Smoking Status, Cigarettes Per Day, and Their Relationship to Overweight and Obesity Among Former and Current Smokers in a National Adult General Population Sample

Background: Weight gain after smoking cessation is perceived to be a barrier against quitting smoking. The goal was to analyze overweight and obesity depending on smoking status and number of cigarettes per day (cpd) among former and current smokers.

Methods: The sample included 7124 residents of Germany aged 18-79 y from a national health examination survey (participation rate: 61.4%). Body weight and height were objectively measured; smoking status and cpd were assessed by a questionnaire administered in a health examination center.

Results: The number of cpd was positively related to being overweight and more so to obesity among former smoking men, but not women. The results were adjusted for age, school education, exercise and alcohol consumption. Men who formerly had smoked more than 30 cpd had an adjusted odds ratio (OR) of 5.0 for obesity compared to men who had never smoked.

Conclusion: With an increasing number of cpd more psychological and physiological processes of compensation of nicotine supply after smoking cessation may be expected. Male smokers should be provided with information on how to prevent weight gain after smoking cessation. To foster smoking cessation, female smokers should be informed that women who stop smoking manage to have no increase in the rates of overweight or obesity when considered at the general population level.