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Updated 7:00 AM December 7, 2009
 

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  Research
Obesity trends outweigh health benefits gained by quitting smoking

If obesity trends continue, the negative effect on the health of the U.S. population will overtake the benefits gained from declining smoking rates, according to a study by U-M and Harvard researchers.

"Obesity plays a large role in life expectancy," says co-author Allison Rosen, assistant professor in the Department of Internal Medicine. "Despite the fact that we are smoking less, body-mass indexes (BMI) are going up. These increases in obesity are overtaking these changes in smoking behaviors."

The research was published last week in the New England Journal of Medicine.

Using a technical analysis that includes forecasting future trends based on historical data, researchers found that despite declines in smoking, the remaining life expectancy of a typical 18-year-old would be held back by 0.71 years by the year 2020 because of the increased BMI of the general population. The researchers also looked at quality of life. That same 18-year-old could expect to give up 0.91 years of increased quality-adjusted life expectancy.

If all U.S. adults became nonsmokers of normal weight by 2020, their life expectancy would be forecast to increase by 3.76 years or 5.16 quality-adjusted years.

The researchers say the study's results, however, don't imply that life expectancy will fall — more likely, life expectancy will continue to rise due to other factors, but less rapidly than it otherwise would.

"In the past 15 years, smoking rates have declined by 20 percent, but obesity rates have increased by 48 percent," says lead author Susan Stewart, a Harvard University research associate for the joint project of the National Bureau of Economic Research and Harvard's Program for Health System Improvement. "If past trends continue, nearly half of the population — 45 percent — is projected to be obese by 2020."

Rosen says this study does not indicate that people are getting heavier because they are not smoking. The weight gain associated with quitting smoking is temporary and thus not significant enough to drive the rising trend in increased BMIs.

Public health efforts to discourage smoking have worked, and a similar effort could help turn around obesity rates, Rosen says. Many weight control interventions have proven successful and their use should be encouraged.

"Losing weight is harder than quitting smoking. People don't have to smoke to live. People have to eat to live," she says.

"The hypothetical scenario of having everyone a non-smoker of normal weight may be unachievable. But these results show the dramatic toll that both smoking and obesity can have on both the length of life and the quality of life."

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