Coffee, Sugar, and Cigarettes

Apples and Oranges, Tobacco and Sugar

Fruit juice, soda, cigarettes, and vapes. They’re all killing us, but we keep consuming them. Tobacco and sugar are close neighbors on the slippery slope to poor health and premature death. Right? Well, not really.

News and journal articles might give you an impression that sugar and tobacco are very similar bad actors. We hear from public health advocates that both smoking and sugar-sweetened beverages “have a dose-response relationship with disease.” Both have some value to consumers and both cause harm. So if we’re going to tax tobacco, we should tax SSBs, they tell us.

Such are the arguments we hear from advocates for fighting the sugar epidemic.

Objective Measures of Risk

Do those comparisons bring clarity or confusion? Let’s look objectively at the hazards.

Two recent studies examine the association between sweet beverages and the risk of death. First, Circulation published a large observational study. Researchers found that people drinking the most SSBs – more than two 12-oz servings per day – had a 21 percent higher risk of an earlier death than people who seldom or never drank them. People who drank them only occasionally had little or no increased risk.

Next, JAMA Network Open published an observational study of both SSBs and fruit juices. In this study, the researchers found that the highest consumers of both SSBs and fruit juices had a 14 percent increase in their risk of premature death. It made little difference whether people drank soda or fruit juice. The correlation was about the same.

Now for comparison, let’s look at the risk of death associated with smoking. At the very lowest levels of smoking ever studied – 1-4 cigarettes per day – the added risk of an early death is 47 percent for women and 57 percent for men. Even for non-smokers, passive smoke confers an increased risk of death. And of course for heavier smokers, the risk is very high – a hundred percent increase or more.

Plainly Not Comparable

So no. The risks of smoking and the risks of drinking a sweet beverage are not comparable. Not at all. For smoking, there’s no safe level. Even the lowest levels of smoking are more dangerous than the highest levels of SSB consumption.

In contrast, modest amounts of sweet beverages are safe. People can consume an occasional soft drink or a bit of sugar in a cup of tea without fear. Of course, serving size and frequency matters. A daily habit of sugary drinks is not a good idea. Water is the best default.

Fear and Dread for Public Health

We have serious concerns about using fear and dread as a tool for promoting public health. Suggesting that tobacco and sugar have similar risks is simply dishonest. Each has its own risks, but they are very different.

Exaggeration will come to harm the credibility of public health. After a while, people start tuning out fear mongers. But when people stop listening to public health authorities, bad things happen. Consider the resurgence of measles if you need a case study.

Let’s stick to the facts with a passion for objectivity.

Coffee, Sugar, and Cigarettes; photograph © Gino Mempin / flickr

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May 28, 2019