Epidemiological and clinical studies on the lifestyle-related obesity have identified smoking, physical activity and alcohol intake as risk factors for obesity. However, no consensus has yet been reached on the effect of smoking on visceral adiposity. This study was designed to assess whether smoking is associated with the accumulation of visceral fat, glucose and lipid metabolism. The subjects were 450 males aged from 24 to 68 years old, who were examined at the health control center in the regular health check conducted by their company. A self-administered questionnaire was used to ascertain smoking status, daily physical activity and alcohol drinking. The number of Brinkman index as an index for smoking status was positively related to being visceral fat area (VFA). In smokers whose Brinkman index was higher, the percent of subjects with abnormal body mass index, VFA, triglyceride, high density lipoprotein-cholesterol, atherosclerotic index, plasma glucose, immunoreactive insulin, or homeostasis model assessment of insulin resistance (HOMA-IR) was higher than that in non-smokers. When evaluated in terms of age-adjusted odds ratios for incidence of a VFA of 100 cm(2) or greater, alcohol drinking was associated with the highest odds ratio. Smoking, physical inactivity and excessive alcohol drinking were associated with visceral adiposity, and smoking affected glucose and lipid metabolism. In conclusions, these findings suggest that smoking is a risk factor for visceral fat accumulation and deterioration of glucose and lipid metabolism.