Chapter 11: Tobacco Control as a Model for Trimming the Obesity Problem
David T. Levy and Marilyn Oblak INTRODUCTION Smoking has long held the title as the ‘leading preventable cause of death’ (USDHHS, 2001). It still holds that title, but if trends continue it may not in the foreseeable future. The prevalence of smoking has been on a downward trend in the USA since the widely publicized Surgeon General’s Report in 1964, which provided strong evidence of the risks of smoking. Smoking prevalence in the USA has declined from a peak of about 50 percent of the adult population to slightly above 20 percent in recent years, with some states nearing 15 percent (CDC, 2002). Obesity, on the other hand, is still growing and reaching ‘epidemic’ proportions. During the past decade, the obesity rate has risen by 74 percent, with at least one in ﬁve adults now classiﬁed as obese (Mokdad et al., 1999; Mokdad et al., 2000; Flegal et al., 2002; Baskin et al., 2005). In light of the addictive nature of cigarettes, ‘tobacco control’ might be viewed as a contradiction in terms. Nevertheless, a large part of the decline in smoking rates is attributable to better information about its health risks. In addition, evidence presented in the Surgeon General’s Report indicates that a large part of the decline in the number of smokers can be attributed to other public health policies. Numerous studies provide evidence for the eﬀectiveness of population-based strategies, such as increases in cigarette taxes, clean air restrictions, and media campaigns (USDHHS, 2000; Levy et al...
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