Are There Public Health Lessons That Can Be Used to Help Prevent Childhood Obesity?

In keeping with our increasing emphasis on thematic issues of pressing public health importance, I am pleased that this issue of Health Education Research is devoted to the topic of childhood obesity, and I sincerely thank Associate Editor Jenny O'Dea for spearheading this timely effort. Increasing rates of childhood overweight and obesity have rapidly spread throughout the world, starting in developed countries, like the United States, and now beginning to be observed in the developing world as well. In fact, some developing countries are being confronted with the double burden of malnutrition or undernutrition in some segments of the population and obesity or over-nutrition elsewhere. The obesity epidemic has taken center stage, usurping tobacco as the global cause celebre on the front page of the global media, and even sparking a lively debate in the United States whether and when obesity would surpass smoking as the leading cause of death. Because the study of obesity as a public health problem appears destined to be intertwined with the study of tobacco, it is useful to consider two related issues. First, what can be learned from the efforts to reduce tobacco use and do these lessons have relevance for the prevention of childhood obesity? Second, but more broadly, how can we do more to increase the generalizability or external validity of our research efforts so as to know better if and when certain approaches can be extended to multiple public health problems? There has been substantial scholarship on the applicability of potential public health lessons, particularly from tobacco control, to the prevention of childhood obesity. This research has focused on the major types of tobacco control interventions and commented on the potential relevance or general-izability to obesity prevention, with, in my opinion, no clear consensus as to effectiveness or feasibility. Most would agree that the hallmarks of contemporary tobacco control include intervention strategies such as normative change of the social acceptability of tobacco use, tax increases, marketing restrictions and countermarketing, prevention and cessation services, policy and legislative actions, litigation and most recently the first-of-its-kind global treaty. This heavy emphasis on policy interventions has not always been the case, with the early years of tobacco control focused on clinical and small-group interventions. These individually focused interventions were supplanted with a greater emphasis on population efforts, partly due to the increasing advocacy for social change driven by the non-smokers rights movement and partially driven …