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Tackling smoking, childhood obesity and back pain: it’s not for want of trying

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Humans are complex beings, and few of even our simplest actions are entirely rational. The more of us there are, the more unpredictable things get. It’s not entirely unexpected then that evidence on how to tackle complex health conditions, particularly at the population level, has been limited and simple solutions elusive. A recent crop of Cochrane reviews shows mixed results.

Let’s start with good news. Reducing exposure to second-hand smoke through legislation banning smoking in public and work places has been commonplace in Australia for many years. It’s reassuring then that a review of 77 studies from 21 countries demonstrated consistent evidence of a positive impact of these laws, especially on improving cardiovascular health outcomes and reducing mortality from smoking-related illnesses. However, the evidence was less consistent for respiratory and perinatal health, and for smoking prevalence and tobacco consumption (doi: 10.1002/14651858.CD005992.pub3).

Tackling childhood obesity is a huge challenge, even more so when many parents struggle with their own weight. Might interventions directed at helping parents change their family’s diet and lifestyle have an impact on their children’s weight? The evidence from a review of 20 wide-ranging studies is not especially encouraging. Diet, physical activity and behavioural treatments…