Body Weight Does Not Associate with Smoking Prevalence or Cigarette Consumption in Adult Women

Abstract

Introduction Women are reported to smoke more in association with body weight effects than nicotine dependence, findings that may support including sex-specific dietary interventions in smoking cessation programs. To evaluate this proposition, we examined the influence of sex and BMI classification on adult smoking prevalence and nicotine dependence (measured as cigarette consumption). Methods National Longitudinal Study of Adolescent and Adult Health (Add Health) data were filtered to US adults reporting smoking histories 10-15 years prior. Binary logistic regression modeling tested associations of sex and BMI classification (Normal, Overweight, Obese) with adult smoking status (former smoker versus smoker). Linear regression modeling tested the influence of sex and BMI classification on cigarette consumption in adult smokers. Results In 4,472 adults [Age x̅ (SD) = 37.89 (1.88) years)], significant sex-by-BMI classification interaction on smoking status was observed [Wald X2 = 257.2 on 8 df, p < 0.0001]. Normal BMI men smoked at the highest rates overall. No other pairwise comparisons showed between- or within-sex relationships. Median differences in cigarette consumption in persisting adult smokers, disaggregated by sex and BMI classification, amounted to no more than 2 cigarettes daily. Conclusion Adult women show no greater smoking prevalence or cigarette consumption in association with body weight. Sex-specific interventions do not appear to be indicated. Implications for multiple health behavior approaches are discussed.