In light of the increasingly intense debate throughout the US about the government’s role in Americans’ health and safety, I must admit that there’s something about this debate that I’ve never quite understood. The national debate and political proposals and policies seem to focus primarily on firearms, cannabis, sugar, salt, and calories, opioids, and tons of other nutritional labeling regulations while giving the nation’s most dangerous substances a pass.

Considering that I’ve treated thousands of patients who called an ambulance for medical emergencies involving COPD, heart disease, strokes, vascular disease, and lung cancer, I know all too well that the single biggest detriment to our health is undisputedly smoking cigarettes. The CDC estimates that over 16 million Americans are living with diseases caused by smoking. Cheeseburgers and alcohol are probably responsible for a significant amount of death and disability in the US, as well. So, why is cannabis federally illegal? Why are sugar, salt, and calories so tightly regulated by local governments? Why are guns regulated by infinite laws throughout the country while cigarettes, alcohol, and cheeseburgers remain readily available to all Americans? 

In order to appreciate the simple, true numbers that demonstrate the top causes of death in the US, I recommend reading this list posted by the US government Center for Disease Control. Heart disease kills the most people in the US every year. Cancer kills the 2nd most people in the US each year. Accidents are in 3rd place, though they cause less than a third of the deaths that cancer does. Just below accidents is lung disease, killing 100,000 Americans each year. Stroke is the 5th leading cause of death. Alzheimer’s is 6th. Diabetes is 7th. The CDC lists the Flu/Pneumonia in 8th place. Kidney disease is in 9th place and suicide is the 10th leading cause of death in the US. 

So far, nearly every single leading cause of death could be caused (at least in part) by smoking cigarettes. Yet, every adult in the US could buy and smoke as many cigarettes as they want! Imagine how many lives we could save and how much we’d save on healthcare costs if we banned smoking! 

Heart disease has remained the leading cause of death in the US. It’s common knowledge that cheeseburgers contribute to heart attacks due to the cholesterol, fats, carbs, meat, and the other unhealthy substances that find their way into the traditional burger. Recently, the link between red meat and cancer is becoming more concrete. Being that cheeseburgers contribute to the #1 and #2 causes of death, prohibiting them is a no-brainer. 

According to the NIAAA, 80,000 Americans die each year from alcohol related causes. This means that alcohol kills as many people as diabetes – the 7th leading cause of death in the US! Additionally, alcoholism is the leading addiction in the US and damages relationships perhaps as much as anything in the history of humanity.

Another massive part of this debate that seems to be totally neglected by media, politicians, writers, doctors, and Facebook experts is fitness. Studies show that exercise/remaining fit is the best way to live a long, healthy life. The CDC says that exercise could reduce the risk of nearly every one of the leading causes of death in the US. My experience in fitness and medicine lead me to believe that fitness is extremely important to our health. Now that the majority of Americans agree that the government has the responsibility and authority to encourage healthy living, why wouldn’t they start passing some fitness laws? Once again, fitness regulations are a no-brainer. The US government could mimic the Japanese government’s fitness mandates. America could go further than Japan, though. The federal government should mandate that doctors measure and record BMI (body mass index) of every patient once a year. Patients with a BMI greater than 30 – who are obese according to the CDC – would receive a hefty fine (or perhaps imprisoned).

Americans agree that the government has the authority to protect ‘Life, Liberty, and the Pursuit of Happiness’. People who suffer from these diseases and people who die from these top causes of mortality certainly can no longer enjoy any of the three aforementioned things that the government has a responsibility to protect. If a few new regulations could save millions of lives, why wouldn’t we implement them?