No, Cancer Research UK, Obesity Is Not Like Smoking
Presumably, the folks at Cancer Research UK (CRUK) knows something about cancer. Sadly, though, they’re proving that they don’t understand obesity. They’re spending a bundle of money to promote a false meme that equates obesity with smoking. It’s a clever lie, but it’s still a lie. Smoking is a behavior. Obesity is a condition. They are not alike.
Cancer Research UK should stop this shameful campaign of misinformation.
A Controversy Promoting Stigma
In an open letter to CRUK, more than 50 dietitians, researchers, academics, and advocates called this campaign inaccurate and harmful:
The campaign, which draws a comparison between smoking, weight and cancer risk, is not only inaccurate, it is harmful to people who are at a higher weight, including those with cancer.
Social media is teeming with dismay about the CRUK campaign, expressed in this tweet:
As medical professionals you know the underlying causes of obesity are related to many things, including poverty. This advertising campaign targets some of the most vulnerable members of society in a very negative way and gives more ammunition to simple minded bullies.
But the fans of stirring fears about obesity are undaunted, offering comments like this:
Excellent campaign – creating awareness and generating discussion as any campaign should.
Fear of Fat Doesn’t Promote Health
That kind of thinking has a serious flaw. The fact is that fear doesn’t promote health. As we’ve said before, this is especially true for obesity. Campaigns that tap into fear and disgust serve mainly to promote stigma. In turn, stigma leads to inaction and poorer health. People who feel shamed about their weight avoid healthcare. They avoid health screening for things like cancer.
This is a matter of fact, not speculation. So the result is that by promoting shame and blame for obesity, Cancer Research UK is reinforcing a barrier to cancer screening. They should stop. Just stop.
Click here for the press release from Cancer Research UK and here for the open letter of opposition. You can read and sign on to the petition asking CRUK to stop here. In fact, we recommend it.
Obesity Is Like Smoking, billboard by Cancer Research UK
Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.
July 5, 2019
July 05, 2019 at 12:12 pm, Lizabeth Wesely-Casella said:
The applauding you hear is from this direction. I can’t even begin to tell you the number of times I’ve had to have this discussion – and with all types of people. THANK YOU for the reinforcement!!! Consider republishing this every month… 😉
July 05, 2019 at 1:31 pm, Ted said:
Thank you, Lizabeth!
July 05, 2019 at 7:01 pm, Annette Neary (Dr) said:
Thank you. Looked after people with weight issues & hypertension for 25 years – also struggled with my own weight. Really appreciate what you have written here.
July 07, 2019 at 11:52 am, Joe Gitchel said:
At the risk of irking everyone involved in this discourse, I offer a few points:
While smoking is a behavior and obesity is a condition, central to long-term daily smoking (and associated with substantial risks to health) *is* a condition: dependence to nicotine delivered in tobacco smoke (or a Substance Use Disorder in DSM-5 speak).
To argue that smoking is a ‘lifestyle choice’ thus is also gravely misleading.
Further, it seems to me (as someone who chose his parents *so* wisely as to not be burdened by obesity nor smoking) that the open letter is essentially arguing that stigmatizing smoking and smokers is acceptable, or at least that people with obesity should not be treated in the same way as “those” people who smoke or consume nicotine.
My overall view is that yes, it is appropriate to raise awareness of disease risks that arise from (at least somewhat) modifiable risk factors and conditions. However such awareness-raising (which typically tends towards fear-arousal) needs to be considered against the potential for those who experience the condition to be able to get the help and support they need to reduce those risks. Creating fear without a ready outlet to address it is a recipe for stigma, shame, and harm.
CRUK’s position (https://www.cancerresearchuk.org/about-us/we-develop-policy/our-policy-on-preventing-cancer/our-policy-on-tobacco-control-and-cancer/our-policy-on-e-cigarettes) on nicotine and vaping is world-leading and laudable as they have illuminated a clear and consumer-appealing pathway for smokers to reduce their risk. Given that the current treatments for those with obesity are of substantially less efficacy and/or reach than those for smoking, the reasoning of inducing population-level fear when those at greatest risk are so limited by society’s failure to provide the help they need feels miscalibrated.
But mischaracterizing smoking is a poor counterargument to make that case.
Disclosures
My employer, PinneyAssociates, provides consulting services on tobacco harm minimization (including smokeless tobacco and vapor products) to RJ Reynolds Vapor Company and RAI Services Company, subsidiaries of Reynolds American Inc. British American Tobacco purchased Reynolds American Inc. in July 2017. I also own an interest in intellectual property for a novel nicotine medication that has not been developed or commercialized.