Body Mass Index, Body Dissatisfaction and Adolescent Smoking Initiation

Laurence Howe, Lea Trela-Larsen, Michelle Taylor, Jon Heron, Marcus Munafo, Amy Taylor

Research output: Contribution to journalArticle (Academic Journal)peer-review

25 Citations (Scopus)
338 Downloads (Pure)


Background: Smoking influences body weight, but there is little evidence as to whether body mass index (BMI) and body dissatisfaction increase smoking initiation in adolescents.

Methods: We evaluated the association between measured BMI, body dissatisfaction and latent classes of smoking initiation (never smokers, experimenters, late onset regular smokers, early onset regular smokers) in the Avon Longitudinal Study of Parents and Children. In observational analyses we used BMI (N=3,754) and body dissatisfaction at age 10.5 years (N=3,349). In Mendelian randomisation (MR) analysis we used a BMI genetic risk score of 76 single nucleotide polymorphisms (N=4,017).

Results: In females, higher BMI was associated with increased odds of early onset regular smoking (OR: 1.11, 95% CI: 1.04, 1.18) compared to being a never smoker, but not with experimenting with smoking (OR: 1.04, 95% CI: 0.99, 1.10) or late onset regular smoking (OR: 1.01, 95% CI: 0.94, 1.09). No clear evidence was found for associations between BMI and smoking initiation classes in males (p-value for sex interaction ≤ 0.001). Body dissatisfaction was associated with increased odds of late-onset regular smoking (OR: 1.71, 95% CI: 1.32, 1.99) in males and females combined (P-value for sex interaction = 0.32). There was no clear evidence for an association between the BMI genetic risk score and smoking latent classes in males or females but estimates were imprecise.

Conclusions: BMI in females and body dissatisfaction in males and females are associated with increased odds of smoking initiation, highlighting these as potentially important factors for consideration in smoking prevention strategies.
Original languageEnglish
Pages (from-to)143-149
Number of pages7
JournalDrug and Alcohol Dependence
Early online date8 Jun 2017
Publication statusPublished - 1 Sept 2017

Structured keywords

  • Brain and Behaviour
  • Tobacco and Alcohol


  • tobacco
  • body mass index
  • body dissatisfaction
  • Mendelian randomization


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