More Soft Control

Can any anti-smoking measures be adapted to anti-obesity efforts? What has succeeded in mitigating other unfortunate social maladies like nicotine addiction? It seems that public relations campaigns based on stigmatization may not be the right fit.

In 2009, the Food and Drug Administration was authorized to regulate the tobacco industry. Restrictions on the industry began to tighten, and attitudes solidified. As always, the Law of Unintended Consequences was at work, guaranteeing that “hard-hitting anti-tobacco ads could exacerbate health disparities and discourage access to high-quality health care.”

The American Medical Association’s Journal of Ethics said,

Given the current demographics of tobacco use, these campaigns might further stigmatize low-income and other vulnerable populations of smokers, who currently represent the majority of tobacco users. And people who already feel disempowered tend to feel even more resentful, defensive, and demoralized after exposure to anti-tobacco campaigns.

What happens when authorities take measures? Sometimes, events they did not foresee; or outcomes they could have predicted, but brushed aside, for better or worse. For instance, in some schools, any effort to remove vending machines entirely, or to offer the less junky kinds of junk food, seems to invite defiance. A black market starts up, giving both buyer and seller the thrill of breaking the rules. In other words, any ban can produce antisocial and even criminal behavior.

On the political side

In 2012 the Centers for Disease Control tried something new, a national ad campaign that featured real people with illnesses cause by their own smoking or by secondhand smoke. “Tips from Former Smokers” is said to have inspired more than a million and a half Americans to quit smoking. Supposedly, 100,000 succeeded, although there is no way to know how many later relapsed, or even how many reported honestly.

The campaign cost $54 million, which was less than 1 percent of what the tobacco industry spends on a year of advertising. It also proved why people are suspicious of the government. Together, the states rake in $26 billion a year from the Master Settlement Agreement and from taxes. How many politicians promised that cigarette tax money would be used to fight smoking? Yet the states spent less than 2 percent of those revenues on trying to prevent smoking.

Some Americans see the whole sin tax concept as government overreach, pure and simple. In that camp, “nanny state” and “social engineering” are two hot-button phrases.

Public opinion does alter, and legislation can change behavior to a certain extent. But then, especially in the U.S.A., there comes a point where people have enough of government regulation, and kick up a fuss about their rights, real or imagined. Before trying big outreach psychology on people, well-intentioned activists need to look at all the angles.

Anyone can make mistakes, and they can cost millions. In some battles, the better part of valor is to “keep your powder dry.” A misconceived attempt could sway opinion away from accepting government intervention, and skew the public mindset for years.

Your responses and feedback are welcome!

Source: “Decreasing Smoking but Increasing Stigma? Anti-tobacco Campaigns, Public Health, and Cancer Care,”, May 2017
Source: “CDC’s Anti-Smoking Ad Campaign Spurred Over 100,000 Smokers to Quit,”, 09/09/13
Source: “Sin Tax,”, 05/03/18
Image by Aine via Flickr

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Profiles: Kids Struggling with Weight

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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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