Weight concerns and smoking in a general population:

Abstract

Objective.

No previous studies have explored weight concerns in relation to smoking habits, or investigated how weight concerns affect smoking cessation in a general population.

Method.

Inter99 is a population-based lifestyle interventional study, conducted in 1999–2001 in Copenhagen, Denmark, comprising 30–60 year old men and women. All daily smokers (N = 2408) were offered help to quit. The baseline investigation (N = 6784) was used for analysing associations of smoking status with weight concerns (cross-sectional design). To analyse how weight concerns affected smoking cessation we included the 1387 daily smokers attending 1-year follow-up; 221 of these were verified quitters (longitudinal design).

Results.

Daily smoking men and women had a significantly lower body mass index than never smokers (men: 3%, women 5%) but reported to be significantly less concerned of their weight (men: OR = 0.64, 95%CI = 0.4–0.9), women: 0.78(0.6–1.0)). Ex-smoking normal weight women were significantly more likely to be frequently concerned of their weight than never smoking normal weight women (OR = 2.06, 95CI% = 1.6–2.7). Fifty-two percent of the women and 32% of the men with a previous quit attempt reported that weight gain was a reason for relapse. Neither weight concerns nor eating patterns were predictive of point abstinence at 1-year follow-up.

Conclusion.

Smokers are believed to be very concerned of their weight but in this population-based study, daily smokers more frequently ate what they wanted, had a lower BMI and were significantly less concerned of their weight than never smokers. Weight concerns and eating patterns did not predict abstinence at 1-year follow-up. It seems that weight gain and weight concerns are independent factors.

Introduction

Giving up smoking has well documented health benefits, but weight gain is very frequent after smoking cessation (Filozof et al., 2004, Klesges et al., 1997, Williamson et al., 1991). Most quitters will gain 4–5 kg but as many as 13% of quitters may gain 11 kg or more (Klesges et al., 1989, Swan and Carmelli, 1995). In some studies weight gain after smoking cessation has been found to be associated with relapse among abstainers (Borrelli and Mermelstein, 1998), while other studies have shown that post-cessation weight gain was predictive of higher abstinence rates (Hall et al., 1986, Norregaard et al., 1993, Swan and Denk, 1987).

Even though it is clear that many smokers, and especially female smokers, are concerned of post-cessation weight gain (Pomerleau et al., 2001), it is unclear how weight concerns affect smoking cessation. Actually, some studies have reported that weight concerns were unrelated to quit attempts and did not predict smoking status. However, these studies have mostly been in selected materials: female smokers (French et al., 1992, Glasgow et al., 1999, Perkins et al., 2001), smokers attending a specific smoking cessation program (Borrelli and Mermelstein, 1998, Meyers et al., 1997), smokers in work places (French et al., 1995, Jeffery et al., 2000), military recruits (Talcott et al., 1995) or medically ill smokers (Sepinwall and Borrelli, 2004) but not in a population based sample of smokers. Also, to our knowledge, no previous studies have explored weight concerns in an unselected general population consisting of smokers, ex-smokers, occasional smokers and never smokers to see whether smokers are more concerned of weight than non-smokers.

The aim of this article was to explore if weight concerns and eating patterns were predictors of abstinence at 1-year follow-up in a sample of unselected smokers from a general population. Furthermore, we wanted to describe weight concerns and eating patterns in a Danish general population according to smoking status, and look at difference in gender.