Health Promotion

  • Richard Kent Zimmerman


There are 524,000 excess deaths annually due to nine chronic diseases for which risk factors such as smoking could be modified.1 Five risk factors account for 90% of the potential benefit (in descending order): smoking, obesity, lack of regular exercise, hypercholesterolemia, and hypertension (Fig. 8.1). If the benefits from risk reduction from smoking, cholesterol, obesity, sedentary life style, and heavy alcohol consumption are calculated, life expectancy at birth in the United States would increase by 3.85 years.1 Thus healthy life styles can result in significant gains in longevity.


Nicotine Replacement Therapy Environmental Tobacco Smoke Nicotine Patch Cardiac Risk Factor Recent Myocardial Infarction 
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  1. 1.
    Hahn RA, Teutsch SM, Rothenbert RB, Marks JS. Excess deaths from nine chronic diseases in the United States, 1986. JAMA 1990;264:2654–9.Google Scholar
  2. 2.
    Centers for Disease Control and Prevention. Cigarette smoking-attributable mortality and years of potential life loss-United States, 1990. MMWR 1993;42:645–9.Google Scholar
  3. 3.
    US Preventive Services Task Force: Guide to clinical preventive services. 2nd ed. Baltimore: Williams & Wilkins, 1996.Google Scholar
  4. 4.
    Hodgson TA. Cigarette smoking and lifetime medical expenditures. Milbank Q 1992;70:81–125.PubMedCrossRefGoogle Scholar
  5. 5.
    Stockwell HG, Goldman AL, Lyman GH, et al. Environmental tobacco smoke and lung cancer risk in nonsmoking women. J Natl Cancer Instit 1992;84:1417–1422.CrossRefGoogle Scholar
  6. 6.
    Centers for Disease Control and Prevention. Cigarette smoking among adults—United States, 1992, and changes in the definition of current cigarette smoking. MMWR 1994;43: 342–6.Google Scholar
  7. 7.
    Fiore MC, Jorenby DE, Baker TB, Kenford SL. Tobacco dependence and the nicotine patch: clinical guidelines for effective use. JAMA 1992;268:2687–94.PubMedCrossRefGoogle Scholar
  8. 8.
    Glynn TJ, Manley MW. How to help your patients stop smoking: a National Cancer Institute manual for physicians. Bethesda: National Institutes of Health, 1989. US DHHS/NIH Publ 89–3064.Google Scholar
  9. 9.
    Bruvold WH. A meta-analysis of adolescent smoking prevention programs. Am J Public Health 1993;83:872–80.PubMedCrossRefGoogle Scholar
  10. 10.
    Fiore MC, Novotny TE, Pierce JP, et al. Methods used to quit smoking in the United States: do cessation programs help? JAMA 1990;263:2760–5.PubMedCrossRefGoogle Scholar
  11. 11.
    Cummings SR, Rubin SM, Oster G. The cost-effectiveness of counseling smokers to quit. JAMA 1989;261:75–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Kottke TE, Battista RN, DeFriese GH, Brekke ML. Attributes of successful smoking cessation interventions in medical practice: a meta-analysis of 39 controlled trials. JAMA 1988; 259:2882–9.CrossRefGoogle Scholar
  13. 13.
    Oster G, Huse DM, Delea TE, Colditz GA. Cost-effectiveness of nicotine gum as an adjunct to physician’s advice against cigarette smoking. JAMA 1986;356:1315–18.CrossRefGoogle Scholar
  14. 14.
    Silagy C, Mant D, Fowler G, Lodge M. Meta-analysis on efficacy of nicotine replacement therapies in smoking cessation. Lancet 1994;343:139–42.PubMedCrossRefGoogle Scholar
  15. 15.
    Tang JL, Law M, Wald N. How effective is nicotine replacement therapy in helping people to stop smoking? BMJ 1994; 308:21–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Glynn Tf, Manley MW. How to help your patients stop smoking: a National Cancer Institute manual for physicians. Bethesda: National Institutes of Health, 1995. US DHHS/NIH Publ 95–3064.Google Scholar
  17. 17.
    Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW Physical fitness and all-cause mortality: a prospective study of healthy men and women. JAMA 1989;262: 2395–401.PubMedCrossRefGoogle Scholar
  18. 18.
    Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. Am J Epidemiol 1990;132:612–28.PubMedGoogle Scholar
  19. 19.
    Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS. Physical activity and reduced occurrences of non-insulin-dependent diabetes mellitus. N Engl J Med 1991;325:147–52.PubMedCrossRefGoogle Scholar
  20. 20.
    Paffenbarger RS, Hyde RT, Wing AL, Lee I, Jung DL, Kampert JB. The association of changes in physical activity level and other lifestyle characteristics with mortality among men. N Engl J Med 1993;328:538–45.PubMedCrossRefGoogle Scholar
  21. 21.
    Blair SN, Kohl HW, Barlow CE, Paffenbarger RS, Gibbons LW, Macera CA. Changes in physical fitness and all-cause mortality: a prospective study of healthy and unhealthy men. JAMA 1995;273:1093–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Steptoe A, Edwards S, Moses J, Mathews A. The effect of exercise training on mood and perceived coping ability in anxious adults from the general population. J Psychosom Res 1989;33:537–47.PubMedCrossRefGoogle Scholar
  23. 23.
    Moses J, Steptow A, Mathews A, Edwards S. The effects of exercise training on mental well-being in the normal population: a controlled trial. J Psychosom Res 1989;33:47–61.PubMedCrossRefGoogle Scholar
  24. 24.
    Pollock ML, Carroll JF Injuries and adherence to walk/job and resistance training programs in the elderly. Med Sci Sports Exerc 1991;23:1194–1200.PubMedGoogle Scholar
  25. 25.
    Lane NE, Michel B, Bjorkengren A, et al. The risk of osteoarthritis with running and age: a 5-year longitudinal study. J Rheumatol 1993;20:461–8.PubMedGoogle Scholar
  26. 26.
    Centers for Disease Control and Prevention. Public health focus: physical activity and the prevention of coronary heart disease. MMWR 1993;42:669–72.Google Scholar
  27. 27.
    Lewis B, Lynch W. The effect of physician advice on exercise behavior. Prev Med 1993;22:110–21.PubMedCrossRefGoogle Scholar
  28. 28.
    Logsdon DN, Lazaro CM, Meier RV. The feasibility of behavioral risk reduction in primary medical care. Am J Prev Med 1989;5:249–56.PubMedGoogle Scholar
  29. 29.
    Pate RR, Pratt M, Blair SN, et al. Physical activity and public health: a recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 1995;273:402–7.PubMedCrossRefGoogle Scholar
  30. 30.
    DeBusk RF, Stenestrand U, Sheehan M, Haskell WL. Training effects of long versus short bouts of exercise in healthy subjects. Am J Cardiol 1990;65:1010–3.PubMedCrossRefGoogle Scholar
  31. 31.
    Lee I, Hsieh C, Paffenbarger RS. Exercise intensity and longevity in men: the Harvard alumni health study. JAMA 1995;273:1179–84.PubMedCrossRefGoogle Scholar
  32. 32.
    Browner WS, Westerhouse J, Tice JA. What if Americans ate less fat? A quantitative estimate of the effect on mortality. JAMA 1991;265:3285–91.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1998

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  • Richard Kent Zimmerman

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