The association of cigarette smoking with appetite, appetite-related hormones and food reward: a matched-pair cohort study

This study examined associations of cigarette smoking with appetite perceptions, appetite-related hormones, food preferences and eating traits. In a cross-sectional matched-pair cohort design, 25 participants who smoke cigarettes and 25 who do not were matched 1:1 by age, sex, ethnicity, and BMI. Across two visits, participants’ food preferences (Leeds Food Preference Questionnaire), cravings (Control of Eating Questionnaire), and eating traits (Three-Factor Eating Questionnaire) were assessed. Fasting and postprandial appetite perceptions (visual analogue scales) were also assessed during a 4-h mixed-meal tolerance test (MM-TT), while fasting leptin and fasting and postprandial acylated ghrelin and total peptide-YY (PYY) were measured for 2 h postprandially. Group differences in study outcomes were analysed using generalised linear models. After adjustment (age and BMI), explicit liking and wanting for high-fat foods and cravings for savoury foods were higher in participants who smoke versus those who do not (P≤0.065; d≥0.52). Cognitive restraint was lower, while disinhibition was higher in participants who smoke compared to those who do not (P≤0.014; d≥0.69). Smoking was also associated with lower fasting acylated ghrelin and lower postprandial total PYY (P≤0.041; d≥0.58), whereas fasting leptin was similar between groups (P=0.821; d=0.06). Additionally, participants who smoke had higher fasting perceived fullness (P=0.021; d=0.65), while no other fasting or postprandial differences were identified for other appetite perceptions (hunger, prospective food consumption, satisfaction; P≥0.373; d≤0.25). In conclusion, cigarette smoking is associated with altered food preferences and less favourable eating traits, while more subtle differences may exist in appetite perceptions and appetite-related hormones.