摘要：Sitting has frequently been equated with smoking, with some sources even suggesting that smoking is safer than sitting. This commentary highlights how sitting and smoking are not comparable. The most recent meta-analysis of sedentary behavior and health outcomes reported a hazard ratio of 1.22 (95% confidence interval [CI] = 1.09, 1.41) for all-cause mortality. The relative risk (RR) of death from all causes among current smokers, compared with those who have never smoked, is 2.80 (95% CI = 2.72, 2.88) for men and 2.76 for women (95% CI = 2.69, 2.84). The risk is substantially higher for heavy smokers (> 40 cigarettes per day: RR = 4.08 [95% CI = 3.68, 4.52] for men, and 4.41 [95% CI = 3.70, 5.25] for women). These estimates correspond to absolute risk differences of more than 2000 excess deaths from any cause per 100 000 persons per year among the heaviest smokers compared with never smokers, versus 190 excess deaths per 100 000 persons per year when comparing people with the highest volume of sitting with the lowest. Conflicting or distorted information about health risks related to behavioral choices and environmental exposures can lead to confusion and public doubt with respect to health recommendations. Sedentary behavior is any waking behavior characterized by an energy expenditure less than or equal to 1.5 metabolic equivalents (METs), while in a sitting, reclining, or lying posture. 1 Sedentary behaviors are pervasive, require minimal effort, and are accumulated throughout the week (particularly evenings and weekends) and across multiple domains (e.g., leisure, occupation, transport). 2 According to studies that used device-based measures of sedentary behaviors, adults typically spend 9 hours per day sitting. Older adults are sedentary, on average, 10 hours per day. 3 Over the past decade, media coverage of sitting research has been widespread and the health consequences of sitting have often been compared with those of smoking (i.e., “sitting is the new smoking”). A recent analysis of news articles found almost 300 articles claiming that sitting is the new smoking. 4 Here, we provide a brief perspective on recent findings on the relationships of sitting with health outcomes. We compare the sitting-related risk estimates and absolute risk differences for all-cause mortality and prevalent chronic diseases (incidence and mortality) to smoking-related risks, and argue that promulgating direct comparisons of the health consequences of sitting and smoking is not recommended.
