Does obesity cause more deaths than smoking?

Astudypublished inBMC Public Healthfinds that adiposity now accounts for more deaths in England and Scotland than smoking among middle- and old-age people. Author Frederick K Ho tells us more about the research in this blog.

We have several anti-smoking policies in the UK in recent decades – the bans on indoor/workplace smoking, tobacco adverts around sports, and tobacco sales in vending machines, to name a few. Indeed, smoking has been the major target of public health interventions, and rightfully so given that it made the largest contribution to avoidable deaths. These public health interventions have been quite successful and, as a result, the number of smokers has been decreasing over the past 20 years.

随着肥胖症患者的越来越少,吸烟的人更少,现在质疑吸烟是否仍然是英国死亡的最大贡献者。

However, while smoking became less popular, we had more people with obesity. In 2003, 23% of people in England had obesity (BMI ≥30 kg/m2),这一数字在2017年上升到29%。在英国其他国家也可以观察到类似的趋势。随着肥胖症患者的越来越少,吸烟的人更少,现在质疑吸烟是否仍然是英国死亡的最大贡献者。

We answered this question in our research by synthesizing two sets of numbers. The first set is the yearly proportions of people with different levels of obesity, and those of current, former, and never smokers. We extracted these numbers from the Health Surveys for England and Scottish Health Surveys. These surveys recruited random samples of people in England and Scotland, making their findings more representative.

The second set of numbers is what we called the risk ratios of obesity and smoking. Risk ratios quantify to which extent people with obesity and smokers are at higher risk of adverse health events, such as death. We extracted risk ratios from the latest meta-analysis studies, which should provide more robust estimates.

Frederick K Ho et. al BMC Public Health

Combining these two sets of numbers, we found that smoking contributed 23% of all deaths in 2003, and that number decreased to 19% in 2017 (Figure). Meanwhile obesity contributed 18% deaths in 2003 and that number increased to 23% in 2017. The contribution of obesity exceeded that of smoking in 2013. The general trends were consistent across age, sex, and education level. But for younger people under 45 years of age, smoking remained the larger contributor to deaths.

但是,应该指出的是,分析假设风险比可以准确反映肥胖和吸烟在15年中导致死亡的程度。此外,我们的研究仅考虑死亡,但是肥胖和吸烟的影响扩展到慢性疾病和残疾。还没有考虑吸烟的遗产,例如烟,电子烟和被动吸烟。当有更好和最新的数据可用时,可以进一步研究这些。

Our analysis estimated obesity is now contributing to more deaths than smoking

Historical efforts to protect the public from the harms of smoking have been successful. Our analysis estimated obesity is now contributing to more deaths than smoking, which highlights the need to focus our efforts to address it. This could include government policies and legislation to create an environment that can facilitate weight management, as well as interventions to support individuals.

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