Tobacco saga must inform obesity war

The great public health war of recent decades focussed on tobacco and the terrible impact it had — or continues to have — on users’ health.

Though smoking is not in any way as socially acceptable as it once was, far too many people still smoke, despite startling figures that show the final, unavoidable consequences of that lethal habit.

Around 7,000 people die from smoking-related disease in Ireland every year; 90% of lung cancers are caused by smoking and 50% of all smokers will die from smoking-related diseases. That all of these diseases — or premature deaths — might be avoided if people thought rationally about the health advice around smoking, seems an irrelevance to those who still smoke.

It took decades to significantly change the culture around smoking; to change the idea that smoking was a sophisticated habit, that it was an expression of manliness or a certain charismatic ruggedness.

Tobacco conglomerates fought governments at every hand’s turn, denying that they were selling a poison or that they were a threat to their customers’ health. It took years, if not decades, and great sums of public money to make the reality around smoking the widely accepted truth it is today.

The health war against smoking may not have been as successful as it might have been, or must be yet, but it has diverted millions of people from a life-changing habit.

Unfortunately, that battle has moved to the developing world, where tobacco companies are free to build markets based on their customers’ addiction, without the aggressive intervention of public health authorities.

In the developed world that health campaign is changing its focus away from tobacco and looking at measures to reduce the increasingly unwise use of sugars and fats, in an effort to fight the escalating obesity epidemic.

The World Health Organisation has described obesity as a global epidemic and has predicted that by 2025 up to half of Americans will be obese. In Ireland, 39% of adults are overweight and 18% are obese. Childhood obesity has reached epidemic proportions across Europe, where off-the-scale bodyweight is the primary health issue for millions of children.

There is a multitude of reports and suggestions about how this crisis must be tackled. The latest, from the Department of Health’s special advisory group on obesity, will recommend a 10% tax on a range of foods including cakes, biscuits, sweets, fizzy drinks and chocolate, as an opening gambit.

This seems a step in the right direction but the welcome must be diminished by the experience with tobacco. Today a packet of cigarettes costs nearly €10 but millions still smoke, therefore economic sanction can be seen as only one arrow in what needs to be a pretty full quiver. Taxes can play a part in fighting fats and sugars in our food but cultural change would be by far the better option. In that context, those who use their celebrity status to market soft or energy drinks should reconsider their position — after all, they are the Malboro Man of their time.

This shift has consequences for Irish agriculture, especially the dairy sector, where so many fat-laden products originate.

One thing can be said with some certainty about the war against sugar and fat misuse — we cannot prevaricate for decades like we did on tobacco before making the right decisions, even if they are the hard ones. The stakes are just far too high.