Associations between body mass index and smoking behaviour: A cross-sectional study of the German adult population

Isabel Wolters; Sabrina Kastaun; Daniel Kotz

doi:10.1016/j.physbeh.2023.114436

Associations between body mass index and smoking behaviour: A cross-sectional study of the German adult population

Physiol Behav. 2024 Mar 1:275:114436. doi: 10.1016/j.physbeh.2023.114436. Epub 2023 Dec 14.

Authors

Isabel Wolters¹, Sabrina Kastaun², Daniel Kotz³

Affiliations

¹ Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
² Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany; Institute of General Practice (ifam), Centre for Health and Society (chs), Patient-Physician Communication Research Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany.
³ Institute of General Practice (ifam), Centre for Health and Society (chs), Addiction Research and Clinical Epidemiology Unit, Medical Faculty of the Heinrich-Heine-University, Düsseldorf, Germany; Department of Behavioural Science and Health, University College London, London, United Kingdom. Electronic address: Daniel.Kotz@med.uni-duesseldorf.de.

PMID: 38103627
DOI: 10.1016/j.physbeh.2023.114436

Abstract

Background: Both smoking and high body weight are risk factors for disease, hence, the association between smoking and body weight is an important health issue. Furthermore, concern about weight gain after quitting smoking is for many smokers a barrier to smoking cessation. The present study aims to explore the association between body mass index (BMI) and current tobacco smoking status in the population of Germany, and smoking and quitting behaviour amongst smokers (and recent ex-smokers =<12 months since quitting).

Methods: Cross-sectional analysis of two waves of data collected from March through June 2021 through a representative face-to-face household survey in Germany (N = 3 997 respondents aged ≥18). The associations between smoking and quitting behaviours and BMI were analysed through four regression models adjusted for socio-demographic, socio-economic, and smoking characteristics of respondents.

Results: Long-term ex-smokers (>= 12 months since quitting smoking) were more likely to have a higher BMI compared to never smokers (β = 0.64, 95% confidence interval (CI) = 0.10-1.19). There was no statistically significant association between current smoking status or recent ex-smoking status and BMI (β = -0.29,95 %CI = -0.75-0.17 and β = -0.53, 95 %CI = -2.45-1.40). Among current smokers, no statistically significant association was found between BMI and the motivation to stop smoking (OR = 1.01, 95 %CI = 0.99-1.03). Neither number of cigarettes smoked a day nor outcome of most recent quit attempt were related to BMI (β = 0.01, 95 %CI = -0.04-0.05 and OR = 0.41, 95 %CI = 0.05-3.05).

Conclusion: In the German population long-term ex-smoking but not current and recent ex-smoking was associated with increased BMI. Future research should further explore the association between smoking behaviour and abdominal obesity, preferably using a more accurate measure for abdominal obesity than BMI.

Keywords: Body mass index; Motivation to stop smoking; Population survey; Smoking.

MeSH terms

Adult
Body Mass Index
Cross-Sectional Studies
Humans
Obesity, Abdominal*
Smoking / epidemiology
Smoking Cessation*