{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T21:41:35Z","timestamp":1792014095332,"version":"4.4.0"},"reference-count":229,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Milbank Quarterly"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>Policy Points<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>Ultraprocessed foods (UPFs) are engineered to heighten reward and accelerate delivery of reinforcing ingredients, driving compulsive consumption and disrupting appetite regulation. This is a growing challenge for health policy.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>UPFs share key engineering strategies adopted from the tobacco industry, such as dose optimization and hedonic manipulation. These parallels should inform how we classify and regulate UPFs.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Policy tools that helped reduce tobacco\u2010related harm, including restrictions on child\u2010targeted marketing, taxes, improved labeling, limits on availability in schools and hospitals, and litigation, should be adapted to address the public\u2010health threat posed by UPFs.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Ultraprocessed foods (UPFs) now dominate the global food supply and are strongly associated with risks for heart disease, cancers, metabolic disease, diabetes, and obesity. UPFs are likely associated with rates of neurologic issues such as dementia and Parkinson's disease and predict premature death. Drawing on the history of tobacco regulation, we examine how the design, marketing, and distribution of UPFs mirror those of industrial tobacco products. Such information speaks to the sophistication and aims of food product manipulation and its consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review synthesizes findings from addiction science, nutrition, and public health history to identify structural and sensory features that increase the reinforcing potential of both cigarettes and UPFs. We focus on five key areas: dose optimization, delivery speed, hedonic engineering, environmental ubiquity, and deceptive reformulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Cigarettes and UPFs are not simply natural products but highly engineered delivery systems designed specifically to maximize biological and psychological reinforcement and habitual overuse. Both industries have used similar strategies to increase product appeal, evade regulation, and shape public perception, including adding sensory additives, accelerating reward delivery, expanding contextual access, and deploying health\u2010washing claims. These design features collectively hijack human biology, undermine individual agency, and contribute heavily to disease and health care costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>UPFs should be evaluated not only through a nutritional lens but also as addictive, industrially engineered substances. Lessons from tobacco regulation, including litigation, marketing restrictions, and structural interventions, offer a roadmap for reducing UPF\u2010related harm. Public health efforts must shift from individual responsibility to food industry accountability, recognizing UPFs as potent drivers of preventable disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1468-0009.70066","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T05:03:14Z","timestamp":1770094994000},"page":"76-115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["From Tobacco to Ultraprocessed Food: How Industry Engineering Fuels the Epidemic of Preventable Disease"],"prefix":"10.1111","volume":"104","author":[{"given":"ASHLEY N.","family":"GEARHARDT","sequence":"first","affiliation":[{"name":"University of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KELLY D.","family":"BROWNELL","sequence":"additional","affiliation":[{"name":"Sanford School of Public Policy Duke University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALLAN M.","family":"BRANDT","sequence":"additional","affiliation":[{"name":"Harvard Medical School Harvard University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"e_1_2_17_2_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980010003241"},{"key":"e_1_2_17_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2025.02.018"},{"key":"e_1_2_17_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16101"},{"key":"e_1_2_17_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018003762"},{"key":"e_1_2_17_6_1","article-title":"Ultra\u2010processed food exposure and adverse health outcomes: umbrella review of epidemiological meta\u2010analyses","volume":"384","author":"Lane MM","year":"2024","journal-title":"BMJ"},{"key":"e_1_2_17_7_1","doi-asserted-by":"publisher","DOI":"10.1159\/000527322"},{"key":"e_1_2_17_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2024.11.013"},{"key":"e_1_2_17_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980020003353"},{"key":"e_1_2_17_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16065"},{"key":"e_1_2_17_11_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2019.305482"},{"key":"e_1_2_17_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l736"},{"key":"e_1_2_17_13_1","volume-title":"The Cigarette Century: the Rise, Fall, and Deadly Persistence of the Product That Defined America","author":"Brandt AM","year":"2007"},{"key":"e_1_2_17_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-0009.2009.00555.x"},{"key":"e_1_2_17_15_1","unstructured":"SpiringJ PeruzziC NewlandF ChappellC WhiteG.Sweetest innovations 2025.Confectionery News. 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