Kicking the habit

At some point in recent history, America's youth got the message that Marlboros were hazardous, but Doritos were hip.

For all of society's hand-wringing over childhood obesity, the latest studies show the epidemic only getting worse. Since 1980, when potato chips and TV and poverty were just as plentiful, obesity rates among youngsters haven't just swelled. They've tripled.

But smoking has decreased -- to the degree that 80 percent of 10th-graders would rather not even date a smoker, up from 68 percent who told that to University of Michigan pollsters in 1997.

So experts wonder: Could the bold strategies of the anti-tobacco campaign be duplicated in a full-bore, in-your-face mission to get more kids on board with healthy eating and exercise?

One TV ad produced by the New York City health department takes off the gloves when it comes to guzzling sugary sodas. A handsome young

man pops open a can and pours into a glass some goopy, yellow, chunk-filled sludge, representing fat.

An actor downs the drink, which drips down his chin. The screen reads: "Drinking 1 can of soda a day can make you 10 pounds fatter a year."

The ad has more than 500,000 hits on YouTube.

"I don't think we have a choice but to take on obesity," said Lloyd Johnston of the Institute for Social Research at Michigan. But Johnston would advocate a more subtle educational strategy without shaming youths into eating better or getting off the couch.

"There has been a major shift -- a sea change, I'd say -- in attitudes about smoking among kids ... but you're looking at very different problems," he said.

"Unlike cigarettes, people need food to consume, and all of us like tasty food. You can't just say, 'Don't do it.' So the question becomes, what kinds of food should we be letting our kids eat?"

First lady Michelle Obama launched the Let's Move campaign, with a sky-high goal -- "solve the problem of childhood obesity in a generation."

To do that, many said, would require not just tweaking the attitudes of young Americans but educating their parents, taxing soda and fatty foods to price the youngest buyers out of the market, posting warning labels, regulating advertising, and holding companies accountable for the damage their products can do.

All of those tactics were used in the decades-long campaign to change smoking habits.

"I think we follow that same path," said Amy Porter, a pediatrician for Kaiser Permanente. "You don't want to disparage young people for being overweight. ... But we do need to change habits and practices."

An extra-large fit

Advocacy groups took years to convince Hollywood to cut back on smoking in movies and TV, and even today, depictions of cigarette use, such as in the 1950s-60s era drama "Mad Men," drive some crazy.

At one time, the screens were ruled by thin, fit talent -- with the exception of comedy's king, Jackie Gleason, and a small minority of character actors.

Now, the rotund have found a more comfortable extra-large fit. And those "doctors" and rugged "cowboys" who once pitched cigarettes on TV? They've been replaced by athletes advertising McDonald's and Oreos.

In a culture getting beyond making fun of fat folk (partly because there are so many of us), experts acknowledge the trickiness of attacking diet habits that press against other troubles of children and youth -- self-esteem, social acceptance, class, eating disorders.

A new study by Kaiser Permanente finds childhood obesity most prevalent in African-American girls and Latino boys; do we dare address why? Family role models and the low costs of processed foods come into play.

Hollywood capitalizes on America's growing girth with TV programs once unthinkable, with titles such as "More to Love," "Bulging Brides" and "Kirstie Alley's Big Life."

The entertainment media also make obesity the villain in a reality show on racing to slim down: "The Biggest Loser."

But the British reality show "Honey, We're Killing the Kids" is more serious. It uses computer-generated digital images to show parents what their kids may look like as adults if they continue poor dietary and exercise habits.

A new multimedia advertising campaign called "Did You Play Today?" and launched by the U.S. Department of Health and Human Services takes a gentler approach. It uses characters from Maurice Sendak's classic children's story, "Where the Wild Things Are," to try to lead children to healthy lifestyles.

"Kids don't buy the groceries and they don't cook the meals," said Nnedima Anya, a lean freshman at the University of Missouri-Kansas City, sitting with friends in the cafeteria. "They eat what they are used to, and they are used to what their parents serve."

Any campaign to change kids' ways has to focus as much on their parents, they said.

Some argue that not even popular entertainment and hard-hitting ads can change an entire culture of indulgence.

"I'm not sure you can fix this," said Michael F. Jacobson of the Center for Science in the Public Interest, a food-label watchdog. "So much of modern society has caused this obesity -- the automobile culture, the video-game culture, sitting at computers ...

"This epidemic could even be linked to something very insidious that we're not thinking about," he said, such as chemical pollutants, the lining in cans, or fetal conditions for babies born to overweight mothers.

Lessons in smoking

The stop-smoking offensive dates to U.S. surgeon generals' warnings of the 1960s. But even in recent years, Johnston found, the attitudes and behavior of youths changed sharply.

In 1996, when "Joe Camel" strutted cool with a cigarette dangling from his chops, 21 percent of eighth-graders reported smoking. By 2009, their ranks had shrunk nearly 70 percent -- down to 6.5 percent currently smoking.

University of Michigan polling also found a growing aversion, with three out of four 12th-graders calling it "dirty," and nearly half of them said they strongly disliked being near people who smoked.

Public attitudes also were shaped by messages aimed at youths -- on MTV, radio and online -- linking the tobacco industry's products to yellow teeth, bad breath and teens being manipulated for profit.

Putting the black hat on PepsiCo and Sara Lee is not so easy -- nor is it justified, said Anthony Signorelli, who directs good-health campaigns for the nonprofit Ad Council. Practically everyone consumes products from the companies, ranging from whole grain to sugary sweet.

"For us, the message to youths is more about educating them" and stressing the positive, Signorelli said. "Carrots have beta carotene that's good for your eyesight. Bananas have potassium that develop muscles to help you be the fastest runner in your class."

The science behind food advertising and its effect on our waistlines is in its infancy. The University of Illinois at Chicago Institute for Health Research and Policy got a $2.2 million federal grant to see if the food being pitched on television affects children's diet, physical activity and weight.

What the four-year study has to factor out, of course, is the sheer time spent in TV watching, which promotes sedentary habits coupled with snacking while watching.

The government in Great Britain just selected an advertising firm to beat back obesity there. Again, the idea is not to single out and scold the heaviest among us, but to encourage good health for all.

The target audience? Those who fail to link life-shortening disease to diet -- a tactic that experts said ultimately worked in getting teens to lay off cigarettes.

Get the kids moving

The other challenge -- maybe less vexing than changing how children eat -- is getting them up and moving.

Huntington, W.Va., was labeled the fattest, most unhealthy city in the nation. That tag would change after schools partnered with the Konami game company and the Public Employees Insurance Agency to put "Dance Dance Revolution" video games in every elementary and middle school in town. The game debuted nationally in 2001, before Wii, as the gaming industry's response to accusations that video games foster a nation of fat, lazy kids. A million copies had sold in the U.S. by 2003.

"Dance Dance Revolution" allows players to mimic the steps of a boogieing dancer on the video screen. The better a kid gets at stomping on colored arrows on an electronic dance mat, the faster the music and the flashing of the arrows.

West Virginia University researchers found that many students lost weight playing the game. Those who didn't lose weight didn't gain.

UMKC student Jordan Hunt of Independence agreed that economics and the lure of leisure form the root of unhealthy eating: "It is easy and it's extremely cheap."

Hunt, eating alone, filled a cafeteria stool. "I'm overweight," she said, "but I never had any problem. I wasn't the biggest kid in school. I never remember kids saying, 'Don't eat that, it's not healthy.' "

It would help, said Hunt, 24, if school cafeterias and fast-food chains put nutritional facts such as calories and fat content on all they serve.

She saw no lack of effort on society's part to persuade people to trim down: From local billboards urging us to "Eat small," to Nickelodeon taking a daily break from cartoons so kids might play.

But maybe more could be done. "If the media and advertising can make you go to Burger King for a Whopper and fries once a week, every week, your whole life," Hunt said, "it can make you stop, too."