The-F-Word.org

“When ends don’t meet it’s easier to justify the means…” Bruce Cockburn

My dad, now 52, began smoking at age 14. He also has asthma and, by medical standards, is morbidly obese, both of which, coupled with his nicotine habit, contributes to his poor health and mobility. For my older brother and myself, the daily images of seeing our father hack, cough and sputter his way through life, not to mention the many hospitalizations he’s had for illnesses like pneumonia and bronchitis, have always proved a deterrent to smoking. I’ve never been tempted to light up, not ever, but it didn’t stop my younger brother and sister from taking up the habit.

And my siblings are in good company. According to the American Lung Association, nearly 6,000 children under 18 years of age start smoking each day; of these, nearly 2,000 will become regular smokers for a total of 800,000 annually. The ALA estimates that at least 4.5 million U.S. adolescents smoke cigarettes, or about one in four teens. Anti-smoking groups have tried valiantly to discourage teen smoking, from raising cigarette taxes to implementing school-based efforts and state and national campaigns. After being diagnosed with cancer in the 1990s, the ubiquitous Marlboro Man appeared in TV spots warning of the dangers of smoking, while edgy “Truth” TV ads try to appeal to kids on a hipper plane. Activist groups have harped at length on the health dangers of smoking, including the big ones heart disease and cancer. They’ve initiated lawsuits, enacted smoking bans, posed as Cops in Shops and lobbied for congressional reform.

But there’s one tactic anti-smoking activists haven’t tried, and according to a new study, it may be the strongest tool yet in the anti-smoking arsenal: Smoking will make you fat.

That’s the conclusion reached by a group of Finnish researchers, as published in the latest issue of the American Journal of Public Health. The team found that smoking during adolescence strongly predicted the development of abdominal obesity in adulthood, among both men and women. The conclusion isn’t exactly revelatory — a team of Swedish researchers discovered much the same thing in 1992 study.* What’s different about this study is that researchers are now encouraging anti-smoking groups to incorporate fat phobia into teen prevention campaigns, as reported by Reuters. Here’s study chief Dr. Suoma E. Saarni:

This research, Saarni added, “gives a tool” to highlight the risks of smoking to adolescents and young adults “by showing the unhealthy effect on the body shape.” This can be an important deterrent, “because usually young people find cardiovascular disease and type 2 diabetes or even cancer so distant risks that they have very little impact on ones smoking behavior.”

The strategy promises to be an effective one. After all, the 2003 Youth Risk Behavior Surveillance found that almost 60 percent of female and 29 percent of male school students were trying to lose weight. Many are resorting to desperate measures to shed the pounds. A 2000 survey of 5-year-olds found that the majority would rather lose an arm than be fat. A study released just last year found that one-third of overweight teens engage in dangerous and extreme behaviors, like purging or taking laxatives or diet pills to lose weight. And in a 2003 study of teenage girls ages 12 – 15, those girls who attached great importance to being thin were four times as likely to become established smokers.

Popular perceptions on weight in the U.S. first began to change at the tail-end of the nineteenth century. The myth that smoking makes or keeps one thin** arose not long after. As early as the 1920s, tobacco advertising covertly tied cigarettes to health, beauty, and slimness with advertisements geared toward women that included messages such as “Reach for a Lucky instead of a sweet.” The campaign’s brainchild was one Edward Bernays, the ‘father of public relations’ who mastered the art of the propaganda trade during his tenure with the WWII Committee on Public Information. The positioning of Lucky Strike as an aid to weight control led to a greater than 300 percent increase in sales for this brand in the first year of the advertising campaign. Cigarette manufacturers today continue to play on these myths by marketing cigarette brands as ‘slims’ or ‘thins’, thus further reinforcing the association of smoking with weight control, and by using images of slim, toned and athletic models in advertisements.

Abdominal fat may pose health concerns, so it’s not unreasonable to include this smoking health hazard in campaigns. As recent studies have indicated, it isn’t how much fat you have that contributes to weight-related health problems as it is where fat is stored. What makes abdominal fat of particular concern is that it is believed to function differently than other forms of fat and often lodges deep within and surrounds vital organs — more here. In fact, many researchers and doctors are now calling for the replacement of BMI with waist-to-hip ratio (WHR) as a more reliable indicator of weight-related health risks.

So, if abdominal fat poses health risks, what’s the big deal in using this information to discourage teen smoking? The problem is not in the information itself, it’s in the why and how it’s being used. Remember, the smoking-abdominal fat correlation was discovered at least 16 years ago. According to the CDC, teen smoking rates spiked in the 1990s, climaxing at 36.3 percent in 1995, scarcely three years after the Swedish study’s release. They’ve been on a sharp decline since, falling to 21.9 percent in 2003. Why only now is this health threat being deployed?

To answer this, we turn not only to history but also to sociology. Cultural biases towards fat have long existed, but obesity itself didn’t emerge as a major news items until the early 2000s. It’s quickly gained speed, with everything from global warming to international terrorism blamed on the widening girths of Americans. I should also note here that the people who helped to create the alarmist “obesity epidemic” were the very same groups who stood to profit the most from it, but I digress. The demonization of obesity in recent years as a national health risk and personal shortcoming has both strengthened existing fat biases and fostered anew, while also providing a socially acceptable, medically-sanctioned justification for expressing them openly and blatantly. In all of my exhaustive graduate research on perceptions of weight and body image in America, never before have I discovered fat discrimination to be so prevalent or vitriolic as it is today — and I’m not the only researcher to come to this conclusion.

The motives for including anti-obesity nostrums in teen anti-smoking campaigns aren’t so much out of concern for the health risks of abdominal fat as it provides an ample opportunity to play on current fat stereotypes and fears in order to prevent teen smoking. Think about it… Current campaigns have found that kids don’t seem to care or worry about the health risks of cancer or heart disease. Are they now going to suddenly care about the health risks of abdominal fat? Or will their thought processes read more like, “OMG, fat is ugly! I’d rather lose my arm than be fat! I better not smoke!” What benefit is it to dissuade kids from smoking only for them to develop a lifetime’s struggle with body image and self-esteem, disordered eating and/or an eating disorder?

Cigarette companies used fat phobia to sell smoking to past generations of women (and men). Today, fat phobia is being used to discourage future generations from lighting up. Sure, preventing teen smoking is an important national health goal, but at what cost?

Jeff Fecke at Amptoons also had something to say about this issue.

* Lissner, L., Benbtsson, C., Lapidus, L., Bjorkelund, C.,1992. “Smoking Initiation and Cessation in Relation to Body Fat Distribution Based on Data from a Study of Swedish Women.” American Journal of Public Health. Vol. 82 (2) pp. 273-275.

** People who quit smoking usually gain more weight than those who keep smoking or never smoked — for the why, read here. However, smoking itself has very little effect on maintaining body weight.