Sitting Is as Bad for You as Smoking? Not Even Close!

by Chris Centeno, MD /

which is worse sitting vs smoking

Is sitting the new smoking? You've likely seen the news articles proclaiming that the biggest health risk we face is sitting too much. We even bought stand-up desks for all of our doctors because it seemed to be the right thing to do. So what does the research say?

A Few Things We Know About Smoking

It seems there is nothing in our body that smoking doesn’t impact. Focusing all the way down to the cellular level, even our stem cells (our body’s repairmen) aren’t safe from the effects of smoking. Studies have shown that smoking can disrupt the function of stem cells as well as reduce the numbers of circulating stem cells. There are also the diseases well known to be caused by smoking: lung cancer, throat cancer, heart disease, emphysema, and so on. In pregnancy, smoking is associated with stillbirth, miscarriage, premature birth, ectopic pregnancy, and much more. It doesn’t stop here. Lesser known smoking related health conditions include chronic low back pain, which smokers are three times more likely to suffer, and smoking is also associated with increased complications following knee or hip replacements.

In the United States, not smoking is said to be the most preventable cause of death. In the past few years, however, hundreds of news articles have pushed sitting as the new smoking. So is sitting as bad for you as smoking? Not even close according to a new study…  

Direct Comparisons Shouldn’t Be Made Between Sitting and Smoking

The purpose of the new study was to investigate a variety of study sources to determine if sitting really is as detrimental to health as smoking. Researchers shared and explained evidence showing that those who sit long periods of time (>8 hours per day) are at a 10–20% increased risk of death from any cause or an increased risk of chronic diseases, such as type 2 diabetes, when compared with those who are not sedentary; however, just the risk of death from any cause due to smoking is increased by 180% when compared with those who do not smoke.

Comparing smoking and sitting is misleading according to researchers as smoking is a chemical addiction that has led to a major public health disaster—sitting, or a sedentary lifestyle, is simply a behavioral habit and doesn’t even register on the same health-destruction scale as a smoking addiction. Forcing comparisons between the two is minimizing the focus on the dangers of smoking by shifting it to sitting and irresponsibly claiming it is just as bad. The study pointed out that news reporting these forced comparisons has drastically increased since 2012.

Sitting is Bad, Just Not as Deadly as Smoking

The most likely purpose of the standard “sitting is the new smoking” plug found in hundreds of news articles is to put enough fear into those who are sedentary to inspire them to get up and start moving—I don’t want to be as unhealthy as a smoker. In this respect, despite the fact that, as the new study shows, it’s not true, it may actually be effective at getting some who are sedentary off the couch. However, for smokers, it may have a reverse effect—I’m no worse off as a smoker than a nonsmoker who doesn’t exercise.

The study isn’t suggesting a spotlight shouldn’t be shined on sitting and a sedentary lifestyle; it’s just suggesting we don’t dim the brighter spotlight on smoking in the process. There are many reasons we should all eschew a sedentary lifestyle; it seems, however, that claiming it’s as bad as smoking just isn’t one of them. However, over the years, I’ve covered many reasons we should minimize sitting and maximize activity.

With most of us spending so much time at our computers and on our electronic devices nowadays, not just at the office but also at home, we’re doing a lot of sitting. One study found that regular exercise reduces the adverse effects to our health due to all that screen time, lowering the risk of cancer, heart disease, and other major diseases.

Those who sit a lot also are at a greater risk for obesity; add to that a genetic predisposition for obesity, and it’s the perfect storm for metabolic disorders, such as diabetes, heart disease, and much more. Again, exercise, along with healthier food choices, can come to the rescue here as one study found exercise may keep those obesity genes from taking over.

If you find yourself reaching middle age having lived a mostly sedentary lifestyle, it’s not too late. Trading in your couch for a treadmill and sticking with a good exercise routine has heart benefits even if you don’t start until middle age or later.

The upshot? So if you sit a bit too much, a New Year's resolution should be to be more active. As a comparison, smoking is like taking a nuclear bomb to your health, whereas sitting is simply a hand grenade. So should you buy that standing desk? I kind of like mine, but I guess it's not going to make me nearly as healthy as I thought!

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Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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