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Reducing Obesity: Policy Strategies from the Tobacco Wars

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Document date: July 24, 2009
Released online: July 27, 2009

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To combat the epidemic of obesity, lawmakers can adapt policy approaches that have substantially cut tobacco use. A 10 percent tax on fattening food, identified based on a model used by the British government to determine the foods that may not be advertised to children, would reduce consumption while raising more than $500 billion over 10 years. Adding simple, "traffic light" nutrition labels to the front of each food package would change consumers' buying habits, as would listing calories on menus at chain restaurants. Consumption of fattening food would be further reduced by banning its advertisement in the mass media.


Obesity is widely recognized as one of the country's leading public health problems. The obese and overweight experience chronic illness, poor health, and more than 100,000 preventable deaths each year. For the average affected individual, obesity has a much greater impact on health status and health care costs than either smoking or heavy drinking.

In purely financial terms, obesity and excess weight reduce the productivity of American industry and cause over $200 billion in annual health care spending, half of which is funded by the taxpayers. Further, private premiums for nonobese workers are nearly $26 billion higher each year because of obesity-generated health care costs. If recent trends continue, 40 percent of adults will be obese in just 6 years and, for the first time in history, Americans' average life span will shrink rather than grow.

In attacking the epidemic of obesity, policymakers can turn for guidance to the country's long-term effort to combat another, equally pressing public health problem—tobacco use. The share of adults who smoke fell from 42.4 percent in 1965 to less than 20 percent in 2007. Still further progress is likely under recently enacted measures that placed tobacco under the Food and Drug Administration's regulatory authority.

Aggressive public policy interventions that helped bring down tobacco use could be modified and applied to fight obesity, including

  • imposing excise or sales taxes on fattening food of little nutritional value, as the tax on cigarettes has proven to be the single most effective weapon in decreasing tobacco use;
  • putting graphic, simple labels on the front of packaged foods showing their nutritional value in a form that consumers can easily understand and use;
  • requiring restaurant chains to put simple nutrition information on the menu next to each listed item; and
  • banning advertising and limiting the marketing of fattening food.

A national excise or sales tax on fattening food would also yield revenue that could finance both anti-obesity activities and national health care reform. Foods subject to taxation could be identified using a carefully developed, repeatedly validated nutrient profiling model applied by the British Food Standards Agency to identify the foods that may not be advertised to children and adolescents. A 10 percent tax on fattening foods, defined using this model, would yield more than $500 billion in revenue over ten years. If combined with a subsidy that lowered the price of fruits and vegetables by 10 percent, the net revenue would exceed $350 billion. Similar state taxes could help states close short-term budget gaps while laying the foundation for better population health over the long term. To avoid a net adverse impact on low-income households, some of the resulting revenue could finance increased food stamp allotments and support community-based initiatives that bring nutritious, relatively affordable foods to low-income communities that lack access to such foods today.

(End of excerpt. The entire report is available in PDF format.)

Topics/Tags: | Economy/Taxes | Health/Healthcare

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