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. 2021 Nov 27:1:100008.
doi: 10.1016/j.dadr.2021.100008. eCollection 2021 Dec.

An exploration of associations between smoking motives and behavior as a function of body mass index

Alice V Ely  1 , Heather Keyser  1 , Nathaniel Spilka  1 , Teresa R Franklin  1 , Reagan R Wetherill  1 , Janet Audrain-McGovern  1
Affiliations

An exploration of associations between smoking motives and behavior as a function of body mass index

Alice V Ely et al. Drug Alcohol Depend Rep. .

Erratum in

Abstract

Objective: Cigarette smoking and obesity are the leading causes of premature morbidity and mortality and increase the risk of all-cause mortality four-fold when comorbid. Although research suggests that smoking motives may differ based on body mass index (BMI), it is unclear how these differences translate to smoking behavior.

Method: Three groups of adults who smoke cigarettes (N = 79; obese n = 25, overweight n = 30, and lean n = 24) completed measures of smoking and the Smoking Motivations Questionnaire. Groups did not differ on age, education, cigarettes per day (CPD), pack-years, or nicotine dependence, as measured by the Fagerström Test for Cigarette Dependence (FTCD).

Results: Analyses revealed different associations between reasons for smoking and smoking behavior depending on lean, overweight, or obesity status. Participants (N = 37 female, average age 39.8 years) self-reported smoking was positively associated with Addictive, and Automatic subscale scores among lean participants, with only the Addictive subscale score among those with overweight, and only the Automatic subscale score among those with obesity. Post hoc MANCOVA analysis revealed a significant interaction effect of Group x Automatic Smoking on Pack-years (F(2, 79)=3.34, p = 0.04).

Conclusion: Findings suggest smoking motives are differentially associated with smoking behavior in adults who smoke depending on weight status. The daily smoking rate of participants with obesity may be less related to the addictive quality of smoking, and automaticity may be less associated with smoking history in those with overweight. Additional research on the influence of BMI on cigarette smoking is necessary to fully elucidate how obesity may impact treatment outcomes to optimize smoking cessation treatment among those with excess body weight.

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Conflict of interest statement

The authors declare no financial interests or conflicts of interest.

Figures

Fig 1
Fig. 1
Within-group partial correlations demonstrating associations between Addictive Smoking Motivation subscale scores and cigarettes per day (CPD) controlling for age and sex. Among Lean participants and those with overweight, greater endorsement of Addictive Motivation was significantly positively correlated with heavier daily smoking. There was no correlation with CPD among participants with obesity.
Fig 2
Fig. 2
MANCOVAs comparing groups on smoking characteristics as a function of reasons for smoking showed interactive relationships only with Addictive Smoking. The interaction of BMI group and Automatic Smoking subscale scores was significantly associated with number of pack-years, with those in lean and overweight groups reporting greater pack-years with higher automatic motivation when controlling for age and sex, while there was no such relationship shown in the group with overweight.
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