Is drinking a soda as bad or more harmful than smoking a cigarette?

Question

The claim is easy to find on google, but here are a few specific examples (emphasis added):

Soda, which is loaded with sugar primarily in the form of high fructose corn syrup, is a leading contributor to the rising rates of obesity, diabetes, heart disease and other chronic diseases facing Americans.

So when I say that drinking a can of soda is just as bad for you as smoking a cigarette (and maybe even worse) it is not an exaggeration.

Source: here and here.

Also:

Research on the health effects of drinking soda have been popping up everywhere in past few years. Some even claim that drinking soda could be as dangerous to our health as smoking cigarettes. Is soda the new cigarette?

Source

Subtitle of this article:

The Case Against Soda

Why the sweet stuff might be as bad for your health as smoking or drinking excessive alcohol.

And the title of this article:

Drinking Soda Is Now as Bad as Smoking

It appears to me that the first links are looking at aggregate statistics, and from this drawing the conclusion that the overall harm to our society's health is greater from sodas than from smoking. I am willing to accept that this may indeed be true. But the articles all appear to be making a much different claim, that:

On an individual basis, or perhaps on a per-serving basis, drinking a soda is more harmful than smoking a cigarette.

Is there any validity in this claim?

Considering that the types of harm inflicted by each substance is different, I'm open to suggestions on how to best compare the two. Two proxies I can imagine for comparing the two might be:

1. Given a habitual smoker who smokes N cigarettes per day, compared to a soda drinker who also consumes N fizzy drinks per day, who is likely to have the higher medical bills from chronic disease?

2. Drinking N sodas reduces a person's life expectancy by an amount equal or greater than the smoking of N cigarettes.

Answer 1

The claim 'drinking a can of soda is just as bad for you as smoking a cigarette' can be denied on two factors mentioned below.

1. A study researching dietary patterns, food groups, and telomere length in the Multi-Ethnic Study of Atherosclerosis (MESA) in 2008 found no connection between sugar-sweetened soda and telomere length (i.e. shorter telomeres). This can mean that decrease of telomere length which is a useful biomarker of lifetime exposure to environmental and biological stressors and a major factor of study in the claim is not related to soda consumption.

Of all the food groups studied, only processed meat intake was significantly associated with telomere length after multivariable adjustment, including adjustment for other food groups. Neither the dietary pattern for fats and processed meat nor the dietary pattern for whole grains and fruit was significantly associated with telomere length after adjustment for demographic and lifestyle factors. Additional adjustment for BMI did not change these results. Adjustment for gross family income or more refined categories of educational status [proxies for socioeconomic status (SES)] also did not change these results.

Conclusions: Processed meat intake showed an expected inverse association with telomere length, but other diet features did not show their expected associations.

2. Smoking-attributable mortality is high when compared to obesity associated deaths in a large population which is seen by the following example in USA. "Approximately one-half of the population aged 2 and older consumes sugar drinks on any given day. Studies in children and adults have found that reducing sugary drink consumption can lead to better weight control" among those who are initially overweight. "An estimated 42.1 million adults in the United States currently smoke cigarettes and an estimated 3,000 kids each day under the age of 18 try their first cigarette and another 700 become regular, daily smokers".

These numbers reflect that tobacco use is far worse than consumption of soda in terms of deaths i.e. the population in the U.S. consumes more sugary beverages than smoke cigarettes, yet 440,000 people die every year from tobacco use compared with just 112,000 from obesity.

Per Daniel Engber of Slate, "drinking a soda a day is not nearly as bad as smoking a pack a day. The paper doesn’t show that the long-term health effects of soda and tobacco are comparable and tobacco is far, far worse than soda. We know (or think we know) that soft drinks are a deadly vice and that they send a toxic dose of sugar straight into our veins. The authors push the story further, saying that soda doesn’t only make us sick, it “ages our cells.” And if that’s what soda does, with all its lethal sugar, then “cellular aging” must be something real—a valid measure of our inner rot".

Researchers from the University of California, San Francisco, took five years studying a sample of 5309 US adults aged 20 to 65 years, with no history of diabetes or cardiovascular disease by a national health survey conducted between 1999 and 2002 comparing extrapolated habits from interviews to their measurements of telomeres to reach the conclusion that soda drinkers had shorter telomeres than non-soda drinkers. A similar study correlating shortened telomeres to processed meat, published in 2008, found no connection whatsoever between carbonated-soda intake and cellular aging.

The conclusions of Blackburn, Epel, Lin, Cindy Leung and other collaborators were "regular consumption of sugar-sweetened sodas might influence metabolic disease development through accelerated cell aging". However, as the researchers noted, "association does not demonstrate causation" as they "only compared telomere length and sugar-sweetened soda consumption for each participant at a single time point."

Research into cellular aging is based on the fact that a cell’s chromosomes are capped at either ends with telomeres. "Telomeres are complex structures made up of nucleic acid and protein, located at the ends of chromosomes where they provide a protective cap and maintain the integrity of the genome. Telomeric DNA is gradually lost each time a cell divides, until the length of any given telomere reaches a critical level that triggers cell senescence and death. Average telomere length measured in peripheral blood cells decreases as humans age. Certain enzymes work in the opposite direction that they help rebuild the telomeres and slow that aging down and hence research states telomere length erosion may be a potentially useful biomarker of lifetime exposure to environmental and biological stressors."

A 2010 review of 10 studies of telomere length and early death showed that five studies found no relationship between shortened telomeres and increased risk of mortality. "Different groups also tried and failed to link the length of telomeres with patients’ blood pressure, lung function, and grip strength (an indicator of overall health). More research led to more confusion as some studies did find that shorter telomeres predicted cognitive impairment—cellular aging might predispose to dementia, for example but other analyses found the opposite."

According to a summary of the field from 2013, it is certain that telomeres get shorter with age and the only proven correlations across research are with age, gender, and race. A study published in 2014 found no evidence of a relationship between telomere length and life stressors.

Answer 2

The BMJ says that even one to four ciggies a day almost triples your heart disease risk, and adds 50% to your chance of dying of anything (not sure exactly how express that correctly!).

For being obese, the West Virginia Health Statistic Center says that obesity increased cardiovascular death risk by a factor of almost three, and overall the "relative risk (RR) was 2.68 among men and 1.89 among women."

So, that would suggest that obesity is more dangerous than light smoking. To tie up to the drinking soda risk, this paper's abstract says that "A 1% rise in soft drink consumption was associated with an additional 4.8 overweight adults per 100 (adjusted B; 95% confidence interval [CI] = 3.1, 6.5) [and] 2.3 obese adults per 100".

I think that overall the evidence suggests that obesity is worse than light smoking, and consumption of soda (or other empty calories) contributes significantly to obesity.

Answer 3

A huge amount of sugar is often much worse for your health than cigarettes. This is especially true if you are not exercising and it is exacerbated by the quantity. A host of disorders can result, from low nutrition to diabetes and their resulting disorders. However, if you consume it healthily, smoking cigarettes is usually worse. The biggest threats from cigarettes are physical irritation, which can be damaging, and the introduction of free radicals. Both of these can be mitigated to some extent by being aware of irritation and damage to health and doing what you can to avoid them (dry vocal cords with no coating are more easily damaged and making sure to consume a healthy supply of antioxidants -- along with being healthy in general -- generally prevents cancer).

Sources:

Smoking and free radicals: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1568603/

I didn't find a study on whether smoking causes irritation, but here's some evidence from a medical institute: http://www.upmc.com/patients-visitors/education/breathing/pages/smoking-and-lungs.aspx

In regards to whether smoking causes irritation, I think the question is absurdly incontrovertible and no one would fund such a childish experiment (although you can be the first).

Also, some may not know of any connection between diabetes and sugar consumption. Here's a layman's article:

http://www.ucsf.edu/news/2013/02/13591/quantity-sugar-food-supply-linked-diabetes-rates

Diabetes is characterized by irregular insulin levels, and associated with insulin resistance.

http://care.diabetesjournals.org/content/33/Supplement_1/S62.full http://www.ncbi.nlm.nih.gov/pubmed/11172473

About sugar and insulin:

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7244 (layman's article)

Background information for those wishing to learn about insulin

http://health.howstuffworks.com/diseases-conditions/diabetes/diabetes1.htm

Here's a source that gives a general overview of anti-oxidants and cancer:

http://cancer.stanford.edu/information/nutritionAndCancer/reduceRisk/

However, interestingly, I found that the opposite may also be true:

http://www.the-scientist.com/?articles.view/articleNo/39022/title/Antioxidants-Speed-Up-Lung-Cancer/

I think the general consensus is that by reducing free-radicals (via anti-oxidants or other methods if they achieve the same result), then fewer cells will become cancerous (often attributed to cell damage, sources following).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1850635/ http://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer http://www.cancer.org/cancer/cancerbasics/what-is-cancer

Answer 4

No of course not, don't be silly.

A cigarette does immediate damage, and is very addictive. Most people are addicted after their very first smoke, so a cigarette is inevitably followed by more.

A soda on the other hand is only harmful insofar as that it can contribute to obesity. But a single soda won't make you obese and many people who drink soda are not obese.

The main differences are:

• Smoking damage is immediate, sugar only becomes a problem when your intake is too high.
• Smoking damage cannot be counteracted, sugar can be counteracted by exercise or compensated for.
• Cigarettes are extremely addictive, sodas aren't for most people. (There are cases of people having a food or sweets addiction, but those are not the norm.)

My personal advice is to limit sodas to social occasions and stick to tea, fruit juice and other normal drinks in daily life.