Prevalence of obesity and smoking among adults in Germany - trends from 2003 to 2023.

Background: Non-communicable diseases (NCDs) are a significant public health challenge. Obesity and smoking are among the major risk factors for their development. In addition to individual behavioural changes, public health measures can help prevent NCDs by creating health-promoting conditions for the population. The aim of this paper is to analyse trends in obesity and smoking prevalence in Germany over time and place these trends in the context of existing public health measures for structural prevention.

Method: The prevalence of obesity and smoking over the last 20 years was examined using data from the Robert Koch Institute Telephone Health Surveys and the German Health Update.

Results: Between 2003 and 2023, the prevalence of obesity increased from 12.2 % to 19.7 % among women and men, for all age and education groups. The prevalence of smoking decreased from 32.1 % to 28.8 %, especially among younger people and in the highly educated group, but the decline has slowed in recent years.

Conclusions: The continuous increase in obesity prevalence between 2003 and 2023 indicates that measures taken so far to prevent obesity have been insufficient. It is therefore imperative not only to address behavioural change at the individual level, but also to implement population-wide, settings-based prevention measures. In addition, more consistent implementation of regulatory measures is needed to further reduce tobacco consumption.