A groundbreaking study published on February 3, 2026, in The Milbank Quarterly contends that ultra-processed foods (UPFs)—ubiquitous items like sodas, chips, cookies, and ready meals—mirror cigarettes in their design, marketing, and devastating public health toll, urging regulators worldwide to impose stringent tobacco-like controls.
Led by researchers from Harvard T.H. Chan School of Public Health, the University of Michigan, and Duke University, the analysis draws parallels between UPFs and tobacco products. UPFs are defined by the NOVA classification system as industrially formulated products with ingredients not typically used in home cooking, such as high-fructose corn syrup, hydrogenated oils, artificial sweeteners, flavor enhancers (e.g., monosodium glutamate), and stabilizers like emulsifiers. These additives, often numbering five or more per product, are engineered for hyper-palatability: optimal ratios of sugar, fat, and salt trigger dopamine release in the brain's reward centers, akin to nicotine's effect in cigarettes. This "bliss point" engineering, pioneered by food scientists like Howard Moskowitz, fosters compulsive overeating, with studies showing UPFs are consumed 500 calories more per day on average than unprocessed foods.
The researchers highlight manipulative marketing tactics, equating "health halo" labels like "low-fat," "natural," or "sugar-free" to mid-20th-century cigarette ads touting filters as "healthier" options—claims later debunked by evidence linking them to lung cancer. Today, UPF giants spend billions annually on ads targeting children via cartoons, influencers, and social media, while sponsorships infiltrate schools and sports events. Professor Ashley Gearhardt, a clinical psychologist at the University of Michigan and co-author, reports that many patients equate UPF cravings to nicotine withdrawal: "They describe an irresistible pull, much like my former smokers who swapped cigarettes for Diet Coke and Doritos."
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Unlike tobacco, food is biologically essential, amplifying the crisis. In modern environments—supermarkets with 40,000+ items, 60% of which are UPFs—avoidance is nearly impossible. Epidemiological data underscores the stakes: UPFs comprise 58% of U.S. calories and correlate with a 62% higher all-cause mortality risk per 10% dietary increase (BMJ 2024 meta-analysis). They drive obesity (now 1 in 8 people globally), type 2 diabetes (422 million cases), cardiovascular disease, and even mental health disorders via gut-brain axis disruption from emulsifiers eroding intestinal barriers.
The study advocates tobacco control playbook adaptations: mandatory health warnings on packaging, advertising bans (as in Quebec's 1980s model, reducing youth smoking 4x faster), front-of-pack labeling (e.g., Chile's black octagons slashing junk food buys by 24%), taxation scaling with processing level, and lawsuits holding manufacturers liable for addiction-like harm. Successful precedents include Mexico's soda tax (10% drop in purchases) and the UK's high-fat-salt-sugar reformulation deals.
Critics, however, caution against overreach. Professor Martin Warren of the UK's Quadram Institute argues the tobacco analogy risks hyperbole, as UPF harms often stem from displacing nutrient-dense foods like vegetables rather than inherent addictiveness alone. Industry groups, such as the International Food Information Council, counter that moderation and education suffice, citing self-regulatory pledges. Yet public health advocates, especially in Africa where UPF sales surged 64% from 2009–2021 (per FAO data), warn of overwhelmed systems facing NCD epidemics—diabetes alone costs $1 trillion yearly globally.
As UPF consumption climbs amid economic pressures favoring cheap calories, the study warns of a "slow-motion tobacco reckoning." Without bold regulation, Gearhardt predicts, "We'll treat generations of diet-related diseases we could prevent today."
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