Is Sitting the New Smoking? The Hidden Health Hazard and How Physiotherapy Can Help
Updated: 5 days ago
Many of us spend most of our waking hours sitting: at work, while commuting and while relaxing at home. Research shows that long periods of sitting, especially combined with low levels of physical activity, are linked with poorer health. The phrase "sitting is the new smoking" has become popular, but how accurate is it, and what can you do about it?
Is Sitting Really the New Smoking?
The phrase is a useful wake-up call, but it overstates the risk. Smoking is far more harmful than sitting. However, research does show that high amounts of sitting, combined with little physical activity, are linked with a higher risk of heart disease, type 2 diabetes, some cancers and earlier death.
The encouraging news is that movement makes a big difference. A large analysis of over one million adults found that 60–75 minutes a day of moderate activity, such as brisk walking or cycling, appeared to largely offset the increased risk of death linked to high sitting time.
How Did We Get Here?
Over recent decades, many jobs have shifted from physical work, such as farming, construction and factory work, to desk-based roles. Leisure time has also become more screen-based. Many adults now sit for eight hours a day or more.
What Are the Health Effects of Too Much Sitting?
1. Heart and metabolic health
Long periods of sitting are linked with higher blood sugar, blood fats and blood pressure, which increase the risk of heart disease and type 2 diabetes. The World Health Organization identifies physical inactivity as one of the leading risk factors for death worldwide.
2. Weight
Sitting uses less energy than standing or moving, and long sedentary periods can contribute to weight gain over time.
3. Back and neck discomfort
Long periods in any one position can leave you feeling stiff and uncomfortable. Research hasn't shown that sitting posture itself damages the spine or causes disc problems, but regular movement and staying active help keep your back and neck comfortable.
4. Mental wellbeing
Higher sedentary time and low activity are linked with a higher risk of low mood and anxiety. Regular physical activity is one of the most effective ways to improve mood and reduce stress.
5. Life expectancy
High sitting time combined with low activity is linked with a shorter life expectancy. Regular moderate to vigorous activity, along with breaking up long periods of sitting, reduces this risk.
How Physiotherapy Can Help
1. Getting You Moving
Physiotherapists help people of all fitness levels become more active safely, especially if pain, injury or a health condition has made activity difficult. A tailored plan with clear milestones can help you build activity gradually and confidently.
2. Managing Back and Neck Pain
Back and neck pain are common in people who sit for long periods. Physiotherapists can assess your pain, explain what's going on and guide you through an exercise-based plan. Hands-on treatment, such as joint mobilisation, massage or dry needling, may be used for short-term relief alongside exercise.
3. Workplace Advice
A physiotherapist can advise on setting up your workspace for comfort and, more importantly, on building movement into your working day. Options include:
A sit–stand desk, used to change position regularly rather than to stand all day
A screen at a comfortable height
A chair that lets you sit comfortably and change position easily
4. Movement Breaks
Regularly breaking up sitting helps. One commonly suggested approach is the "20-8-2" pattern: for every 30 minutes, sit for 20, stand for 8 and move around for 2. Any regular break is helpful, whether that's standing for phone calls, walking to a colleague's desk or a short walk at lunchtime.
5. Exercise Prescription
Physiotherapists can design a balanced programme including strength, aerobic and mobility exercise, built around your goals and progressed until you can continue independently.
Exercise to Counteract Sitting
1. Strength Training
Strength training at least twice a week helps maintain muscle, bone and metabolic health. Useful exercises include:
Glute bridges: for the hips and glutes
Planks: for the trunk
Rows: for the upper back and shoulders
Squats or sit-to-stands: for the legs
2. Mobility
Stretching and mobility exercises can ease the stiffness many people feel after sitting:
Hip flexor stretches
Chest stretches
Hamstring stretches
Spinal twists
3. Aerobic Activity
The World Health Organization recommends that adults do at least 150–300 minutes of moderate activity, or 75–150 minutes of vigorous activity, each week, as well as reducing sedentary time. Walking, cycling and swimming are all great options. Every bit of movement counts.
Conclusion: Take Action Today
Long periods of sitting combined with low activity are linked with poorer health, but the solution is within reach. Regular physical activity, strength training and breaking up sitting time can substantially reduce the risks.
A physiotherapist can help if pain or injury is holding you back, or if you'd like support to become more active safely. Small, regular changes add up: stand up, move more and build activity into your day.
References
World Health Organization. WHO guidelines on physical activity and sedentary behaviour. Geneva: WHO; 2020.
Barlow CE, Shuval K, Balasubramanian BA, Kendzor DE, Radford NB, DeFina LF, Pettee Gabriel K. Association between sitting time and cardiometabolic risk factors after adjustment for cardiorespiratory fitness, Cooper Center Longitudinal Study, 2010–2013. Preventing Chronic Disease. 2016;13:160263.
Ekelund U, Steene-Johannessen J, Brown WJ, et al. 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. 2016;388(10051):1302–1310.
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