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Which is Worse: Smoking or Being Obese?


Updated August 31, 2010

Question: Which is Worse: Smoking or Being Obese?
Answer: If you had asked me this question a while ago, I would have answered, “Smoking, without a doubt, smoking.” But as more and more research is being done on the impact of obesity on life expectancy, the answer to this question about smoking and obesity is become less clear.

Smoking and Life Expectancy

With smoking, we know that the loss in life expectancy is up to 14 years lost (depending on the amount smoked daily and the number of years that someone has smoked. This is a huge number and represents the extreme effect of smoking on health. On average, smoking costs the smoker somewhere between 8 and 10 years of life. This number doesn’t represent any quality of life lost due to complications of smoking such as emphysema.

Obesity and Life Expectancy

It seems being obese can have a similar impact on life expectancy. For people aged 40-45, the loss of life expectancy from being obese was 8 to 10 years. How do we know this? Well, an article was published in the Lancet, a prestigious British medical journal that examined 57 studies (almost one million people) that looked at the connection between body-mass index (or BMI) and life expectancy.

How “Big” are These Problems?

According to the Centers for Disease Control (CDC), about 20% of adults in the U.S. smoke. That number is a shocking to me. Of course, that number is less than it was years ago, but represents a large number of the population. For obesity, the National Institutes of Health (NIH) estimates that one-third of the U.S. population is obese, making the U.S. the fattest society that the world has ever known. By simply not smoking and keeping your weight normal, you can add years to your life. Here are a couple of things to try to help you:


Prospective Studies Collaboration. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. The Lancet, Volume 373, Issue 9669, Pages 1083 - 1096, 28 March 2009.

Centers for Disease Control. Prevalence of Current Smoking among Adults Aged 18 Years and Over: United States, 1997–June 2008.

National Institutes of Health. Medline Plus. Obesity.

National Institutes of Health. Medline Plus. Smoking.

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