In Depth

Is sitting down the new smoking?

Research suggests that sedentary lifestyles cost the NHS around £700m a year, increasing the risk of chronic health problems

Spending too much time sitting down may contribute to tens of thousands of deaths a year in the UK, according to new research. The findings have prompted some experts to compare the negative effects of a sedentary lifestyle to those of smoking.

Teams of researchers at Queen’s University and Ulster University in Belfast found that sedentary lifestyles could be linked to almost 70,000 of the deaths in Britain at an annual cost of £700m to the NHS.

In recent years, the number of health conditions associated with prolonged periods of sitting has made for “uncomfortable reading”, the Daily Mail says. These include cardiovascular disease, type 2 diabetes, certain forms of cancer (such as lung cancer) and premature death from all causes.

The newspaper says that sitting seems to have such a negative impact on our health “that some have dubbed it the new smoking”.

But not everyone is convinced by this comparison. A late 2018 study published in the American Journal of Public Health says that although sitting “has frequently been equated with smoking, with some sources even suggesting that smoking is safer than sitting”, sitting and smoking are “not comparable”.

How inactive are we and why is sitting down so bad?

According to the NHS, many adults in the UK “spend more than seven hours a day sitting or lying [down], and this typically increases with age to 10 hours or more”.

The health service warns that spending this much time sitting down increases the risk of cardiovascular disease, type 2 diabetes, cancer and other forms of premature death.

In the study published this week, the researchers took into account factors including people’s smoking status, body mass index (BMI) and exercise.

They argued that if sedentary behaviour was eliminated in the UK, 9% of cases of colon cancer, 8% of endometrial cancer and 7.5% of lung cancer could be prevented, as well as 17% of cases of type 2 diabetes and about 5% of cardiovascular disease cases, The Guardian reports.

According to previous research, prolonged sitting leads to raised cholesterol, causing heart problems. It also increases the risk of diabetes by changing the behaviour of insulin, a hormone that keeps blood sugar levels within the normal range by absorbing excess sugar in cells.

Research suggests that prolonged sitting “reduces the activity of some of the enzymes responsible for this kind of clear up”, the Daily Mail says, “leaving more fats and sugar circulating in the blood”.

Sitting for long periods of time can also spark musculoskeletal disorders and mental health conditions that are not included in the Belfast study, says the newspaper.

Dr Mike Brannan of Public Health England says: “Even if you are physically active, sitting for long periods of time damages your health and greatly increases your risks of a broad range of health conditions.”

Is there a case for comparing sitting to smoking?

Despite the warnings from researchers, the adverse effects of sitting “aren’t equal” to those of smoking, Healthline says.

“This falsified idea has been propagated in a number of different circles, including the scientific community and the media”, the medical service adds.

In a study published in the American Journal of Public Health, researchers claim that the health risks associated with smoking “far outweigh” those for sitting. They add that a previous study of 1.2 million people across 54 countries revealed that sitting time was responsible for 3.8% of all-cause mortality, while 21% of deaths among men and 17% among women were “attributable to smoking”.

This week’s research suggests that 11.6% of all deaths in the UK are linked to sedentary behaviour. This places the figure far below the risks associated with smoking.

The study also said that the financial impact of sitting on the NHS was far lower than that of smoking. Despite showing that sitting down for at least six hours a day is “behind £424m of spending on cardiovascular disease, £281m on type 2 diabetes and £30m on colon cancer” – a total of £735m – research in 2017 revealed that smoking may cost the NHS upwards of £6bn per year, The Daily Telegraph reports.

What can be done about it?

The NHS says that if adults wish to sit down less throughout the day, they should use their commutes and working hours to stand.

The health service suggests standing on the train or bus while commuting, taking the stairs, setting a reminder to get up every 30 minutes, placing a laptop on a box to work standing up and walking to a co-worker's desk instead of emailing or calling.

At home, the NHS suggests swapping some TV time for more active tasks or hobbies, and giving children a daily screen time limit. It also suggests making the bedroom a TV and computer-free zone.

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