title: Dose-dependent positive association between cigarette smoking, abdominal obesity and body fat: cross-sectional data from a population-based survey.
abstract: BACKGROUND
  Although smokers tend to have a lower body-mass index than non-smokers, smoking may favour abdominal body fat accumulation. To our knowledge, no population-based studies have assessed the relationship between smoking and body fat composition. We assessed the association between cigarette smoking and waist circumference, body fat, and body-mass index.
  
  
  METHODS
  Height, weight, and waist circumference were measured among 6,123 Caucasians (ages 35-75) from a cross-sectional population-based study in Switzerland. Abdominal obesity was defined as waist circumference ≥ 102 cm for men and ≥ 88 cm for women. Body fat (percent total body weight) was measured by electrical bioimpedance. Age- and sex-specific body fat cut-offs were used to define excess body fat. Cigarettes smoked per day were assessed by self-administered questionnaire. Age-adjusted means and odds ratios were calculated using linear and logistic regression.
  
  
  RESULTS
  Current smokers (29% of men and 24% of women) had lower mean waist circumference, body fat percentage, and body-mass index compared with non-smokers. Age-adjusted mean waist circumference and body fat increased with cigarettes smoked per day among smokers. The association between cigarettes smoked per day and body-mass index was non-significant. Compared with light smokers, the adjusted odds ratio (OR) for abdominal obesity in men was 1.28 (0.78-2.10) for moderate smokers and 1.94 (1.15-3.27) for heavy smokers (P = 0.03 for trend), and 1.07 (0.72-1.58) and 2.15 (1.26-3.64) in female moderate and heavy smokers, respectively (P < 0.01 for trend). Compared with light smokers, the OR for excess body fat in men was 1.05 (95% CI: 0.58-1.92) for moderate smokers and 1.15 (0.60-2.20) for heavy smokers (P = 0.75 for trend) and 1.34 (0.89-2.00) and 2.11 (1.25-3.57), respectively in women (P = 0.07 for trend).
  
  
  CONCLUSIONS
  Among smokers, cigarettes smoked per day were positively associated with central fat accumulation, particularly in women.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. Carole.willi@gmail.com
authors.forename: Carole
authors.initials: C
authors.lastname: Clair
authors.forename: Arnaud
authors.initials: A
authors.lastname: Chiolero
authors.forename: David
authors.initials: D
authors.lastname: Faeh
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.forename: Fred
authors.initials: F
authors.lastname: Paccaud
authors.forename: Vincent
authors.initials: V
authors.lastname: Mooser
authors.forename: Gérard
authors.initials: G
authors.lastname: Waeber
authors.forename: Peter
authors.initials: P
authors.lastname: Vollenweider
mesh_terms: D000273:Adipose Tissue; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000209:etiology*; D011159:Population Surveillance; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology*; D011795:Surveys and Questionnaires; D013557:Switzerland; D055105:Waist Circumference