The Complex Relationship between Cigarette Smoking and Obesity

Andrew Fenelon, Brown University
Andrew Foster, Brown University

Cigarette smoking and obesity are the first and second largest causes, respectively, of premature mortality in the United States. Among individuals, there is a negative relationship between cigarette smoking and body weight; smokers tend to weigh less than non-smokers. At the aggregate level, the relationship is more complex. We use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the inconsistency between the individual-level relationship and the state-level relationship between these two behavioral risk factors. We show a positive relationship across states: states with a high prevalence of smoking also experience a high prevalence of obesity. We also note that this geographic pattern does not violate the individual-level relationship: individual smokers within states weigh less than non-smokers. We suggest that state differences in approaches to health-related behavior interventions and policies may contribute to the acceptability of both behaviors over time.