The Mayor of the city of New York, Mr. Michael Bloomberg, is a fitness-freak who keeps taking steps and enacting rules that will go to make its citizens healthy. First, he banned smoking in public spaces in the city. He justified this ban based on scientific reports on the dangers of passive smoking. Smoking not only injures the health of the one who engages in it, but also affects the people nearby through passive inhalation. Thus, if you smoke in public places in New York City, you are likely to be hauled up by a cop.

Mr. Bloomberg is currently on a move to reduce the consumption of large amounts of sugary drinks, such as colas, in public places. He is proposing to ban the sale of sweetened beverages beyond 16 ounces (500 ml), either bottles or on tap, in restaurants, bars, movie theatres, sports venues and street cars of New York City. This ban would affect sweetened drinks such as Coke, Pepsi, Sprite and Iced Teas, which have more than 25 calories per 8 ounces (250 ml). The Mayor’s claim is that he wants to combat obesity in New Yorkers.

Cola facts

Do colas promote obesity? Take a typical 12 ounce (360 ml) bottle of Coca Cola. It has 39 grams of sugar and packs 140 calories (about 13 per cent of the recommended daily allowance). A 12 ounce bottle of Pepsi Cola has 41 g and Sprite 38 g of sugar. In addition, colas are highly acidic, with a pH value 2.5, strong enough to dissolve and erode the tooth enamel. (Try this simple experiment: drop a broken tooth (if you are unable to, small piece of marble will do) in a glass containing about 50 ml of cola and check it the next day).

Sugarcane juice that we buy on the Indian streets too is packed with calories. A 120 ml glass contains 76 calories; the saving grace is it is not as acidic as the colas, even after the vendor crushes a lemon along with the cane as he makes it (though the water he washes the glass with could be contaminated with microbes).

The New York ban appears relevant elsewhere, and surely in Indians cities, with the new Mall or movie-complex culture. We buy popcorns (which come in large bags; each 8 cup-size bag packs 500 cals and 30 g fat) or French Fries (a small pack packs 230 calories) and colas (a 250 ml bottle gives 260 calories). Is it small wonder that the mod city kid in New Delhi tends to be obese?

Bloomberg’s campaign in the city’s subway trains states: “are you pouring on the pounds?” He has also recruited celebrities, film makers and sports persons for this cause. In opposition, hundreds of soft drinks makers and sellers, restaurants and theatre owners have formed the group “nycbeveragechoices.com” and attack him for curbing personal freedom guaranteed by the American constitution.

To which, the mayor counters: “I am not banning you from getting the stuff. If you want 32 ounces, the restaurant has to serve it in 2 glasses. And the supermarkets are not banned from selling jumbo sizes”. And on the charges of curtailing personal freedom, he is reported to say: “This is not exactly taking away your freedom. It is not something that the Founding Fathers fought for” (USA Today, July 19, 2012).

The debate is on. In order for Bloomberg to get his ban official, he needs the Board of Health in New York to vote on the proposal in September. It would be of interest to see what happens and if he wins, whether other cities follow.

Then there is the issue of personal freedom versus what the state decrees. On one side is personal choice and on the other is public good. And the cola sale ban highlights this debate. How much does restriction on colas in public places affect public health?

When I smoke in a public place, I affect the health of others as well. Thus, when the American Surgeon General C. Everett Koop campaigned in the 1980s (successfully) against smoking, he found support across cities and nations. When I hold a noisy party at home, I might disturb neighbours, and a ban is understood as for the common good. Is the effort to control obesity of citizens comparable to the laws against smoking or noisy parties; does it affect public health or welfare? Am I my brother’s keeper?

Governments will point out that it does, by increasing the expenditure budget of the state. Arguments on costs of health insurance, medical care provided by the state, fitness of soldiers and similar measures are based on this precise issue. Here again, though, there are two points of view — for and against governmental intervention.

That it will not succeed is suggested in the paper by Marlow and Sheirs (see http://www.jpands.org/vol15no3/marlow.pdf), while another by O’Brady and Capretta (see 74094.5743.assessing obesity interventions.0312.pdf ) gives a variety of arguments for state involvement in controlling obesity.

Closer to home, and very similar, is the ban on the manufacture and sale of chewable tobacco (gutka and similar products) by Kerala, Bihar, MP, Rajasthan and Maharashtra, under the Food Safety and Standards Regulation Act 2011 of India. Medical evidence shows that chewable tobacco causes twice as many deaths as lung cancer (see the editorial in The Hindu of July 26).

While chewable tobacco affects only the user and not others, and thus different form smoking, it adds to the burden on public spending on health. I may not be my brother’s keeper, but when his acts affect me and my fellow citizens, I might have to act.

D. BALASUBRAMANIAN

dbala@lvpei.org