Is Sitting as Bad as Smoking? Not Even Close

Granted, it’s hard to imagine life without sitting down, whether it’s on your commute to and from work or simply enjoying downtime on the couch watching Monday Night Football. So imagine the nationwide panic when a medical practitioner at the Mayo Clinic dropped the health bombshell, stating that ‘sitting was the new smoking.’

From that point on, you’d be forgiven for wanting to put every seat in the house on Craigslist, but here’s why the science behind the claims is far more ambiguous than the killer phrasing might suggest.

Where Did ‘Sitting Is the New Smoking’ Come From?

As health slogans go, it certainly did the job in capturing the world’s attention, with the phrase itself widely credited to Dr. James Levine, a professor of medicine at the Mayo Clinic whose work in the early 2010s focused on the health impacts of sedentary behavior. 

Headline-worthy in its own right, the decisive phrasing played into the negative narrative about smoking that had been building up over time but made it extremely relatable based on an activity that forms part of our everyday routine. 

Whether ‘sitting is the new smoking’ terminology was the catalyst, a subsequent scientific study entitled ‘Evaluating the Evidence on Sitting, Smoking, and Health’ published in 2018 revealed that news stories making “new smoking” or “as bad as smoking” comparisons increased twelvefold between 2012 and 2016.

What Excessive Sitting Actually Does to Your Health

Regardless of its notoriety, the potency of its implied smoking equivalence is wholly misleading, but like with many wellness supplement marketing ads, a catchy tagline can often oversimplify the scientific evidence behind it.

That being said, there are a number of longer-term health implications that do come with lifestyles that are prone to longer periods of sedentary behavior and inactivity. Even if they’re not intentional, repeatedly spending long hours sitting at your desk or taking the weight off your feet in the evenings can eventually lead to health concerns ranging from: 

• Cardiovascular disease
• Type 2 diabetes
• Shorter lifespans
• Certain types of cancers
• Higher cancer mortality

Critically, the key distinction here is that spending too much time sitting down and not getting enough regular exercise are two separate issues, even though they are often paired together.

Someone can meet recommended exercise targets while still spending much of the day sitting down. Conversely, spending less time seated doesn't necessarily mean someone is getting enough exercise.

A point highlighted in a pooled study of more than 44,000 middle-aged and older adults, which found that around 30–40 minutes of moderate-to-vigorous activity a day weakened the association between sedentary behavior and mortality.

Why The Comparison to Smoking Goes Way Too Far

Put simply, the claim that enjoying the comfort of a chair could be as dangerous as lighting up a cigarette just doesn’t hold up against the science. 

Straight off the bat, the same 2018 scientific commentary illustrated the discrepancy between the estimated 22% higher all-cause mortality risk discerned between high versus low sedentary lifestyles and the roughly 180% higher risk for smokers compared with people who had never smoked, albeit this was based on two separate studies rather than a head-to-head experiment. 

However, perhaps more tellingly, the comparison implies that spending one hour in a chair may be tantamount to having a few puffs on a cigarette. In doing so, it creates the impression that every minute you’re seated is in some way doing as much harm as cigarettes, despite the decades of research confirming tobacco's lethal effects.

Sources: 2018, American Journal of Public Health, 2023, JAMA Network Open, 2010, Sleep

So How Much Sitting Is Too Much?

Fortunately, just like the notion about getting a regimented eight hours of sleep a night, there is no universally agreed daily sitting limit or magical stopwatch before which your chair becomes dangerous. However, there are steps you can take to break up extended stints of sitting down, particularly for those who live less active lifestyles.

Whether you’re stuck behind your desk, vegging out on the La-Z-Boy at home, or even sitting on a long-haul flight to Tokyo, just a couple of minutes of moving around every hour is a step in the right direction. 

Furthermore, in the UK, NHS guidance recommends at least 150 minutes of moderate activity or 75 minutes of vigorous activity each week, with ideally two days involving strengthening work. This, of course, makes for the perfect excuse to kill two birds with one stone, be it taking a short stroll around the office between tasks or tackling a few household chores during the commercials in the evenings.

The Bottom Line

Ultimately, ‘sitting is the new smoking’ would likely win any modern-day wellness-themed slogan contest, but by insinuating sitting is as unhealthy as smoking, it arguably oversells the danger. Nevertheless, an element of praise should be given to Dr. Levine's approach; after all, he met the objective of raising awareness of the potential health implications of extended sessions of inactivity while being seated.

The slogan may have succeeded in getting people off their couches, but it also distorted the science. Sitting less and moving more are worthwhile goals. Treating your favorite chair like a pack of cigarettes isn't.