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Mitchell H. Katz, MD

JAMA. 2009;302(6):683-685.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The chronic health problems of obesity, diabetes, heart disease, and cancer commonly affect adults living in developed countries and are both difficult to treat and costly, leading experts to stress the importance of prevention.¹ Elimination of the 3 behavioral risk factors of sedentary lifestyle, poor diet, and smoking would decrease mortality by 35%.² But how do we get individuals to exercise more, eat better, and stop smoking?

Health education has been effective in diminishing these risk factors, especially smoking, but education alone is unlikely to bring further progress. In fact, it would be difficult to find a sedentary obese smoker who did not know that he should exercise more, eat less, and stop smoking.

Intensive one-to-one and group behavioral interventions have been demonstrated to increase activity,³ reduce obesity,⁴ and promote smoking cessation,⁵ but effects have been modest and difficult to maintain. Moreover, translating these findings into . . . [Full Text of this Article]

Structural Interventions to Increase Physical Activity, Improve Diet, and Decrease Smoking

Author Affiliation: San Francisco Department of Public Health, San Francisco, California.

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