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Generations are often defined by shared challenges.  In health, Baby Boomers had to confront smoking and, similarly, Millennials will have to confront obesity.

In the chart below, I’ve plotted smoking and obesity rates in the US over the last 50 years (data from CDC and NHANES).  Smoking and obesity, both primary risk factors for chronic disease in the US, have virtually switched places.  While smoking rates have been cut in half, obesity rates have more than doubled over the last 50 years.

Behaviors contributing to obesity (i.e. lack of physical activity and poor nutrition) are as worrisome today as smoking was 40-50 years ago.  Altering these behaviors will demand the same effort and investment that lowered smoking rates.  So what can we learn from the success in decreasing smoking rates to help reduce the obesity rate?

There are many reasons that people quit smoking in the US, but essentially, we’ve created lots of negative reinforcement that make it harder to be a smoker.  We've made smoking more:

1. Expensive.  In the last 10 years alone, average cigarette sales tax has more than tripled (data from taxfoundation.org).
2. Stigmatized.  Millions of dollars are invested every year for anti-smoking media campaigns and tobacco companies are limited on how they can advertise.  The end result is that smoking has largely lost the coolness factor.
3. Logistically Challenging.  Clean Air Laws put up a significant logistical barrier by making people go outside of restaurants and bars to smoke.

I recently talked to someone with many years of experience as an HR consultant about the challenge of lowering the obesity rate.  He suggested that the types of initiatives that worked so well in lowering smoking rates would be less successful in the battle against obesity.  While it seems reasonable to make a smoker’s life more uncomfortable, doing the same to someone that is obese is obviously not socially acceptable.

I agree with this point, but I think there are still valuable lessons from the success in reducing smoking rates.  We can take the same principles that worked for smoking, but reframe them as positive reinforcement rather than negative.  For example, make proper nutrition and exercise more:

1. Affordable.  Some companies are already making a big difference through subsidized healthy cafeterias (e.g. Clayton Homes), but there is a lot more work to be done.
2. Socially Reinforced.  There are so many fun ways to be sedentary with friends (watch TV, play video games, surf Facebook, etc.).  Physical activity may have a long way to go to compete, but it has to be more of a fun, social experience.  Running on the treadmill isn’t cutting it.
3. Accessible.  It’s too difficult to eat healthy and exercise.  For example, people often tell us that they dread the logistics involved in going to the gym (packing bag, changing, etc.).  Can we remove some of these barriers?

These are just a few ideas.  What lessons do you think can be taken from the campaign against smoking to help reduce obesity rates?