A new study titled “From Tobacco to Ultraprocessed Food: How Industry Engineering Fuels the Epidemic of Preventable Disease”, published in The Milbank Quarterly, warns that ultraprocessed foods are deliberately engineered in ways similar to cigarettes and should be treated as a major public health threat rather than as ordinary food products.
The paper is authored by Ashley N. Gearhardt of the University of Michigan, Kelly D. Brownell of Duke University’s Sanford School of Public Policy, and Allan M. Brandt of Harvard Medical School. It argues that ultraprocessed foods now dominate the global food supply and are strongly associated with heart disease, cancers, diabetes, obesity, metabolic disorders, neurological conditions such as dementia and Parkinson’s disease, and premature death.
According to the authors, ultraprocessed foods are “highly engineered delivery systems” designed to maximize pleasure, rapid consumption, and repeated use. The study documents how food manufacturers precisely calibrate refined carbohydrates and added fats to deliver powerful reward signals without triggering aversion, closely mirroring tobacco industry strategies used to optimize nicotine intake.
The paper notes that cigarettes typically contain between 1.0% and 2.0% nicotine by weight to balance reward and tolerance. In comparison, ultraprocessed foods often contain carbohydrate levels ranging from 25% to more than 50% by weight, while some confectionery products contain sugar concentrations between 55% and over 80%. By contrast, whole foods such as bananas, potatoes, and corn generally contain about 15% to 25% carbohydrates and digest much more slowly.
Drawing on addiction science, the authors cite evidence showing that refined sugars can increase dopamine levels in the brain by around 150% above baseline, with some studies reporting increases of up to 300%, comparable to responses produced by nicotine. When refined carbohydrates are combined with added fats—a pairing that is rare in nature—the dopamine response is even stronger, increasing the risk of compulsive consumption.
The study explains that ultraprocessed foods are engineered for speed of delivery by stripping away fiber, protein, and water that normally slow digestion. Some products are effectively “pre-chewed” or “pre-digested” through industrial and enzymatic processing, allowing sugars and fats to reach the bloodstream rapidly, in a manner comparable to inhaled nicotine from cigarettes.
The authors also trace historical links between the tobacco and food industries, noting that tobacco corporations such as Philip Morris and R.J. Reynolds owned major food companies including Kraft, General Foods, and Nabisco from the 1980s through the mid-2000s. This corporate overlap, the paper argues, enabled the transfer of product engineering and marketing strategies from cigarettes to food products.
Industry language cited in the paper underscores the commercial logic behind such engineering. One food industry advertisement referred to “turning consumer cravings into commercial wins,” while an industry newsletter described indulgence as the sector’s “profit engine,” reinforcing the authors’ claim that manipulating reward responses is central to profitability.
The paper also criticizes health-focused marketing practices, noting that ultraprocessed foods are often promoted as low-fat, sugar-free, or vitamin-enriched while retaining highly reinforcing sensory profiles. The authors compare this to the marketing of “light” cigarettes, which were presented as safer despite maintaining addiction potential.
“These design features collectively hijack human biology, undermine individual agency, and contribute heavily to disease and health care costs,” the authors write, arguing that an emphasis on personal responsibility has delayed effective public health action.
Drawing lessons from tobacco control, the authors call for measures such as restrictions on marketing to children, taxes on ultraprocessed foods, stronger warning labels, limits on availability in schools and hospitals, and the use of litigation to hold corporations accountable. They conclude that ultraprocessed foods should be evaluated not only through a nutritional lens but also as industrially engineered products driving a growing epidemic of preventable disease.
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