Association of BMI Changes Between Adolescence and Young Adulthood With Smoking Cessation

Abstract

Purpose: Weight gain frequently accompanies smoking cessation. This study examined if increasing body mass index (BMI) during the early years of smoking influences quitting by young adulthood. Design: Longitudinal, observational study using in-home interview data. Setting: National Longitudinal Study of Adolescent and Adult Health (Add Health) 1994 to 2008. Subjects: Nine hundred forty-nine adolescent smokers (12-19 years) followed into young adulthood (20-32 years) through 4 waves of in-home interviews. Measures: Outcome variable: Young adult smoking status (yes or no) reported at in-home interviews. Factors: Gender and 4 longitudinal adolescent/young adult BMI trajectories—normal/normal, normal/overweight, normal/obese, and overweight/obese. Covariates: Race-ethnicity, education, household income, and recent quit attempt in adolescence. Analysis: Binary logistic regression analysis. Results: Overall, the rate at which young adults quit smoking was not significantly different based on gender. However, longitudinal changes in BMI trajectory and gender interact to influence young adult smoking status. Women having normal/overweight and normal/obese BMI trajectories were less likely to quit smoking than men. Odds that young adults having some college or post-high school education quit smoking were greater than those with high school education or less. Conclusion: At a minimum, providing direct information regarding anticipated weight changes after quitting is indicated in smoking cessation intervention, in addition to strategies to mitigate postcessation weight gain. Faced with weight gain, younger smokers, particularly women, may be more resistant to quitting smoking.