environment receptive to increases in public involvement and support for public policies to reduce the harm caused by alcohol-impaired driving (DeJong and Hingson, 1998; Shults et al., 2001). The popularity of designated drivers, minimum legal drinking age, blood alcohol concentration laws, community traffic safety programs, and other interventions are a direct result of changing social norms. The desire of nonsmokers to be protected from exposure to secondhand smoke is a critical element in changing the tobacco control environment and how smoking is perceived in society. As a result of nonsmokers’ rights advocacy, most workplaces are smoke-free, serum cotinine levels have been reduced by nearly 75 percent in the last decade (CDC, 2003), and the social norms associated with smoking have been permanently changed. It is not clear, however, that the prevention of childhood obesity has a dimension that can serve as a parallel to nonsmokers’ exposure to secondhand smoke.

There are a number of possible ways to engage the interest and involvement of society in the issue of childhood obesity in a similar way that it has been secured by other public health problems. One way, which is already happening, is the increasing public concern about the magnitude of the problem and the need for collective action. Given the rapid increase in the prevalence of childhood obesity, the “visibility” of the problem, and the seriousness of the problem for the affected individuals, social and normative change is already beginning to occur. Further, the social costs of obesity that are being borne by society as a whole, suggest the appropriateness of collective and policy interventions.

One of the biggest changes in the social environment for tobacco control is that some tobacco companies are beginning to acknowledge that their products are harmful and addicting. Despite the decades of scientific evidence on the adverse health effects of tobacco use, tobacco companies, primarily for legal reasons, have denied the harm and addictiveness of tobacco products. As a result of the MSA, tobacco companies have begun to become more candid about the harm caused by their products, both in public statements and on their websites. But the level of candor is not consistent among all companies, nor is it consistent in all instances, especially in litigation, where companies tend to continue to deny that their product contributed to the harm claimed by the plaintiff.

At this point in time, it is not clear how the food industry will respond to social and public health pressures to limit marketing of unhealthful products to children and to assume at least partial responsibility for the epidemic of childhood obesity in this country and around the world (Daynard, 2003). However, some change has already begun, with companies such as Kraft announcing changes in portion size and fat content in some of the products most popular with children. Like tobacco companies, it is likely that the food industry will not respond monolithically. Instead



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