Improving diet and physical activity: 12 lessons from controlling tobacco smoking

doi:10.1136/bmj.330.7496.898

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Derek Yach, professor of public health1,
Martin McKee, professor of European public health2,
Alan D Lopez, professor of medical statistics and population health (C.griffin@cca-uk.com)3,
Tom Novotnyon be-half-of for Oxford Vision 20204

¹Yale University, New Haven, CT, USA
²London School of Hygiene and Tropical Medicine, London
³University of Queensland, Brisbane, Australia
⁴School of Medicine, University of California, San Francisco, CA, USA Thomas E Novotny professor in residence, epidemiology and biostatistics

Correspondence to: Conor Griffin, Chandler Chicco Agency, London W1M 1JD

On behalf of Oxford Vision 2020, a partnership dedicated to preventing the forecast worldwide growth of chronic diseases, the authors suggest that 12 lessons learnt from attempts to control tobacco smoking could be used to tackle the chronic disease epidemics evolving from unhealthy diets and a lack of physical activity

Introduction

Increasingly, developing countries need to tackle obesity and associated chronic diseases as well as hunger and undernutrition

Credit: GILDEN/MAGNUM BRUCE

This year three new books have been published about the progress made globally in research, policy, and actions to control tobacco smoking.1-3 In addition, Sir Richard Doll reported this year on 50 years of following British doctors to document the impact of smoking on their health.4 We have reviewed the evidence and approaches taken to control tobacco smoking, well described in these new texts, because of the rapid global increase in the risk factors of unhealthy diets and lack of physical activity. As part of the Oxford Vision 2020 process,5 we have proposed 12 lessons from tobacco control that might speed up progress in tackling these new public health threats. We also drew on other recent insights from tobacco control in addressing other chronic disease risks.6-8

1. Address the issue of individual responsibility versus collective or environmental action early and often

This issue pervades debates on the role of government versus that of the individual, and both sides of the issue need to be addressed. However, the World Health Organization's statement in its Ottawa charter remains valid: “Healthy choices need to be the easy choices.”9 Individual responsibility can have its full effect only in a society where governments, private interests, and other sectors work together to support individuals making healthy choices. In all societies special support is required for children, who are neither competent nor legally able to make fully informed decisions about behaviours with lifelong …