The longitudinal association of smoking behaviors with obesity risk among Chinese adults from the China Health and Nutrition Survey 1991–2015

Background: Present study aims to longitudinal explore independent association of smoking status and cigarette consumption with general obesity and abdominal among Chinese adults by gender. Methods This study include 75,348 adults (35,907 males and 39,441 females) aged 18-65 years from the longitudinal data of China Health and Nutrition Survey (CHNS, 1991-2015). Multilevel mixed-effects linear and logistic regression models were performed for association analysis. Results Among males and females, heavy smokers (> 25 cigarette/d) increased from 5.5% and 0.05% in 1991 to 6.8% and 0.1% in 2015, respectively ( p < 0.001). After controlling for confounding factors, the net effect on male light (1–14 cigarette/d), moderate (15–24 cigarette/d), and heavy smokers was a significant decrease of 0.40 kg/m 2 (β: −0.40, 95% CI: − 0.48, −0.31), 0.51 kg/m 2 (β: −0.51, 95% CI: −0.60, −0.43), and 0.29 kg/m 2 (β: −0.29, 95% CI: −0.43, −0.14) in BMI, respectively. From moderate and light smokers to nonsmokers were linked with significant WC decreases of 0.87 cm (β: −0.87, 95% CI: −1.14, −0.58) and 0.86 cm (β: −0.87, 95% CI: −1.12, −0.59) in males and 1.58 cm (β: −1.58, 95% CI: −2.94, −0.22) and 1.37 cm (β: −1.37, 95% CI: −2.13, −0.59) in females, respectively. The odds ratio (95% CIs) for general obesity in males were 0.72 (0.65–0.81) for light smokers and 0.68 (0.61–0.76) for moderate smokers compared with nonsmokers. Similarly, the odds ratio (95% CIs) for abdominal obesity in males were 0.80 (0.76–0.86) for light smokers and 0.81 (0.76–0.87) for moderate smokers compared with nonsmokers. Moreover, the odds ratio (95% CIs) for abdominal obesity in females were 0.83 (0.71–0.98) for light smokers and 0.73 (0.58–0.91) for moderate smokers compared with nonsmokers.Conclusions Compared with nonsmokers, current smokers had lower BMI and WC among Chinese adults regardless of gender. Heavy smokers are more likely to be general obesity and abdominal obesity in male and abdominal obesity in female than other smokers. These findings may improve the understanding on how smoking behaviors affect fat distribution and provide scientific evidence regarding intervention in smoking and obesity by gender.