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Is Prolonged Sitting The New Smoking?

Ever since Dr. James Levine of the Mayo Clinic coined the phrase “Sitting is the new smoking”, there have been debates if this is truly so. Some health gurus made this phrase their mantra and inspired other people worldwide to work on their desk standing. On the other hand, some people think that the phrase sounds like a curse.

Studies showed that prolonged sitting is linked to diseases such as cancer, diabetes, and cardiovascular diseases --- the same health problems linked to smoking. This comparison became the reason why the phrase came to be.

And if we are going to look at the chart below, it seems that Americans are sedentary more than half of the day.

Is it really true?

Let the Numbers Speak For Themselves

People tend to become less active as they age. Obviously, elderly people aged 75 and above have the lowest level of activity achieving around 20 minutes of physical activity daily. Only one in four elderlies are considered sufficiently active.

According to the Centers for Disease Control and Prevention (CDC), 8.3% of deaths of non-disabled adults ages 25 and older were attributed to physical inactivity. Any extended sitting --- such as at a desk, or behind a wheel, or in a car, on long plane flights, or in front of a computer --- can be harmful. An analysis of 13 studies of sitting time and activity levels found that those who sat for more than eight hours a day with no physical activity had a risk of dying similar to the risks of dying posed by obesity and smoking.

One study said the men who think they sat almost 100% of the time were more likely to be obese than men who think they sat almost none of the time. Watching TV for 3 hours or more per day was associated with increased mortality regardless of physical activity.

What Happens When You’re Sitting For Too Long?

Humans are built to stand upright. Your heart and cardiovascular system work more effectively that way. Your bowel also functions more efficiently when you are upright. Even mobile phones were designed to be used standing but it turns out that people use them more while sitting. So what happens when you’re sitting for too long?

Stiff Neck and Shoulders

Working on your desk and in front of your computer for a long time can lead to pain and stiffness in your neck and shoulders.

Hips and Back

Prolonged sitting shortens your hip flexor muscles which can lead to problems with your hip joints. Poor posture causes compression in the discs in your spine, leading to premature degeneration, which can be very painful.

Legs and Gluteal Muscles

Prolonged sitting weakens your large leg and gluteal muscles. These large muscles are important for walking and for stabilizing you. If these muscles are weak you are more likely to injure yourself from falls, and from strains when you do exercise.


Physical activity helps your body digest the fats and sugars you eat. If you spend a lot of time sitting, digestion is not as efficient, so you retain those fats and sugars as fat in your body which leads to weight gain. Even if you exercise but spend a large amount of time sitting, you are still at risk of having metabolic syndrome. Research suggests you need 60 to 75 minutes of moderate-intensity activity per day to combat the dangers of excessive sitting.

Anxiety and depression

We know that the risk of both anxiety and depression is higher in people who sit more because they miss out on the positive effects of physical activity and fitness.


Studies suggest the dangers of sitting include increasing your chances of developing lung, uterine, and colon cancers although the reason behind this is not yet known.

Heart disease

Sitting for a long time cannot remove the fat from your blood after eating a meal, and that puts you at 147% higher risk of cardiovascular disease, heart disease, and stroke. A study found out that men who watch more than 23 hours of television a week have a 64% higher risk of dying from cardiovascular disease than men who only watch 11 hours of television a week.


If you spend long periods sitting, then you cannot dispose of the glucose in the food that you’re eating. Glucose accumulates in your blood and increases the risk of diabetes. Studies have shown that five days lying in bed can lead to increased insulin resistance in your body which causes your blood sugar to rise. Another research suggests that people who spend more time sitting have a 112% higher risk of diabetes.

Varicose Veins

Prolonged sitting causes blood to pool in your legs which can lead to varicose veins or spider veins (a smaller version of varicose veins). Varicose veins are not usually dangerous.

Deep Vein Thrombosis

In rare cases, prolonged sitting can lead to blood clots which can cause serious problems. Deep vein thrombosis is a blood clot that forms in the veins of your leg. DVT is a serious problem because if part of a blood clot in the leg vein breaks off and travels, it can cut off the blood flow to other parts of the body, including your lungs, which can cause a pulmonary embolism. This is a medical emergency that can lead to major complications or even death.

What To Do?

It is important to reduce sitting time AND do regular exercise to combat the negative effects of physical inactivity. Being active is not as difficult as you think. One study found out that even a two-minute light activity every 30 minutes will keep your blood glucose at a normal level. Another study said five minutes of walking the dog, folding laundry, or taking out the trash for every hour of sitting is sufficient to reduce the negative effects of prolonged sitting. Thus, it is better to build more activity into your day.


The phrase “sitting is the new smoking” should not be taken at its face value. It would be better to say sitting is associated with the same health risks as smoking but both could not be compared.

The damage caused by smoking cannot be offset, but moderate physical activity can offset high levels of inactivity. However, this does not mean that having your regular daily 1-hour exercise allows you to slouch on the couch the rest of the day and still reap the health benefits. No. Meeting the recommended hours of physical activity is helpful but what you will be doing for the next 23 hours is another thing.

To combat the effects of obesity and other chronic diseases, reducing the time you spend sitting is the key. And since you decide what you do in a day, you have that key!


Barlow, Carolyn E. 2016. “Association between Sitting Time and Cardiometabolic Risk Factors after Adjustment for Cardiorespiratory Fitness, Cooper Center Longitudinal Study, 2010–2013.” Preventing Chronic Disease 13.

Becker, Lara. 2020. “Sitting Isn’t the New Smoking, Apparently.” Medical Daily. October 21, 2020.

Better Health Channel. n.d. “The Dangers of Sitting: Why Sitting Is the New Smoking” Accessed December 18, 2021.

Chandler, Meredith. 2018. “Sitting Disease: The Terrifying Facts of Prolonged Sitting.” Ergonomics Health Association. April 19, 2018.

Ekelund, Ulf, Jostein Steene-Johannessen, Wendy J Brown, Morten Wang Fagerland, Neville Owen, Kenneth E Powell, Adrian Bauman, and I-Min Lee. 2016. “Does Physical Activity Attenuate, or Even Eliminate, the Detrimental Association of Sitting Time with Mortality? A Harmonised Meta-Analysis of Data from More than 1 Million Men and Women.” The Lancet 388 (10051): 1302–10.

Graff-Radford, Michelle. 2020. “Sitting Is the New Smoking.” February 11, 2020.

Khan, Coco. 2021. “Is Sitting the New Smoking? We Ask the Expert.” The Guardian. November 5, 2021.

Laskowski, Edward. 2018. “Sitting Risks: How Harmful Is Too Much Sitting?” Mayo Clinic. 2018.

Loh, Roland, Emmanuel Stamatakis, Dirk Folkerts, Judith E. Allgrove, and Hannah J. Moir. 2019. “Effects of Interrupting Prolonged Sitting with Physical Activity Breaks on Blood Glucose, Insulin, and Triacylglycerol Measures: A Systematic Review and Meta-Analysis.” Sports Medicine 50 (2): 295–330.

The Heart Foundation. 2019. “Is Sitting the New Smoking?” The Heart Foundation. August 10, 2019.

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