Why the decline in smoking rates won’t improve the average health of Americans:

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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 published today in the New England Journal of Medicine.

“Obesity plays a large role in life expectancy,” said co-author Allison B. Rosen, assistant professor in the Department of Internal Medicine at the University of Michigan. “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.”

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 body-mass index 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.

However, the researchers say the study’s results 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 T. Stewart, Ph.D, 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.”

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