy less of it. The problem with that theory is, they might also simply decide to spend more on junk food, and less on quality edibles.

The Master Settlement Agreement of 1998, which was supposed to rein in the tobacco industry, somehow allowed it to offer price-discounting schemes that actually made their products more affordable to the young. The Agreement also required the industry to pay the states lots and lots of money, forever, supposedly to offset the expense to the public purse of dealing with the results of smoking. Of course cigarette companies were not going to subtract this from their profits, so they raised prices to the consumer — and raised them more than was needed to cover the difference, so they ended up raking in even more money.

An auxiliary problem is that the states promised to use this windfall money on certain things, like smoking prevention programs, and mostly failed to live up to those promises. Any similar type of effort to curb the sale and consumption of junk food is probably destined to fail as miserably.

Limitation attempts

In the battle against sugar-sweetened beverages, one strategy has been to encourage manufacturers to include less sugar per unit, and it seems unclear at the moment whether “reformulation,” as it is known, actually does any good. The anti-tobacco warriors want to make cigarette manufacturers knock down their nicotine content to “minimally addictive or non-addictive levels” — which is probably impossible, given the difficulty in limiting medications, for instance, to smaller amounts of addictive ingredients.

Realistically, all a consumer needs to do is take two pills instead of one, or smoke two cigarettes instead of one. If smokers need two cigarettes to get the effect they previously got from one, the result is to double the profits of the industry, which is surely not a desirable outcome. Likewise, those who are interested in reducing obesity are in danger of being letting their zeal and optimism lead them into plans that can produce unintended consequences.

In the U.S., most states have no minimum age to legally smoke, and the minimum for buying tobacco products ranges from 18 to 21 years of age. There is a movement afoot to raise the purchase age to 21 everywhere, but of course that would not impede some store owners from doing whatever they please, hoping not to be caught, and would certainly not stop young people from asking older friends or relatives to buy their smokeables. The same goes for alcohol sales, which appear to be strictly enforced but of course, can be gotten around.

Food is an entirely different situation. It is hard to imagine the outcry if any type of food purchase were to be limited by age restrictions.

Your responses and feedback are welcome!

Source: “On 20th Anniversary of State Tobacco Settlement (the MSA), It’s Time for Bold Action to Finish the Fight Against Tobacco,”, 11/26/18
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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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