Ely Alice V, Keyser Heather, Spilka Nathaniel, Franklin Teresa R, Wetherill Reagan R, Audrain-McGovern Janet
University of Pennsylvania, Department of Psychiatry, 3535 Market St Suite 500, Philadelphia, PA 19104, United States.
Drug Alcohol Depend Rep. 2021 Nov 27;1:100008. doi: 10.1016/j.dadr.2021.100008. eCollection 2021 Dec.
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.
Three groups of adults who smoke cigarettes ( = 79; obese = 25, overweight = 30, and lean = 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).
Analyses revealed different associations between reasons for smoking and smoking behavior depending on lean, overweight, or obesity status. Participants ( 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 (2, 79)=3.34, = 0.04).
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.
吸烟和肥胖是过早发病和死亡的主要原因，二者并存时会使全因死亡率风险增加四倍。尽管研究表明吸烟动机可能因体重指数（BMI）而异，但尚不清楚这些差异如何转化为吸烟行为。
三组吸烟成年人（n = 79；肥胖者 = 25，超重者 = 30，瘦者 = 24）完成了吸烟情况测量及吸烟动机问卷。通过弗格斯特罗姆吸烟依赖测试（FTCD）测量发现，三组在年龄、教育程度、每日吸烟量（CPD）、吸烟包年数或尼古丁依赖方面无差异。
分析显示，根据瘦、超重或肥胖状态，吸烟原因与吸烟行为之间存在不同的关联。参与者（37名女性，平均年龄39.8岁）自我报告的吸烟情况与瘦者的成瘾性及自动性分量表得分呈正相关，与超重者仅成瘾性分量表得分呈正相关，与肥胖者仅自动性分量表得分呈正相关。事后多因素协方差分析显示，组别×自动吸烟对吸烟包年数有显著交互作用（F(2, 79)=3.34, p = 0.04）。
研究结果表明，吸烟动机与吸烟成年人的吸烟行为因体重状态不同而存在差异关联。肥胖参与者的每日吸烟率可能与吸烟的成瘾性质关系较小，超重者的自动性可能与吸烟史的关联较小。有必要对BMI对吸烟的影响进行更多研究，以充分阐明肥胖如何影响治疗效果，从而优化超重者的戒烟治疗。
