Does smoking in adolescence affect body mass index, waist or height? Findings from a longitudinal study

Addiction. 2007 Sep;102(9):1493-501. doi: 10.1111/j.1360-0443.2007.01910.x. Epub 2007 Jul 23.


Aim: To assess the effect of smoking uptake on body mass index (BMI), waist circumference and height during adolescence.

Design: Five-year longitudinal study.

Setting: Thirty-six schools in South London, England, selected by a stratified random sampling procedure designed to ensure ethnic and socio-economic diversity.

Participants: A total of 5863 students took part in the HABITS (Health and Behaviour in Teenagers) Study between 1999 and 2003.

Measurements: Self-reported smoking behaviour, saliva cotinine concentrations and measured weight, waist circumference and height were obtained, along with information on gender, ethnicity, socio-economic deprivation, pubertal status, self-reported exercise and dieting. Students were examined annually from school year 7 (ages 11-12) to year 11 (ages 15-16), with response rates ranging from 74 to 84%. A total of 2665 never smokers at year 7 with complete data for years 7 and 11 were included in the analyses.

Findings: Adjusting for year 7 BMI and other potential confounders, regular smokers (more than six cigarettes a week) at year 11 had significantly lower BMI (P = 0.002) than other students. Smokers defined by a cotinine above 15 ng/ml also had lower BMI (P < 0.0001). Waist circumferences were lower in regular smokers (P = 0.014) and cotinine-defined smokers (P < 0.011). No consistent association was found between smoking and height. The adjusted difference in weight between regular smokers and other students amounted to 1.8 kg (95% CI, 0.52-3.17) for an average-height student.

Conclusion: Taking up regular smoking during adolescence may result in a lower BMI, but the effect is small and of uncertain significance.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Body Height*
  • Body Mass Index*
  • Counseling / statistics & numerical data
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Peer Group
  • Risk Factors
  • Self Concept
  • Smoking / adverse effects*
  • Smoking / physiopathology
  • Socioeconomic Factors
  • Waist-Hip Ratio*