Anyone who's ever quit smoking (or tried to) knows that once the puffing stops, the eating begins. And as individual smokers go, so goes the nation: The U.S. has seen smoking rates fall and obesity rates rise in recent decades, and the combination has cut Americans' life expectancy.

A recent New England Journal of Medicine study of trends in rising obesity and falling smoking rates found that the former has "overwhelmed the positive effects of declines in smoking in multiple scenarios." The study predicts: "If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates."
45% of Americans Obese by 2020?

The study examined health trends collected from national health surveys to forecast life expectancy and quality of life, assuming a 15-year trend of a 20% decline in smoking would continue. That alone should boost life expectancy: Between 2005 and 2020, a typical 18-year-old American's life expectancy should increase by nearly four months based on the decline in smoking.

But over the past 15 years, body-mass index rates shot up 48%. And assuming this trend also continues, the study predicts that 45% of Americans will be obese by 2020. That reduces the typical 18-year-old's life expectancy by just over a year. With less smoking and more obesity, the net loss to the U.S. life expectancy is more than eight months.

That doesn't mean that the customary trend of increased life expectancy due to improvements in nutrition, education and health care will suddenly reverse course. But the rising obesity rates may eventually slow this progress.

Taxation or Drugs?

Is the answer in taxing junk food, as the U.S. taxes tobacco? Obviously, people need to eat and don't need to smoke, but researchers recommend taking action. Antismoking campaigns were initially met with skepticism and resistance, but taxes and regulation have changed social norms over time. Similar legal measures could reverse the rising obesity trend. Some proponents argue for a soda tax, while others propose financial incentives for reaching weight-loss goals or paying for some weight-loss medication.

It goes without saying that the pharmaceutical industry would probably get behind such an effort: Arena Pharmaceuticals (ARNA), Vivus (VVUS) and Orexigen Therapeutics (OREX) are all developing diet pills. "If all U.S. adults became nonsmokers of normal weight by 2020," the study notes, researchers "forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years."

The bottom line: If you succeed in giving up tobacco, pay especially close attention to your eating habits. It could add years to your life.

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