The Big Three — More Similarities and Differences

Nicotine, alcohol, and… calories? Yes, it looks like overeating is as much a threat as drinking and smoking to Americans’ personal health and the national budget. Can the methods used to fight any one of them cross over and be useful in the other battles?

In 2009, the Family Smoking Prevention and Tobacco Control Act gave the Food and Drug Administration authority over tobacco products. The Act banned sales to minors, and cut down the likelihood of unauthorized sales by removing cigarette vending machines from all but adults-only venues.

It also forbade the sale of packs of less than 20 cigarettes; sponsorship of sports and other social and cultural events; free samples; and the distribution of any tobacco-branded promotional items. There were also several other provisions, but these most directly affected consumers.

The built environment

As we have seen, hospitals were early adapters in the movement to vanquish smoking, or to at least make it expensive, shameful, and inconvenient enough to convince smokers to slow down a bit. They got rid of cigarette machines and indoor smoking sanctuaries, and they don’t exactly love it when smokers congregate around the entrances, either. Incidentally, since cigarette machines disappeared from hospitals, some retailers, like the CVS chain, have voluntarily removed cigarettes from their shelves.

In other segments of the built environment, in structures and outdoor areas, sensitivity and vulnerability are the indices. Since everyone is to some extent touched by secondhand smoke, and by the customary offensive litter that marks smoking oases, arguments of sensitivity and vulnerability are easy to put forth. Ordinances decree where people can smoke, and fines are levied if the ordinances are disobeyed.

Restrictions have been instituted in some places and tried in others. Cities have implemented comprehensive smoking bans. Sometimes, desired limits cannot be drawn for various reasons. In some instances, rules can be made, but might not do any good.

Banning fast food establishments near schools seems futile when the roach coach can pull right up to the curb next to the playground. And imagine the sighs of frustration when parents realize that the school holds bake sales, and “soccer snacks” are available at sports events. Comprehensive smoking bans have been implemented in cities.

The culture of eating in public

By way of contrast, eating in public is permitted almost anywhere, and in many places, encouraged. In some places, it’s the whole point. Whether at a drag race, an amusement park, or a lush patio café, eating in front of tout le monde is almost universally accepted.

Public eating used to be the exclusive privilege of the most abject slum-dwellers. Given a choice, people chose not to, and with the streets full of horse droppings, who could fault them? Members of the middle class often had only one good outfit, and dry cleaning was not yet invented. They could not risk spilling sauce on their only presentable clothing. The upper class were like, “Dine in the common roadway? Without wine, without serviettes, without attendants? Sir, have you taken leave of your senses? Are you perhaps barking mad?”

Maybe, in certain times and places, compassion has been a motive to stifle public consumption. Someone nearby might be very hungry, and watching a stranger enjoy a meal would cause that person more pain, so showing off one’s good fortune would be rude. Or maybe people with food were careful to conceal the fact, realizing that those who had none just might grab it from them.

Things are different now. For whatever reasons, eating anywhere and everywhere is what we do, and that surely contributes to the obesity epidemic. What are the chances of reversing this trend? “Slim to none, and Slim left town.”

Your responses and feedback are welcome!

Source: “Family Smoking Prevention and Tobacco Control Act — An Overview,”
Photo credit: Peter Lindberg on Visualhunt/CC BY

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Profiles: Kids Struggling with Weight

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The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

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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