Kenneth D Ward Robert C Klesges and Mark W Vander

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University of Memphis Center for Community Health, Memphis, Tennessee, USA

The health consequences of cigarette smoking are well established (1). Smoking has been linked to many serious health problems including cancer, coronary heart disease, stroke, and chronic obstructive pulmonary disease (2). As a result, smoking has been determined to be the single most preventable cause of death in Western society (3). Each year, an estimated 419 000 people in the United States die from smoking-related diseases (4), making it responsible for approximately one in every five deaths (2). Although overall smoking rates have declined over the past 30 years in the United States, nearly 26% of the population continue to smoke (5), including 3.1 million adolescents (6).

One of the many factors which may encourage smoking, despite health risks, is the influence of smoking on body weight. There is considerable evidence that the weight-controlling properties associated with cigarette smoking influence decisions to smoke. For example, the relationship between smoking and weight control has been linked to the initiation of smoking (7,8). In a study examining the relationship between weight concerns and cigarette smoking, French et al. (9) found that concerns about weight were associated with a greater likelihood of smoking initiation among female adolescents over a 1-year period. The relationship between smoking and body weight is also related to smoking maintenance in adults. Smoking for weight control is frequently reported, particularly by women (7,10,11). Additionally, individuals who are concerned about gaining weight are often more reluctant to quit smoking (12,13). Finally, concerns about gaining weight have been associated with failure to quit smoking (14,15) and relapse (7,16) although these effects appear to be equivocal (17-19).

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