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I personally always use my seatbelt, I don’t smoke, have never done drugs in my entire life, and drink relatively moderately. But I’m also a college educated professional. I think that you underestimate how many of the negative lifestyle choices are correlated to poor future time orientation, and how difficult it will be to change those behaviors without being very heavy handed.

When I say heavy handed, I think of what they’re now proposing to do in England. They want to put closed circuit cameras in the homes of “troubled families” to make sure that they’re not hitting the kids, that the kids are eating healthy, etc. That’s what we’d need to do to really achieve what you’re talking about. It would never fly in the US.

I don’t know if you consider seat belt laws heavy handed. The only serious car accident I’ve been in, I was forced off the road and lost control when I was thrown from the drivers seat — I think I could have kept control if I’d had a seat belt, and have been wearing them every since. I’ve been first on the scene for two fatal accidents and from looking at the cars I believe both drivers would have walked away if they’d been wearing shoulder and seat belts.

On smoking, the public education and taxation to reduce smoking I believe are justified in terms of the cost to society of caring for the sickness that results. I quit smoking after a visit to my first wife’s parents and listening to my father in law coughing his guts out with emphysema. I also know that addictions are by definition irrational. My uncle in Ohio was a coal miner and died of black lung — when he was bedridden and on oxygen he still smoked. Neither of these were stupid men in terms of IQ.

On the other hand, the banning of smoking in bars I think were probably a matter of rights and maybe heavy handed. In Portland smoking had disappeared from most restaurants before any ban, because as most people quit the restaurant owners realized it was better for business to eliminate smoking sections. But in the places that smokers hung out, it was probably their right to be left alone.

The health results of heavy alcohol (legal) and drug use (not) are significant. I’ve had two friends who were heavy long time alcohol and/or drug users who got clean and sober and died young of liver failure anyway. One after a liver transplant that eventually failed.

Unhealthy food is another matter. You can quit smoking or drinking, or never start, but you can’t stop eating. This will need to be a cultural change, as will exercise, rather than legislation.

I’m betting on the good sense of the American people, despite H.L. Menckin. If we’re still on this blog in 10 years, let’s compare notes.

Talking public policy, rather than personal philosophy, you’re never going to get people to adopt your lifestyle without being very heavyhanded.

The fight against smoking, while wrapped in the rhetoric of health, really came down to the rights of one individual (the non-smoker) not to be inconveinanced by another (the smoker). You’re going to have a lot harder time addressing habits that don’t directly negatively effect anyone but the person with the habit.

When it comes down to it, behavioral change happens on a neighborhood, individual and friendship group level. That’s why I was excited about the growth of farmers markets about a month ago.

I don’t think this is something the federal government can mandate. Oprah and the Stewarts (Jon & Martha) could probably have more influence than the entire HHS bureaucracy. Michele’s garden and Barack’s basketball as role models may be more important than any policy statements they could make.

I think we’re looking at this differently. I’m focusing on health and you’re focusing on disease — along with most of Western medicine, so I guess you’re in good company.

I would maintain that overall health and well being is the goal including such things as strength, balance, strong cardio, lung capacity and absence of preventable chronic diseases. In addition the mental, psychological and social benefits of exercise are increasingly recognized. Being fit is a holistic experience, not just the lack of certain diseases or conditions. When it comes right down to it, I don’t just exercise because it’s healthy, I do it because it’s fun and I feel good. We’re designed to be active, it’s the set point of being humans and animals.

That’s number one. Number two is that all drugs have side effects, every one of them right down to aspirin. Once you get on the track of using drugs for conditions you could prevent with healthy behavior, you end up with either new risk factors and/or additional drugs to treat the side effects, ad nauseam (literally). This isn’t to say that I don’t use prescription and over the counter drugs, they have their uses but I try to limit them as much as possible.

I’m sure you’ve noticed that we’re the only two commenters on this post. Maybe nobody else is reading this. Maybe Barack should have us over for a beer to talk this out.

And it won’t be very long after that that those drugs are available over-the-counter for $4 a month at Walmart.

At that time, what will be the point of excercising or any of the other behaviors that you cite?

You know what pill we really need? One that improves future time orientation (maybe by boosting IQ?). Then people wouldn’t smoke, drink excessively, or drive without their seat belts.

Sorry, No it’s not. As the Harvard article says, risk factors such as smoking, alcohol, obesity, high blood pressure and elevated cholesterol are all manageable by behavior, including diet and exercise.
• Smoking is absolutely tied to emphysema, heart disease and lung cancer.
• Heavy alcohol and drug use are absolutely tied to liver damage and disease.
• Weight bearing exercise builds bone density and muscle strength.
• Aerobic exercise builds cardiovascular health and lung capacity.
• Maternal diet, fitness, diet and alcohol & drug use are tied to low birth weights and infant mortality.
• Seat belt use reduces serious injuries and deaths.

Studies back to the ’90’s and beyond show that diet and exercise can reduce heart disease and prolong health.
William Evans Biomarkers studies at Tufts. http://www.amazon.com/Biomarkers-10-Keys…/0671778986
Dean Ornish’s studies on preventing and reversing heart disease. http://www.pmri.org/

A leading cause of injury and death in older people is falling, and the best prevention is good balance and strength, which result from exercise. And the problem with falls is often broken bones, which are less likely with strong bones from… diet and exercise.

I agree with you about the BMI and people’s obsession with weight. It’s healthier to be fit and heavy than unfit and skinny. But I’m not sure there’s such a thing as moderate obesity, as opposed to being moderately “overweight”. I think obesity implies and unhealthy amount of fat and low fitness.