Abstract
BackgroundSmoking influences body weight, but there is little evidence as to whether body mass index (BMI) and body dissatisfaction increase smoking initiation in adolescents. MethodsWe evaluated the association between measured BMI, body dissatisfaction and latent classes of smoking initiation (never smokers, experimenters, late onset regular smokers, early onset regular smokers) in the Avon Longitudinal Study of Parents and Children. In observational analyses we used BMI (N=3754) and body dissatisfaction at age 10.5 years (N=3349). In Mendelian randomisation (MR) analysis, we used a BMI genetic risk score of 76 single nucleotide polymorphisms (N=4017). ResultsIn females, higher BMI was associated with increased odds of early onset regular smoking (OR: 1.11, 95% CI: 1.04, 1.18) compared to being a never smoker, but not clearly associated with experimenting with smoking (OR: 1.04, 95% CI: 0.99, 1.10) or late onset regular smoking (OR: 1.01, 95% CI: 0.94, 1.09). No clear evidence was found for associations between BMI and smoking initiation classes in males (p-value for sex interaction≤0.001). Body dissatisfaction was associated with increased odds of late-onset regular smoking (OR: 1.71, 95% CI: 1.32, 1.99) in males and females combined (P-value for sex interaction=0.32). There was no clear evidence for an association between the BMI genetic risk score and smoking latent classes in males or females but estimates were imprecise. ConclusionsBMI in females and body dissatisfaction in males and females are associated with increased odds of smoking initiation, highlighting these as potentially important factors for consideration in smoking prevention strategies.
Highlights
Recent figures suggest that 207,000 children between the ages of 11 and 15 start smoking each year in the United Kingdom, with around 80% of adult smokers taking up smoking before the age of 20 (ASH, 2015)
There is some evidence that high body mass index (BMI) is a possible risk factor for smoking initiation because people may start smoking in order to control or lose weight
Using data from a large longitudinal study, the Avon Longitudinal Study of Parents and Children (ALSPAC), we examined the relationship between BMI, body dissatisfaction and the smoking habits of adolescents
Summary
Recent figures suggest that 207,000 children between the ages of 11 and 15 start smoking each year in the United Kingdom, with around 80% of adult smokers taking up smoking before the age of 20 (ASH, 2015). We examined the relationships between BMI and body dissatisfaction at age 10.5 years with subsequent adolescent smoking initiation between the ages of 13 and 18. Higher genetically determined BMI (using a polygenic risk score based on 32 genetic variants) was found to be associated with smoking more cigarettes per day and increased risk of smoking initiation (Thorgeirsson et al, 2013). These results were interpreted by the authors as evidence for a shared genetic aetiology between smoking and BMI, but the results could be interpreted as evidence for weight influencing smoking behaviour
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