Abstract
BackgroundStudies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently. The present study aimed to assess the associations of smoking status and volume smoked with HC and WC and their ratio in a population with low prevalence of obesity together with high prevalence of smoking.MethodsWe used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997–99 including 65,875 men and women aged 39–44 years. Analysis of associations were adjusted for confounding by socioeconomic position, health indicators, and additionally for BMI.ResultsCompared with never-smokers, when adjusting for confounders and in addition for BMI, mean HC remained lower while mean WC and waist-hip-ratio (WHR) were higher in current smokers. The finding of a lower HC and higher WHR level among smokers was consistent by sex and in strata by levels of education and physical activity, while the finding of higher WC by smoking was less consistent. Among current smokers, BMI-adjusted mean HC decreased whereas WC and WHR increased by volume smoked. Compared with current smokers, former smokers had higher BMI-adjusted HC, lower WHR and among women WC was lower.ConclusionsThe main finding in this study was the consistent negative associations of smoking with HC. In line with the hypothesis that lower percentage gluteofemoral fat is linked with higher cardiovascular risk, our results suggest that smoking impacts cardiovascular risk through mechanisms that reduce the capacity of fat storage in the lower body region.
Highlights
MethodsWe used cross-sectional survey data from 11 of a total 19 Norwegian counties examined in 1997–99 including 65,875 men and women aged 39–44 years
Studies indicate an effect of smoking toward abdominal obesity, but few assess hip and waist circumferences (HC and WC) independently
Current smoking was negatively associated with WC, whereas additional adjustment for body mass index (BMI) changed the direction into a positive association [10]
Summary
Study population Health surveys were performed in Norwegian counties during 1985–99 as part of the National Health Screening Service’s Age 40 Program, inviting all inhabitants who completed 40–42 years during the year the survey started in their county of living [20, 21]. We used the reported number of cigarettes per day as a continuous variable and constructed three ordinal groups of 1–9, 10–19, and ≥ 20 cigarettes per day to indicate the volume smoked: “light”, “intermediate” and “heavy” These ordinal groups were of reasonable size in both genders, as expected from an earlier Norwegian study [23]. Indicators of socioeconomic position Educational attainment was considered as a confounding factor, associated with both smoking and anthropometric measures [25, 26], and was assessed by self-report according to five levels. The models included Model 1Observed, Model 2SEP and health indicators adjusted for body height, education, disability pension, LTPA and alcohol use, and Model 3BMI with additional adjustment for BMI. Interactions between smoking status and education and between smoking status and LTPA levels were assessed by univariate analysis of variance in Model 2SEP and health indicators for the associations of current versus never smoking with anthropometric measures. All data analyses were performed with the statistical package SPSS version 16.0 (SPSS Inc., Chicago IL)
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