07/08/2010 01:05 pm ET Updated May 25, 2011

Gluttony is the Moral Equivalent of Smoking

When I was a young man, smoking was a choice. It was simple, like wearing brown shoes or black shoes. Some people smoked and others did not. It was just a preference without any deep implications.

On Father's Day, my brother and I, both terribly unoriginal, would give my dad a cartoon of cigarettes. Of course we loved him, but in those days, we didn't know better. We never realized that our gift encouraged a dangerous and potentially fatal habit. My father died years later of a heart attack. Thinking back now, I can only hope that our well-intentioned gifts did not substantially contribute to his death.

Times are different and I could never imagine anyone today giving cigarettes as a present to a loved one. Values have changed as well, not just in regard to smoking, but also in other areas of human behavior. I remember, for example, when hearing that someone had driven his car while intoxicated would result in only a disapproving chuckle. Now, if we find out that someone has driven his car while intoxicated, most of us would view that person as irresponsible, foolhardy and immoral. A generation ago, children were routinely left to bounce around in the back seat of moving cars. Today, of course, car seats and seat belts are universally used to ensure safety for these children in case of accidents -- not only because they are required by law -- but because their use is now viewed as the right thing to do. Those who fail to secure their children safely in their car, even if not ticketed, are regarded with universal reproach.

It is not amazing that values and morals are constantly evolving. They have always done so and the position that is held by smokers in American society blatantly reflects those changes. Many of us, including me, would consider offering someone a cigarette as an unkind and, yes, immoral deed. The act of smoking is costly and self-destructive that not only damages the smoker, but damages society at large. The public, in response, has succeeded in banishing smokers from most buildings, restaurants, and even bars and has restricted them to designated "smoking areas." Smokers are forced to leave their places of employment and go outside, even on cold winter days, to practice their unhealthy habits. No one, no matter how accepting and open minded he might be, comes to the defense of smokers. Times sure have changed from the days of the heroic Marlboro man. The effect of all this pressure is actually good with fewer people now choosing to smoke and fewer people dying from the complications of tobacco use. The tough approach seems to be working.

Today, we are witnessing yet another change in the evolving moral values of society, one that has to do with eating.

On a recent weekend, I was on call at our local hospital. One of my colleagues, a very over-weight physician, was also on call. Now anyone who has read a newspaper in the past two years is aware that America is suffering from an epidemic of obesity, a condition that causes heart disease, cancer, diabetes, arthritis, depression, and lung disease and can decrease life expectancy by 16 years. Obesity has replaced cigarette smoking as our number one public health hazard!

Well, my colleague has the custom of bringing boxes of sweet pastries to the nurses at each nursing station. (As you might imagine, he is also one of the most popular doctors with the nursing staff.) While I watched the nurses eagerly munching on cherry tarts and cinnamon buns, I had a revelation. I realized that in my mind bringing chubby nurses pastries was the same as bringing boxes of cigarettes to asthmatics! It was an act that reinforced harmful and potentially dangerous behavior. Promoting unhealthy eating, and the diseases that result from it, can undo all the advances that medical science has accomplished over the past generation. The country, aware of the threat, is striking back. Public sentiment and morality has changed and governmental policy is following that lead. The first lady, Michele Obama, has sponsored a program called "Let's Move" to combat childhood obesity. Municipalities are taxing unhealthful foods and food labels are being modified to disclose more completely food content. It is a battle that needs to be fought, one cheeseburger at a time. Perhaps it is time to restrict the eating of donuts and soda to certain designated areas in large buildings, like smoking areas. They could be termed, instead, "High Caloric Areas." The war must be waged! For what cigarette smoking was to the last generation, obesity is to this generation. Gluttony has now become the moral equivalent of smoking.

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