October 06, 2016

Sugar is the new tobacco

This op-ed of mine ran in yesterday's Charleston Gazette-Mail:

When legislators start scrambling to fill West Virginia’s budget gap next year, they would do well to consider raising the tax on sugary drinks. And maybe finishing the job on the tobacco tax.

There are plenty of reasons to consider this option, but here’s one to start with: sugar is the new tobacco. In more ways than one. And tobacco is the old sugar.

But, let’s start with the old one. According to the Centers for Disease Control and Prevention, cigarette smoking is responsible for more than 480,000 U.S. deaths per year.

For comparison, consider this: that’s more than twice the number of Union and Confederate soldiers killed or mortally wounded in battle in the whole Civil War (around 110,000 and 94,000, respectively).

The CDC estimates economic costs to be more than $300 billion per year, including $170 in direct medical costs and $156 billion in lost productivity.

That’s over 70 times the size of West Virginia’s general fund budget of $4.2 billion in 2015.

That’s bad enough, but many Americans may have forgotten how the tobacco industry knew about the danger of smoking but suppressed the information to protect profits and delay regulation.

As James Surowiecki wrote in The New Yorker, industry researchers “had demonstrated the addictive qualities of nicotine and the health hazards of smoking years before these things became public knowledge, and that tobacco companies had nonetheless embarked on a public campaign to deny what they knew to be true, from their own research, and to cast doubt on the dangers of cigarettes.”

It has recently come to light that the sugar industry was up to the same tricks for years.

According to a recent article in the Journal of the American Medical Association Internal Medicine, more than 50 years ago, sugar industry interest groups became concerned about research on the dietary causes of coronary heart disease, especially those that linked illness and early deaths to sugar intake.

Over a period of decades, the industry dumped a few million dollars on P.R. and “research,” including funding for Harvard scientists who minimized the role of sugar and cast fat as the villain. The scientists didn’t disclose any possible conflicts of interest.

As far back as the 1950s, one influential industry leader argued that “sugar is what keeps every human being alive and with energy to face our daily problems.” In effect, the industry paid for research to back up their claims.

You get what you pay for. Or the industry did anyhow. As the authors of the JAMA article note, “by the 1980s, few scientists believed that added sugars played a significant role in CHD, and the first 1980 Dietary Guidelines for Americans focused on reducing total fat, saturated fat, and dietary cholesterol for CHD prevention.”

As Surowiecki put it, the Harvard researchers “discounted studies suggesting that reducing sugar consumption could help with coronary heart disease, while overstating the evidence blaming saturated fats.”

If you’re old enough to read this, you probably remember the “low-fat” marketing craze that really took off in the ’90s and hasn’t entirely gone away.

This isn’t to say that fat is a new health food, but it’s hard to deny that the low-fat craze helped lead to the high-carb diets that have contributed to the nation’s — and especially West Virginia’s — obesity crisis, which is taking its own toll, in terms of health and financial costs.

Back in 2008, health care policy expert Ken Thorpe was commissioned to advise the Legislature on how to improve the state’s physical (and ultimately fiscal) health. At the time, he noted that we spent 13 percent more per person on health care than the national average.

He also noted that “Data from the U.S. Centers for Disease Control and Prevention indicate that West Virginia has among the highest rates of childhood and adult obesity in the country. These high rates of obesity are associated with high and rising rates of diabetes, hypertension, hyperlipidemia, heart disease, pulmonary disorders and co-morbid depression.”

In a 2009 report titled “The Future Costs of Obesity,” Thorpe reported that obesity-related diseases cost West Virginia $668 million in 2008, a number he expected to rise to $2.4 billion by 2018 if nothing changed.

It’s hard to get up-to-the-minute data on this, and some progress has been made, but it’s clear the public health threat is still with us.

The death toll hasn’t reached Civil War levels, but damage has been done, and our children have been among the targets. In 2012, nearly one in four West Virginia fifth-graders already had high blood pressure, according to West Virginia University measurements of thousands of children. One in five kindergarteners were coming to school obese and were at risk of type 2 diabetes. Nearly one in three adults were obese. According to Try This West Virginia, a campaign to promote healthy lifestyles, seven out 10 health care dollars were spent on preventable diseases.

Let’s just say that if another country had done this to our kids, we’d be at war.

I’m no purist about this stuff. I’m a former smoker and I consume sugary drinks (although you have to be 21 or older to buy most of them), but let’s face some facts.

Budget crisis or not, imposing a tax on things that kill us might not be a bad idea. Part of the revenue could go to addressing the medical costs these things cause. And if, over time, we consume less of them and suffer less harmful effects ... well ... that would be a good problem to have.

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