There are those who say obesity is the new tobacco. It's not.
I understand the argument. While tobacco companies and others like asbestos producers have long gathered top prizes for most toxic products sold, most hospital patients created, most lives shortened prematurely, obesity is becoming one of our greatest killers. Even in poorer countries, the diseases of obesity -- diabetes, heart disease, stroke -- are rapidly moving up the rankings, becoming bigger causes of death and disability than the old classics: AIDS, malaria, tuberculosis, the diseases of undernutrition.
But the refrain that obesity is the new tobacco ignores the fact that tobacco is still the new tobacco.
Those of us living in comfortable countries like the United States and Canada often have the comfortable feeling that the tobacco problem has been licked. Smoking in the U.S. is down to fewer than one in five adults and the numbers look even better in Canada. That's still a sizable number of people putting their health at risk, but it's nothing compared to the hazy decades of the past when nearly half of adults smoked.
It's been a long time already since someone's cigarette smoke trail ruined my restaurant dinner, since going to a bar meant coming home reeking of tobacco exhaust. Sure, youth are still being coaxed into smoking with chocolate-flavoured cigarillos, older adults are still finding the deadly results of smoking on their lung x-rays. But there is a general feeling that the tobacco companies have been beaten and the public health has won.
In much of the world though, smoking, among men at least, is still in its wild west days. Sixty percent of Chinese men smoke (and that's a lot of men), 70% of Russian men. Countries like Chile have more tobacco gender equality with as many as 35% of women smoking compared to over 40% for men.
How big is the problem still? The World Health Organization estimates that over 500 million of those of us alive today will be killed by tobacco.
There are some positive stories. Uruguay has seen an impressive drop in lighting up, usually credited to strong laws that wrestled tobacco to the ground. Ethiopians have never really taken up the habit and have stunningly low rates of tobacco abuse. Hardly anyone in the Sri Lanka smokes either, or so the statistics say.
But it's not time to put tobacco in the "done" pile in order to focus on unhealthy eating and the global weight gain that has resulted. The kinds of diseases that have become the world's biggest killers are products of unhealthy eating and of smoking, and both of those problems require similar approaches.
Those approaches, for unhealthy eating in particular, can be a real challenge, because they bang hard against the reactor core of our economic system -- consumption. Consumption and lots of it. Like tobacco, the fight for healthy eating will challenge the heart of what companies do: sell as much as they can. And it will need to challenge the marketing that seeks to get children and adults hooked on unhealthy products. As with tobacco, that's how the public health will win.
So let's not declare obesity the new public health enemy number one, not while tobacco continues to steal so many lives. Obesity is not the new tobacco, it's just tobacco's new partner-in-crime. And both are unfortunately going to need a little law and order to stop.
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Smoking rates for both men and women have fallen over the last decade. Rates for men fell from 28.1 per cent in 2001 to 22.3 per cent in 2011 and for women, from 23.8 per cent to 17.5 per cent.
Since 2001, the largest smoking decline for both sexes occurred among teens. Young people aged 15 to 17 saw rates falling from 20.8 per cent to 9.4 per cent in 2011. And teens aged 18 to 19 saw rates drop from 33.7 per cent to 19.1 per cent.
The proportion of non-smokers aged 12 and older who were regularly exposed to second-hand smoke at home declined from 10.6 per cent in to almost half at 5.5 per cent in 2011.
In 2011, 40.4 per cent of Canadians aged 12 and older reported that they consumed fruit and vegetables five or more times per day. This was down for the second year in a row from the peak of 45.6 per cent in 2009.
In 2011, 53.8 per cent of Canadians were at least 'moderately active' during their leisure time, up from 52.1 per cent the year before. 'Moderately active' would be equivalent to walking at least 30 minutes a day or taking an hour-long exercise class at least three times a week.
At least 60.1 per cent of Canadian men, about 7.6 million, and 44.2 per cent of women, roughly 5.6 million, had an increased health risk because of excess weight. These rates have remained stable since 2009.
In 2011, 18.3 per cent of Canadians aged 18 and older, roughly 4.6 million adults, reported height and weight that classified them as obese. This rate was unchanged from 2009. Between 2003 and 2011, obesity rates among men rose from 16 per cent to 19.8 per cent, and among women, from 14.5 per cent to 16.8 per cent.
In 2011, 19 per cent of individuals aged 12 and over reported heavy drinking, up from 17.3 per cent in 2010. Heavy drinking increased for both sexes. The proportion among males rose from 24.8 per cent to 26.8 per cent and among females, it rose from 10.1 per cent to 11.4 per cent. Heavy drinking refers to consuming five or more drinks per occasion and at least once a month during the year prior to the survey.
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