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Is the obesity trend linked to higher tobacco taxes?

by Evie / August 2, 2004 11:57 PM PDT
Obesity Epidemic and Alcohol Abuse - Linked to stopping smoking?

"Hints from published research, many clinical observations, a good memory, strong timeline evidence and a more science-based perspective all combined to clearly say that those health threats are linked," says Richard T. Lovelace. "Doing little more than pressure nicotine addicted people to not smoke?with lawsuits, higher taxes, smoking bans, and more?encouraged piling on another lifestyle health risk crisis. And this one raises health care costs more than smoking." According to Lovelace, "Other countries made the same tragic mistake. We humans have added a global overweight and obesity epidemic to the global smoking epidemic."

"Please understand," he requests. "You might respond to what I'm telling with something like, 'My friend is overweight and she never smoked.' I'm giving an explanation for the recent epidemic. That reason doesn?t apply to every situation."

OVERLOOKED REASON FOR THE OVERWEIGHT EPIDEMIC

Information supplied by government agencies and more bureaucracies establish that the current "obesity epidemic" happened within the past 30 years. The significant push to get people to avoid or quit smoking cigarettes started a short time before. Dr. Lovelace is sure the "push" is the primary reason for that "epidemic." "Nicotine smokers didn't have an effective, long-term way to avoid substituting eating for smoking. Many put down their cigarettes and picked up food and chronic excess body fat."

One in five ex-smokers has occasional cravings for several years. Lovelace believes the numbers are higher for "those who tried to stop or reduce smoking with NRT or nicotine replacement therapy. NRT keeps the drug in someone's body longer than he or she would realize." He points out that saying "nicotine replacement" can be confusing. "It's 'cigarette replacement.' The gum, patch, lozenge and spray are alternatives to puffing on cigarettes to get the nicotine. (Later, be sure to see references.) People don't expect to have prolonged cravings. Consequently, they confuse those with hunger for food. Also in those 'stressful' situations where they smoked nicotine for its apparent calming effect, people compensate by eating 'comfort foods' or drinking alcohol. Rather than smoke to 'reward' themselves, they eat and drink. In restaurants, malls, stadiums and bars where they smoked before, now they eat more and drink more alcohol."...


Not politically correct, and I don't think the issue is to promote smoking, but it is an interesting link to ponder.

Evie Happy
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Re: Is the obesity trend linked to higher tobacco taxes?
by Diana Forum moderator / August 3, 2004 12:09 AM PDT
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Re: Is the obesity trend linked to higher tobacco taxes?
by Dick White / August 3, 2004 2:58 AM PDT

two thought come to mind...

You said, "Not politically correct..." - in my experience, truth is often not politically correct.

On the obesity linkage, I can see smoking cessation as a cause of weight gain, but there are many people (e.g., children) with weight/food/inactivity issues who never smoked. I believe a lot of the obesity "problem" is rooted as much in cultural issues (such as politically correct "fat acceptance") as medical cause and effect from other social pogroms.

dw

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Re: Is the obesity trend linked to higher tobacco taxes?
by Evie / August 3, 2004 3:22 AM PDT

Hi ****,

I agree, and it doesn't appear the authors are trying to say it is the only cause just perhaps a contributing one. Consider that some of the drugs prescribed for smoking cessation are actually mild tranquilizers that can become addictive and it becomes ever more clear that the one-size-fits-all approach to demonizing smoking has may often overlooked unintended consequences.

Speaking for myself, I blame the women's magazines and their obsession with weight and diets. There are now decades of evidence that demonstrate that the quickest way to put on excessive pounds is to go on a diet to lose the few extra ones. The best thing I ever did was stop reading those rags! Far too many of the (particularly young) women I know with weight problems read them as if they were the gospel.

Evie Happy

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One caveat ...
by Bill Osler / August 3, 2004 7:39 AM PDT

If this is the same Dr. Lovelace I know (the name and such match, as well as the 'feel' I get from reading the quotes), you should note that Dr. Lovelace may have vested interests in arriving at the stated conclusion.

He has done a lot of smoking cessation counseling as well as weight loss counseling. His services in that area are not limited to the free information available at his web site, and as an author there is some potential for secondary gain in creating this kind of controversy.

I will not go so far as to accuse him of deliberately cooking something up. I do, however, doubt that his claims are based on really good science. Past dealings suggest that he sometimes gets ahead of solid science.

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Re: One caveat ...
by Dan McC / August 4, 2004 2:59 AM PDT
In reply to: One caveat ...

Could that be why he had to distrubute this by pushing it through prwire.com? I'll wait for his work to show up in JAMA.

Dan

.

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Some things to consider ...
by Evie / August 4, 2004 3:16 AM PDT
In reply to: Re: One caveat ...

... one of the CDC's big pushes about nicotine is that it is dangerously addictive. Yeah, this person does seem to have other motives, but nicotine-replacement cessation methods do have their problems, considering that the lowest dose of the patch, for example, still exceeds the addictive nicotine dose.

I'm finding it strange now that all of a sudden people are trying to claim that nicotine isn't addictive and people don't gain weight when they quit smoking. It's really not all that far fetched to believe that higher taxes which have resulted in lower consumption has contributed to the obesity epidemic. Not saying it is conclusive but thought it was worth considering.

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Re: Some things to consider ...
by Dan McC / August 4, 2004 4:08 AM PDT

I haven't seen anyone claim that nicotine isn't addictive that wasn't saying it long ago.

I've never heard anyone say that there's no one that gains weight when they stop smoking.

Dan

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I re-read the article. It is the same Dr. Lovelace.
by Bill Osler / August 4, 2004 1:04 PM PDT
In reply to: One caveat ...

Dr. Lovelace probably is a competent counselor, but my impression is that he does not always let solid science sway his conclusions.

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As to the science ...
by Bill Osler / August 3, 2004 11:00 AM PDT

Or rather, as to the relative lack of science, it's interesting you would highlight this article. Perhaps you have an agenda of your own?

(1) Perhaps I missed something. I do not see that Dr. Lovelace claimed taxation policy was especially important as a cause of the obesity epidemic. Certainly he did not offer any evidence. He did claim there is a link between overall national attempts to reduce smoking and the significant obesity problem in the US, but that is hardly the same thing. He also listed tax policy as a component of the national anti-smoking trend, but I do not see that there is much evidence either in the article or elsewhere that the tax on tobacco has significantly affected smoking rates or attempts to quit. That logical leap is similar to what Dave K and Ed O'Daniel routinely accuse the other of making.

(2) Dr. Lovelace does raise some legitimate concerns about the fact that people who quit smoking do gain weight. I haven't researched the issue lately, but last time I looked, the typical weight gain associated with attempts to quit smoking was small enough that the negative health effects of the smoking far outweighed the negative health effects of the weight gain. Dr. Lovelace would argue that the actual weight gain associated with quitting smoking is larger than has been reported, but even allowing for that it is unlikely that the weight gain is large enough to offset the HUGE negative effects of smoking. There are undoubtedly exceptions, but from a population perspective I doubt that he can support his claim that our national attempts to decrease smoking are worsening our overall health. He's going to have to produce some data, not just a glib marginally plausible theory.

He is clearly right about the fact that many smokers do adopt other unhealthy habits when they quit smoking. Eating certainly can be one of them, but that is hardly a reason to justify continued smoking. Of course, as a professional counselor (not a psychologist actually, since his PhD is more-or-less in social work) Dr. Lovelace believes that his profession offers some hope of eliminating those new dysfunctional behaviors. Perhaps he is right, but the track record of psychologists and such at dealing with self destructive behavior is somewhat underwhelming.

(3) Is smoking cessation linked to alcohol abuse? One of the mini-headlines in the article suggested that it might be. I don't see that the article offered any data to support the inflammatory headline. Headlines and opinions are cheap, but they are not terribly convincing.

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Re: As to the science ...
by Evie / August 3, 2004 9:13 PM PDT
In reply to: As to the science ...

Hi Bill,

Well, I just thought this was interesting, no agenda. I actually came across another article earlier in the day that mentioned the taxation but couldn't recall where. So I Googled to see if I could find another source. Since then I realize that the report I read was on Newsmax: Report: Tobacco Taxes Drive Obesity which references a Canadian National Post article. You basically need to subscribe to read it, but here's the synopsis:

Tobacco taxes blamed for sharp rise in obesity

After fast food, rising taxes on tobacco are the strongest driving force in America's obesity epidemic, according to new economic research.


Incidentally, this article came up on a search of the site for obesity. I get no hits searching on Lovelace so perhaps this is a totally different study. But the author does appear to have an agenda:

Grossman said his research sought to factor out the effects of income, education, age, race, sex, family size, local cost of fast food and other socioeconomic factors, so he could isolate the effect of tobacco taxes on obesity. "But you can never say with 100 percent certainty that this is a causal relationship," he said.

Like other critics of meddling by politicians, Grossman says his conclusions highlight the oft-realized untoward effects of so much social engineering.

"Cigarette smoking is an important cause of a lot of diseases, and we wouldn?t suggest that taxes should be lowered in order to get people to smoke more so they won?t gain weight. That?s not our message. Our message is that there are unintended consequences of public policies," he said.


Just about every smoker I've known has gained weight when they quit. Does that mean they shouldn't have quit? Well the CDC is getting hyperalarmist about obesity related diseases so sometimes you gotta wonder if smoking is necessarily worse than obesity.

As for tobacco taxes, I have no problem with them per se, but they are becoming a favorite cash cow for spend crazy legislators to fund unrelated programs.

Evie Happy

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The CDC is certainly sending some mixed messages on this ...
by Bill Osler / August 4, 2004 1:00 PM PDT

The push to decrease obesity does seem a bit at odds with the fact that ex-smokers almost always gain some weight when they quit.

From a health perspective, though, I'd rather see patients who are a bit overweight than patients who smoke. Smoking is just that bad.

Now, to really do the analysis right, one would need to factor in ripple effects of all kinds. When smokers quit, how much weight do they gain? how much weight do they gain if they try unsuccessfully to quit? do their partners change their eating habits? Just how large an effect does second hand smoke have? ... The problem is that we do not have stable data on that kind of stuff.

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Re: The CDC is certainly sending some mixed messages on this
by Evie / August 4, 2004 10:48 PM PDT

Hi Bill,

I agree that moderate weight gain is probably preferable to smoking. I'm not a fan of the habit which may be a misconception in that I am also not a fan of wasting billions of taxpayer dollars to elevate second-hand smoke to the level of drinking arsenic.

I do know a number of ex-smokers that really ballooned up when they quit, and others that put on some weight and never seemed to be able to take it off. I honestly can't think of any ex-smokers that haven't replaced the habit with something else. One friend of mine became a bit of an exercise addict, another chews gum almost constantly. So it need not be a destructive behavior, but we are creatures of habit and long time habits die hard. That's just anecdotal observation. It would be interesting to be able to calculate just how much this mass effect of that many quitting has added to the obesity stats.

Agreed that all such studies are difficult to control for all factors. But often such concerns are ignored in other studies sponsored by the CDC so why not extend the same courtesy here. It has been my casual observation, particularly where SHS is concerned, that this is EXACTLY what happens. Somewhere in the studies and articles, usually buried WAY at the end with lots of qualifiers, they mention other possible contributing factors.

Evie Happy

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Re: As to the science ...
by Mary Kay / August 3, 2004 11:26 PM PDT
In reply to: As to the science ...

I also feel that these kind of statements assume that people are so addictive by nature that they have to replace one vice with another. As a person who gave up smoking after 50 years (cold turkey) I say this is not the case.

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The impact of taxation is lower on the list
by Dan McC / August 4, 2004 3:03 AM PDT

than the impact of the invention of the deep-fried Twinkie, deep-fried Oreos, deep-fried Snickers, and deep-fried 3 Musketeers.

Dan

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