Tobacco Policy in the United States

Lessons Learned for the Obesity Epidemic

Much effort has been devoted to spurring more healthful behavior by encouraging individuals not to smoke or use other substances, to exercise, to eat healthy diets, and the like. Evidence is growing that the factors that relate to poor health outcomes are as embedded in the social and physical environments of people's lives as they are in their behavioral inclinations, and that advancing health depends on social policies that affect the opportunities and constraints of those environments. Population health issues are pervasive, including the nature of the built environment, exposure to environmental risks through traffic, pollution, and crime, lack of access to jobs, ready availability of dangerous substances, and many more. Alternatively, individuals' access to healthy food, opportunities to exercise safely, education and health care, and social integration and support varies widely.

Social policies that affect populations and communities' material and environmental resources offer innumerable opportunities to prevent illness and enhance health. Kenneth Warner—a major contributor to our understanding of the workings of the tobacco industry—analyzes how we have made significant progress in reducing smoking, the single major cause of death. Warner endorses a multi-factor model of smoking prevention and notes the importance of social and tax policies, regulation of cigarette promotion, and cultural constraints on smoking. As he shows, the great advances in combating the forceful efforts of the tobacco industry and inducements to smoke perhaps reflect global social influences and social policies more than efforts to change the hearts and minds of individual smokers. Warner then turns to the next major damaging influence on health: the epidemic of obesity.

While noting many differences between the food and tobacco industries, he examines which aspects of the strategies and policies used to combat tobacco can be applied to the growing problem of obesity.