Like Smoking, Like Obesity?
Thursday, May 22, 2008
Could strategies from the country's decades-long campaign against smoking serve as a blueprint for anti-obesity initiatives?
Certainly, there are parallels between tobacco and food. Both are deeply entwined in popular culture and customs. Both have powerful interests behind them, industry forces with significant resources and political connections to fight government regulation.
But solving the obesity epidemic will require a much more comprehensive approach because all age groups are affected. Its complexities are "more daunting" than those of tobacco, said James Marks, a senior vice president at the Robert Wood Johnson Foundation, which has committed $500 million over five years to fight childhood obesity.
The most fundamental difference: People can live without tobacco but not without food. So food companies cannot be vilified as cigarette makers were; in fact, Marks and others say, they have to be part of the answer. Certain sectors of the industry, which differs markedly from the tobacco industry in the diversity of products and producers, have agreed to improve nutritional standards.
Several years ago, the nonprofit Public Health Institute gathered leaders of past advocacy campaigns to tap their experience in the obesity fight. According to the project's report, although the highest levels of government might offer opportunities for the most sweeping change, they are often the most difficult places to win support because activists cannot match the industry's lobbying dollars and influence. Crucial anti-smoking legislation was passed by city councils and county boards, and those victories helped create momentum that spread nationally.
"The tobacco industry was able to exert considerable influence in Congress and at the state level, but it had real trouble fighting all these local efforts," said Kelly Brownell, a Yale University psychology professor and co-founder of the Rudd Center for Food Policy and Obesity.
To date, the greatest regulation of snacks and drinks sold in school vending machines has occurred in individual systems and states; federal proposals have been stymied. New York City led the way in banning artificial trans fats in restaurants; an increasing number of local jurisdictions, including Montgomery County, have followed suit.
Yet the prevalence of smoking could not have been cut by more than half without federal action. It started with then-Surgeon General Luther Terry's 1964 landmark report on the hazards of lighting up. Within five years, Congress agreed to require warning labels on cigarette boxes and to ban cigarette ads from television and radio.
"With smoking, it took more than 30 years" to transform the public landscape, said Lori Dorfman, director of the Public Health Institute's Berkeley Media Studies Group. "With obesity, we don't want to wait another 30 years."