Do lessons from the fight against smoking apply to reducing obesity?

A multi-pronged strategy was needed to significantly reduce smoking rates across Ontario over the last few decades.

Obesity is a current and worsening public health threat. 

The obesity epidemic may also need to be attacked from many angles, but may be harder to effectively fight than smoking. took to the street in December 2010 to gather some opinions from about whether taxing sugary soft drinks the way that tobacco is taxed, could help fight obesity. Check out what people had to say in the below video.

 The obesity epidemic

 Obesity rates have risen astronomically over the past 20 years, with nearly 1 in every 2 Canadian adults at increased health risk due to excess weight. Some experts think that the obesity epidemic may soon lead to a decrease in life expectancy, and by increasing the frequency of diabetes and other chronic diseases, it is starting to threaten the sustainability of our health care system.

 The battle against tobacco

 Some wonder whether there are lessons that can be learned from the battle against smoking. Although the battle against tobacco has not yet been won, the reduction in smoking rates has been seen as one of the most important public health achievements of the past century.

The attack against smoking has been waged in the media, convenience stores, physicians’ offices and courtrooms. Higher prices and taxes on cigarettes have discouraged some people from buying cigarettes and have provided governments with funds to fight tobacco, including banning smoking in public spaces, education campaigns targeting youth, and the use of graphic images on cigarette packages.

Can the same approach be used in the fight against obesity?

Obesity and smoking: similar, but different

Dr. Prabhat Jha, a leading authority on tobacco control, says that the epidemics of obesity and smoking are very different, and uses the example of childhood/teen obesity and smoking to illustrate his point. Jha says that the tobacco industry is the one source where teens get cigarettes, and if the prices go up, teens will respond because they are easily influenced by high costs. In obesity, the situation is not so simple. The causes of obesity – cheap snack foods, more expensive fresh produce, suburban sprawl and drops in physical activity – are associated with social, economic and environmental factors. As well, while we can all live without smoking, none of us can live without eating. Thus, the fight against obesity is very complex and cannot be targeted by a single approach.

One approach: taxing sugary drinks

However, in spite of complexity of obesity, some policy makers are trying to figure out how to limit or control access to certain products that are known to cause obesity, and add little nutritional value. Weight gain and obesity are associated with sugar sweetened drinks, including pop and juices, which provide little nutritional value and excess calories.

Similar to anti-smoking efforts that have focused on teenagers, taxing sugar sweetened drinks would impact those who are the most price sensitive – children and teenagers – and those are at risk of gaining the most weight from sugary drinks.  These drinks account for about 15% of calories that the average North American teen consumes, so many think that increasing their cost will have an impact.

Policy makers have suggested that sugary drinks could be taxed at 1 cent per ounce, so about 20 cents for a large bottle of pop.

Similar to tobacco, policy makers could direct money made from a tax on sugary drinks towards funding programs and policies to encourage healthy eating, such as a healthy school lunch program, education about caloric literacy and cooking classes in schools, or subsidies on fruits and vegetables. Dr. Yoni Freedhoff, an expert in weight management, estimates that a tax on sugary beverages could generate up to $1.5 billion a year in Canada.

However, to date politicians have been unwilling to tax these products, perhaps because of the influence of the powerful food and beverage industries. It was reported in December 2010 that the food and beverage manufacturing industry has eclipsed the automotive manufacturing industry in terms of sales and workers. Processed foods and beverages have sales of over $10 billion per year in Canada. Interestingly, when New York State wanted to introduce an 18% sales tax on soda, PepsiCo threatened to move its corporate headquarters out of New York City.  Other people believe that governments shouldn’t interfere in people’s choices, whether they are healthy or not.

The comments section is closed.

  • Heather says:

    A “sin tax” is only one component of a comprehensive strategy to combat obesity. Economic incentives like taxation were only a small part of the successful tobacco strategy. The key component that needs to be transferred from tobacco control to obesity strategies is Industry Denormalization – advertising restrictions to childred, regulating retail environments, all contribute massively to how “denormalizing” unhealthy/sugary products that are targetted to children.

  • Jenny says:

    I don’t think a tax would work especially since the economical influencers on the unhealthy choice in the first place stems from money – or lack of it. I have seen the anti-smoking campaign take tremendous traction. It used to be cool to smoke but now smokers are actually ashamed. You find them hiding behind buildings and smoking in secret or simply stop because it’s too onerous because people collectively know it is simply stupid to smoke. If this can be done with with foods such as sugary drinks then we will have a cultural and behavioural change.

  • Grace says:

    I don’t think a tax on soft drinks is going to solve the problem.
    Exercise, reducing portion sizes and cutting out snacks are ways to reduce weight.
    An easy way to measure how much a person intakes along with how much energy he/she expends might be a way to make people more aware of what is happening.
    A friend on a a current weight management program says this is what her program does. You wear a monitor on your wrist to measure how much you have walked. You input the reading into the computer at the end of the day. You also input what you have eaten and the program automatically calculates the number of calories. Such a program should probably be made available to all individuals. Thinks of all the savings on health care for obesity if people were more conscious of how walking for half an hour is not going to get rid of the Twinkie.
    Reducing the snacks is another way to cut down. Don’t eat during the “grazing hours”. If you snack after supper, don’t eat after supper. If most people did this over time, and the amount of snacks consumed got reduced, the manufacturers would still be looking to produce similar types of snacks but healthier ones.

  • Karen Born says:

    Great discussion on this story! Obesity is an incredibly complex issue with no easy solutions. Here is a great infographic which illustrates the many systems, such as food consumption, food production and activity environment that intersect and related to obesity.

    Please suggest other stories that you’d like to cover around obesity in this thread or through the the ‘suggest a topic’ feature.

  • Brad says:

    My comment is related to the tobacco strategy and the deployment of information/education re: health risks. I was recently in the UK on a study tour and it was explained to me that smoking rates among young people (particularly those young people from ‘under privileged communities’) continue to increase despite the provision of information/education re: health risks. What did make a difference was the provision of information/education re: the huge profits reaped by the large multinational tobacco corporations and the extent to which their profit margins depended on young people – particularly those from ‘under privileged communities.’ The notion that young people did not want to be used as marketing pawns to support or increase tobacco sales was apparently a stronger deterrent than the health risk. I am not advocating one strategy over the other but I do wonder about an education campaign targeted at Ontario’s/Canada’s youth that informs them of the extent to which calorie-rich beverage producers are relying on their unhealthy decision to maintain/increase their sales. Perhaps a combination of strategies is worth considering?

  • Tom Auger says:

    Taxing sugary drinks is a slippery slope; a clearer definition of “sugary” needs to be established first and this won’t be done without considerable debate.

    If we look at current trends in the bottled beverage market, we’re seeing already a huge shift toward sugar-reduced drinks (not to be confused with sugar-free, which is a controversial topic on its own). I’m talking about the Vitamin Waters and that whole category of lightly flavoured waters. While I’m not sure their “medicinal” value is quite as high as their marketing would have you believe, it is certainly pointing to a trend in consumer tastes.

    Perhaps the issue is more with the manufacturers than with the consumer. The problem is that sweet, like sodium, sells. And unregulated, manufacturers will continue to add them to their products. People consume these higher levels and raise their tolerance. So what tasted sweet to someone three generations ago, may no longer taste as sweet today. We need to reverse this trend – gradually perhaps.

    If you spend any amount of time eating sweets in Europe (a dangerous pastime to be sure!) you will discover that the European definition of “sweet” is significantly less “sweet” than the North American one. This points to manufacturing standards and recipes, as much as it does to divergence in cultural tastes. Perhaps the government should look toward regulation and forced marketing (similar to the tobacco Warning labels) rather than taxing a segment of the population that, as another commenter rightly put it, is already economically challenged as it is.

    • Pamela says:

      It is very apparent that it is expensive to eat/drink healthy. I think it would be more beneficial to make healthy drink/food products more affordable. Many times I will see something that interests me, only to look at the price and decide against it.

  • James says:

    How about looking at serving sizes? When I was a child, a can of pop was 10 oz, and you bought it in larger bottles of 26 oz. Since then, cans have grown to 12 oz and the servings at fast food restaurants and places like 7-11 have grown enormously. It’s no surprise that people are getting fatter when they’re being given more.

    • Pamela says:

      Portion sizes are definitely an issue. Portions are a lot smaller in Canada than the U.S., but they are still too large. I lost 33 lbs just by cutting down on my portions.

      If you are eating out in a restaurant it is really hard to find an appetizing nutritional option that is 300 – 350 calories. So you end up ordering something planning to eat only a portion of it. Even with the best intentions, this is a very hard thing to do once you have a meal in front of you.

  • JG says:

    I think that in some cases people drink soft drinks and eat unhealthy food because of socioeconomic factors that a tax will only exacerbate. If money is tight and I can feed my family of five for thirty dollars at a fast food restaurant, I’m going to because at the end they will feel full.

    Instead of charging a tax on consumers, the government ought to force producers to change how they make thier products.

  • Susan says:

    Companies which sell sugary drinks and high caloric foods should be taxed. Governments should be responsive to the citizens (taxpayers) and not to the food manufacturing industry. Hopefully these manufacturing companies will realize that there are profits to be made by the manufacture of “healthy foods”.

  • Margaret says:

    A tax on sugary beverages is not necessarily a bad idea but it isn’t an effective way to create lasting change in peoples behaviour. Taxation wont stop poor decision making, the key is education and exposure to healthy but tasty alternatives.

  • Kate says:

    Education in schools is key here. Like the tobacco industry if children knew what was in the drinks they would be less likely drink them but taxing on soft drinks would not work.

  • Jennifer says:

    I encourage the idea of taxing soft drinks. People shouldn’t drink a container full of chemicals.

  • Emily H. says:

    Michelle: I agree, but I think “sin taxes” can be part of that education – a noticeable tax (I’m not sure that 20c is enough – I’d rather see it much higher) on sugary beverages would send a strong message that these drinks are actually dangerous.

  • Michelle says:

    If people want to drink something that is unhealthy, they will do so despite the cost.
    The key is in educating people on what is inside those sugary drinks, and moreover demonstrating how to eat healthy and its benefits.


Karen Born


Karen is a PhD candidate at the University of Toronto and is currently on maternity leave from her role as a researcher/writer with

Andreas Laupacis

Editor-in-chief Emeritus

Andreas founded Healthy Debate in 2011. He is currently the editor-in-chief of the Canadian Medical Association Journal (CMAJ)

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