Which is Worse: Smoking or Obesity?

Obesity is an incredible epidemic. It’s amazing how deeply we are in denial about our collective health – heart disease kills how many millions per year? If anything else threatened millions of lives, we’d be actively doing something about it. Instead, we’re sitting on our butts… which is pretty much the problem in itself.

“…think of the countless billions we could save.”

I see. End smoking. End obesity. We all live forever.

“Preventing death.” What a foolish concept to it’s core. How about extending happiness? By preventing busybodies from prematurely ending THAT.

Dr. Stibich, what do YOU expect to die from? And who guaranteed that to you?

Audrey, thank you for your comment. When I referred to saving countless billions, I was referring to dollars, not lives. Of course, we will all die someday, but the choices we make contribute to our quality of life while we are alive. By avoiding preventable disease, each individual can reduce the level of healthcare he or she needs in his or get lifetime (thereby saving money) while, more importantly, improving quality of life. Longevity is not about living forever, but about living out our natural lives without prematurely shortening them and aging as healthy as possible.

I appreciate YOUR reply, Dr. Mark. Yes, I realized after I posted that you probably meant in dollars. My regrets for my error. However, the argument doesn’t change much. That too (health costs) is debatable. Recent studies indicate that the healthiest among us cost society the most. However, I prefer not even to argue “cost” since it’s grounded in the flawed ideology that government coercion in private lifestyle choices is acceptable for the collective good. That puts a price on EVERYONE’S autonomy and natural laws. I do not accept that freedom to choose how one will live comes with a price tag attached. That’s socialism (”your body belongs to the state”). I DO believe that people should pay their own way. And contrary to the propaganda, most do. Regarding smoking, the taxes on cigarettes alone more than pay the smoker’s fair share. In fact, smokers subsidize non-smokers directly and indirectly (tobacco taxes for SCHIP go to uninsured children, for one).

I still take issue with your aging philosophy. Life is not about longevity for some people. It’s about a life-well lived. Though it’s still not mutually exclusive because you still cannot guarantee that if this or that is avoided that disease will not occur or, on the flip-side, know that if “happiness” is “prevented” it will increase the quality of life. Many smoking and fat people live as long and longer than nons. You want me to trade my personal choices for coercive measures for no guarantees of anything either way. “Aging as healthy as possible”? The vast majority make it to “aging” and but for a very few all end up in the same miserable state. There’s no such thing as dying “healthy.” For the risk of dying “prematurely” (and funny, an 82 year old smoker who dies of lung cancer but lives past the average age of death for all is called “premature”) I ask for my freedom to do so without government interference by way of taxes, etc. Advise? Fine. Offer help for those that WANT it? Fine. Past that, it ain’t America anymore.

Audrey –

thank you for the interesting discussion. I think we will have to agree to disagree. I believe (and there is much evidence to support this positive) that through a healthy lifestyle combined with preventative screening, many of the disease that cause age-related suffering can be avoided. Of course, each individual must make the decision about his or her lifestyle. My point is that there should be more assistance and opportunity for people choosing a healthy lifestlye. If an individual weighs the options and make an informed decision to live a certain way, that is certainly that individual’s right, no question. I do remain quite optimistic though, that healthy choices can reduce the suffering that we associate with aging a great deal.

Obesity and Smoking are equally as bad. Both are abused by people as a means for dependancy. For me it’s hard to find someone who is both obese and smokes. People from Europe often dis Americans for being fat. They say we eat too big of food proportions, but it is well known that you don’t have to eat much to consume massive amounts of calories. I’m fairly certain the only reason several Europeans are thin is because they smoke so much. I know someone from France, and she explained that it is extremely difficult to find someone who doesn’t smoke in France, adn she was shocked at how few people smoked in America.
Both are as equally dangerous, no doubt each one effects some people more than others. I’m afraid that if it is not food or cigarettes, people will find some other way to harm themselves: like alcohol or drugs.

I see no point on pointing out the evils of either. People will do what they want and if they want to slowly kill themselves with tobacco or ice cream, it’s their choice.

Some how Dr.Marc I think its more of people in there 40’s-50’s the over the hill club who freaks out about longevity and honestly I think you are over rationalism something personal in what you believe it is what you do, I personally believe that stress is the number one killer of people and we blame other things for heart disease, well regardless I believe in many cases someone not having a smoke or a drink at age 70 or 80 could kill them after they have gotten used to it, I do however believe in balance like a light-medium smoker is like overweight-obese then there are the heavyweights for anything the people who never listen I would like to believe its them who fall off first but we can never ever control fate, so dr lets not pretend we are powerful enough to try.

Let’s also hope that all this business with obesity and smoking does not create a sense of complacency in the medical community that is slowing them from finding real cures to real diseases (that also seem to affect slim non-smokers for some reason).