Cigarettes used to be normal.

They were ubiquitous, cheap, and easy to get. They offered no benefit other than a temporary pleasurable sensation. Most folks probably knew they weren’t that healthy, but didn’t question their normalcy, or ubiquity.

These days, sodas are normal. They are ubiquitous, cheap, and easy to get. They offer no benefit other than a temporary pleasurable sensation. Most folks probably know that sodas are unhealthy, but few question their normalcy or ubiquity.

Today, the evidence is clear: smoking too many cigarettes can lead to life-threatening illnesses.

Today, the evidence is clear: drinking too many sugar-sweetened beverages can lead to life-threatening illnesses.

In the last several decades, as we recognize more and more the role our food environment has had in the rise of obesity and its associated health problems, the practices of the food industry have been under increasing scrutiny, and its actions have earned it comparisons to the tobacco industry.

“There are, of course, differences between food and tobacco as substances.” As Kelly Brownell pointed out in a 2009 paper published in The Milbank Quarterly: “The most obvious is that humans must eat to maintain health and life, whereas the unnecessary activity of smoking is, in the words of former Secretary of Health, Education and Welfare Joseph Califano, ‘slow-motion suicide.’”

But, despite these differences, wrote Brownell, “There are significant similarities in the actions that these industries have taken in response to concern that their products cause harm.”

Sodas are not nearly as deadly as cigarettes, but just because an M-80 is not as explosive as a stick of dynamite doesn’t mean you would let it go off in your hand. And unlike other food products, one can’t argue that humans must drink sweetened beverages to maintain health and life. So comparing them to cigarettes is not much of a stretch, especially when you start to examine the behaviors of the tobacco and soda industries side-by-side.

A report released in the late 90s by the London-based Action on Smoking and Health (ASH) detailed the history of the tobacco industry’s decades-long deceit, referencing leaked industry documents and testimonies of whistleblowers. Despite knowing about the addictive properties and the health threats of its products, the tobacco industry engaged in a systematic campaign to deflect responsibility and to obfuscate the science, even while internally discussing potential business opportunities by creating “safe cigarettes,” thus the eventual development of filters, and “light,” and “low-tar” cigarettes. The beverage industry has followed suit. While denying the links between obesity, poor health and soda consumption, we have seen an increase in offerings of diet, low-calorie and low-sugar beverages.

Even while decrying their reputation as a significant driver of obesity, soda companies love to tout their work in reducing obesity, specifically by promoting physical activity but also by reducing the number of sugar calories in the American diet. So which is it? If sugary beverages have not been a significant driver of obesity in America, why has the beverage industry been reducing the amount of sugar in its products?

The American Beverage Association often points people to their “Let’s Clear it Up” website, which it says is “dedicated to presenting information and separating fact from fiction.” Here’s an example of the ABA “clearing it up”:

“MYTH: The obesity epidemic can be reversed if people stop drinking soda.

FACT: Sugar-sweetened beverages account for only 7 percent of calories in the average American’s diet, according to government data.”

There are a few things to tease out here.

First, no responsible health professional or organization claims that ending soda consumption will reverse the obesity epidemic. But most agree that sugary beverages are a major contributor to the obesity epidemic, and recommend a variety of ways to reduce their consumption. Such is the stance of groups like the World Health Organization, the Centers for Disease Control and Prevention, and The Harvard T.H. Chan School of Public Health.

Dr. David Katz I think is responsible for this sandbag analogy—no one would argue that any one sand bag would stop a flood, but all of the sandbags are vitally important. It only takes one missing in the wrong place for the wall to be breached. So it is with obesity. With many causes, we need many solutions. But we also need to be strategic, and identifying the most powerful drivers of obesity and addressing those is the logical first step. It would be irresponsible to ignore sugary beverage consumption as an important target in the fight against rising obesity rates.

Also, 7 percent is no small deal. In a release posted last week, the World Health Organization stated that “nutritionally, people don’t need any sugar in their diet. WHO recommends that if people do consume free sugars, they keep their intake below 10 percent of their total energy needs, and reduce it to less than 5 percent for additional health benefits.”

Though lower than the 10 percent maximum that WHO recommends, that 7 percent represents only calories from sweetened beverages, not from all sources of added sugar. In 2008, the average intake from added sugars represented nearly 15 percent of the caloric intake of a representative cross-section of U.S. residents. So most people are already not meeting the sugar intake recommendations, and if they want to meet them, eliminating liquid calories is a great place to start.  

This is only one example of the many “myths” “debunked” by the beverage industry, but those are just its more overt PR attempts to manipulate understanding of its product’s role in Americans’ poor health. Less obvious are tactics it uses to win the public’s good graces through philanthropic activities, otherwise known as “Corporate Social Responsibility” (CSR) campaigns.

A 2012 paper published in PLOS Medicine compared the tobacco and beverage industries’ CSR tactics, and found striking similarities.  “Soda CSR campaigns echo tobacco CSR in their focus on the consumer and in their likely intent to thwart regulation.”

But the influence reaches beyond public perception and into the realms of science and public policy. More recently, the New York Times and Washington Post  have reported on revelations about the sugar and soda industries’ efforts to compromise health professionals starting as early as the 60s.

In an email, Andy Bellatti, strategic director of Dietitians for Professional Integrity wrote: “Industry sponsorship of health organizations is a well-documented public relations strategy to deflect concerns, give an appearance of "being part of the solution", and silence potential criticism. Despite the appearance of supporting public health, industry spends millions of dollars--and puts significant political muscle into --fighting health policies that ultimately threaten its bottom line.”

Indeed, just this week Vox’s Julia Belluz reported a more than $30 million expenditure by the American Beverage Association to kill soda tax ballot measures in four U.S. Cities. Early evidence suggests those taxes would decrease soda consumption.

The public health group Ninjas for Health just called out the beverage industry for paying dietitians to post tweets opposing soda taxes. 

I reported last year on an effort by the beverage industry to influence America’s Mayors by offering grants for community health programs. (Guess how many of those programs involved reducing sugary beverages?)

These are just some of the more recent developments. There is enough evidence of beverage industry influence to fill a rather thick book—“Soda Politics,” by food policy expert Marion Nestle--that describes an industry that will do anything, say anything, to avoid being held accountable for the harm its products cause.

The revelations keep coming, and they reveal a pattern.

Which begs the question: If the actions of soda industry so mimic the actions of the tobacco industry, will their fates similarly align? In another 10 or 20 years, how normal will drinking sugar still be?