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The association of smoking with different eating and dietary behaviours: a cross-sectional analysis of 80,296 UK adults

journal contribution
posted on 2024-05-29, 14:40 authored by Arwa AlruwailiArwa Alruwaili, James KingJames King, Kevin Deighton, Benjamin Kelly, Zhining Liao, Aidan Innes, Joseph Henson, Thomas Yates, William Johnson, David Thivel, Lore Metz, Alice ThackrayAlice Thackray, Keith TolfreyKeith Tolfrey, David StenselDavid Stensel, Scott WillisScott Willis

Background and Aims Smokers typically have a lower body mass index (BMI) than non-smokers, while smoking cessation is associated with weight gain. In pre-clinical research, nicotine in tobacco smoking suppresses appetite and influences subsequent eating behaviour; however, this relationship is unclear in humans. This study measured associations of smoking with different eating and dietary behaviours. 

Design A cross-sectional analysis of data from health assessments conducted between 2004-2022. Setting An independent healthcare-based charity within the UK. Participants 80,296 men and women (mean±standard deviation [SD]: age, 43.0±10.4 years; BMI, 25.7±4.2 kg/m2; 62.5% male) stratified into two groups based on their status as a smoker (n=6,042; 7.5%) or non-smoker (n= 74,254; 92.5%). 

Measurements Smoking status (self-report) was the main exposure, while the primary outcomes were selected eating and dietary behaviours. Age, sex and socioeconomic status (index of multiple deprivation [IMD]) were included as covariates and interaction terms, while moderate-to-vigorous exercise and sleep quality were included as covariates only. 

Findings Smokers had lower odds of snacking between meals and eating food as a reward or out of boredom versus non-smokers (all odds ratio [OR]≤0.82; P<0.001). Furthermore, smokers had higher odds of skipping meals, going more than 3 hours without food, adding salt and sugar to their food, overeating, and finding it hard to leave something on their plate versus non-smokers (all OR≥1.06; P≤0.030). Additionally, compared with non-smokers, smoking was associated with eating fried food more times per week (rate ratio [RR]=1.08; P<0.001) and eating fewer meals per day, eating sweet foods between meals, and eating dessert on fewer days per week (all RR≤0.93; P<0.001). Several of these relationships were modified by age, sex, and IMD. 

Conclusions Smoking appears to be associated with eating and dietary behaviours consistent with inhibited food intake, low diet quality, and altered food preference. Several of these relationships are moderated by age, sex, and socioeconomic status.


National Institute for Health and Care Research (NIHR) Leicester Biomedical Research Centre

King Saud bin Abdulaziz University



  • Sport, Exercise and Health Sciences

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  • AM (Accepted Manuscript)

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This is the peer reviewed version of the following article: [FULL CITE], which has been published in final form at [Link to final article using the DOI]. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.

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Dr Scott Willis. Deposit date: 23 May 2024

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