Is Smoking Worse Than Being Obese?

middle aged woman smoking

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Comparing smoking to obesity is, in a way, like comparing bad apples to bad apples. Both are unhealthy and can lead to a host of serious health concerns. But if you had to choose which poses more of a risk to you, you—perhaps based on decades of messaging—might say smoking.

No doubt, smoking is one of the worse things you can do to your body. But as more and more research digs into the impact of excessive weight on life expectancy, obesity may very well be even more concerning.

Smoking and Life Expectancy

Smoking causes one out of five deaths each year in the U.S. As the habit is confirmed to cause cancer, heart disease, lung disease, and macular degeneration, smoking may lead to a loss of at least 10 years in life expectancy, depending on the amount smoked daily and how many years it went on. Smokers are also three times more likely to die than nonsmokers of the same age.

These are huge numbers and represent the extreme effect of smoking on health. Importantly, these statistics don't represent any quality of life lost due to complications of smoking such as emphysema, which can further increase the number of years of life lost.

The dangers aren't limited to cigarettes, of course. Cigars, smokeless tobacco, and inhalation products like e-cigarettes can have their own devastating health effects as well.

Obesity and Life Expectancy

Obesity has a similar impact on life expectancy. But while smoking certainly carries numerous and substantial health risks, obesity poses even more.

A 2019 study of nearly 450,000 people in PLoS Genetics linked excessive weight to coronary artery disease, stroke, type 1 and 2 diabetes, chronic obstructive pulmonary disease (COPD), chronic liver disease, renal failure, and lung cancer.

According to a Lancet review of 57 studies, obese people ages 40 to 45 can expect an eight to 10 year loss of life expectancy.

Other research suggests that compared to normal-weight people of the same age, obese individuals have a 67% higher rate of chronic health conditions and spend 77% more on medications. Most dramatically, being obese is "like aging from 30 to 50."

Public Health Impact

According to the Centers for Disease Control and Prevention (CDC), about 14% of adults in the U.S. smoke, and 75% of them do so every day. While smoking has declined sharply over time, that's still about 34 million people. The National Institutes of Health (NIH) estimates that more than one-third of people in the U.S. are obese (with double that number being overweight).

Adding Years to Your Life

Given the number of people who smoke, are obese, or for whom both apply, it's clear that there is a lot of potentially lost life that can be lived. Making lifestyle changes may not be easy, and there are often setbacks. But the benefits you reap are far worth the effort.

While quitting smoking entirely and reaching a healthy weight are ideal, small changes can have a big impact. This research gives you good reason to take that first step and be proud of each milestone along the way:

  • By simply not smoking and losing just 5% to 10% of your body weight, you can improve your quality of life and longevity, according to the National Institutes of Health (that's 10 to 20 pounds for a 200-pound person).
  • Even if you're a smoker and/or obese, a 2017 review of 95 studies found that eating eight or more portions of fruits and vegetables a day may lower your overall risk of death, particularly from cancer and heart disease.
  • Regular physical activity is important, too. A PLoS One study of more than 650,000 people over 10 years found a 1.8-year gain in life expectancy in people who exercised the equivalent of 75 minutes of brisk walking per week. And the more exercise the better, as the highest-volume group (450 minutes per week) achieved a 4.5-year gain in life expectancy.
  • Keep in touch with loved ones, as well, since staying socially active can improve your life expectancy.

If you are trying to quit smoking and struggling, know that support is available.

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