Tobacco smoking in relation to body fat mass and distribution in a general population sample

OBJECTIVE: To investigate the effects of variable amounts of tobacco smoking on body mass index and waist-to-hip ratio among current smokers. DESIGN: Population-based cohort study. SUBJECTS: A total of 22 059 apparently healthy men and women, who enrolled in the Greek EPIC cohort, aged 25 - 84 years, who had never smoked ( 14 751) or were current cigarette smokers ( 7308). MEASUREMENTS: Body mass index and waist-to-hip ratio ( by anthropomentry), amount of tobacco smoking and energy expenditure ( by an interviewer-administered, lifestyle questionnaire), energy intake and ethanol intake ( by an interviewer-administered, validated, semiquantitative, food frequency questionnaire), at enrollment. RESULTS: In comparison to nonsmokers, smokers of the average number of cigarettes have lower body mass index. Among smokers, however, increased amount of smoking tends to be positively associated with body mass index, particularly among men. Waist-to-hip ratio is positively associated with amount of cigarettes smoked per day, among both men and women. CONCLUSION: Among smokers, tobacco smoking is positively associated with body mass index and waist-to-hip ratio. Our data suggest that the lower body mass index of smokers compared to nonsmokers reflects personality characteristics of those who choose to smoke and that the tendency to gain weight after smoking cessation may have behavioral rather than tobacco-related pharmacological roots.