Obesity bigger killer than smoking in England and Scotland – study – The Guardian


Excess weight has been contributing to more deaths since 2014 and gap is widening, researchers say

Wed 10 Feb 2021 20.00 EST

Public health campaigns in the UK to address the dangers of smoking have been hugely successful – but we’ve replaced one oral fixation with another: food. Researchers now estimate that since 2014, obesity and excess body fat have contributed to more deaths in England and Scotland than smoking.

Smoking rates have been falling, from 20.2% of the UK’s adult population in 2011 to 14.1% in 2019, while obesity rates have been rising, from 15% in England in 1993 to 28% in 2019.

“So this was not a surprising result at all,” said the study’s lead author, Dr Frederick Ho, of the University of Glasgow. “We were just trying to quantify when it [the crossover] happened … or whether it will happen in the near future.”

In order to calculate deaths that could be attributed to smoking and obesity and excess body fat, the researchers collated data on 192,239 adults collected between 2003 and 2017 as part of health surveys for England and Scotland.

The participants, whose average age was 50, reported their smoking habits, and trained interviewers or nurses measured their height and weight. The researchers combined this data with estimates of the risk of dying from smoking or obesity and excess body fat.

Overall, the researchers calculated that deaths attributable to current or former smoking declined from 23.1% of the total in 2003 to 19.4% in 2017. For deaths attributed to obesity and excess body fat, the rates rose from 17.9% in 2003 to 23.1% in 2017.

The crossover occurred in 2013, and from 2014 onwards excess body fat and obesity has eclipsed smoking as a contributor to deaths, with the gap steadily widening, the authors said in the journal BMC Public Health.

While the trends across the study population are generally in the same direction, among older age groups the crossover occurred earlier, so the gap is now wider.

Among those aged 65 and over and 45 to 64 respectively, obesity and excess body fat contributed to 3.5% and 3.4% more estimated deaths than smoking in 2017, while smoking accounted for 2.4% more estimated deaths than obesity and excess body fat among those aged 16 to 44.

The trend was more pronounced in men versus women, as men tend to carry a higher risk of death due to obesity and there are more overweight men than women.

One key limitation of the study, Ho noted, was that it did not take into account vaping or e-cigarette use, or exposure to passive smoke.

With a ban on junk food advertising proposed, Ho said the UK was making the right moves. “I think that UK is now heading the right direction, but we need to do more and work faster in order to make a timely difference, or at least to slow down the trend.”