1            Smoking habits in Greek adults           and their relation to body weight.     (Data from first national epi...
2     The present study is part of a nationwide,       cross-sectional epidemiological study   conducted from February 200...
3    Subjects and Methods (a)• Sample selection: Data were collected by a  questionnaire from all members of households,  ...
4    Subjects and Methods (b)• Questionnaire: Households received a sealed  envelope with instructions and with a  questio...
5    Subjects and Methods (c)                  Male             Female                 (8090)            (9313)      age  ...
6       Subjects and Methods (d)   • Weight (kg)                        Calculation of BMI (kg/m2)   • Height (m)   • Wais...
7     WHO definitions for BMI    <18.5:          underweight18.5-24.9:          normal weight25.0-29.9:          overweigh...
8          Cut-off points      of Waist Circumference   <94cm: low risk94-102cm: increased risk                           ...
9                         Results      % smoking and non-smoking in males and females    100                39,1    80    ...
% smoking and non-smoking in males in the 3 main               10                             age groups      100         ...
11   Waist circumference and BMI in male and      female smokers and non-smokers      (statistically significant differenc...
Males: Waist circumference in smokers and non-                          smokers                                           ...
13              Males: BMI in smokers and non-smokers                    in the 3 different age groups                    ...
Females : Waist circumference in smokers and non-                                                                   14    ...
15         Females: BMI in smokers and non-smokers                in the 3 different age groups                (non-signif...
16   Multiple regression analysis in males  Dependent variable=    BMI  Independent variables= age, walking habits, marita...
17  Multiple regression analysis in females  Dependent variable=    BMI  Independent variables= age, walking habits, marit...
18   Multiple regression analysis in males  Dependent variable=     Waist circumference  Independent variables= age, BMI, ...
19  Multiple regression analysis in females  Dependent variable=     Waist circumference  Independent variables= age, BMI,...
20 Multiple regression analysis in male smokers  Dependent variable=     BMI  Independent variables= age, cigarettes/day, ...
21Multiple regression analysis in males smokers  Dependent variable=     Waist circumference  Independent variables= age, ...
22Multiple regression analysis in female smokers  Dependent variable=     BMI  Independent variables= age, cigarettes/day,...
23Multiple regression analysis in female smokers  Dependent variable=     Waist circumference  Independent variables= age,...
24                  Conclusions• Greek males are greater smokers than  females on the whole and in the three main  age gro...
25                  Discussion (a)      A widely held but poorly documented view is that       tobacco smoking may reduce...
26                  Discussion (b)    Different studies on the relationship between smoking     habits and obesity come t...
271st National Epidemiological Large Scale Survey on the
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2005 14th eco1

  1. 1. 1 Smoking habits in Greek adults and their relation to body weight. (Data from first national epidemiological large scale survey on the prevalence of obesity in Greece) E. Chala, I. Kaklamanos, I. Ioannides, T. Tzotzas, M. Kaklamanou and E. KapantaisHellenic Medical Association for Obesity (HMAO), Athens, Greece. 1st National Epidemiological Large Scale Survey on the
  2. 2. 2 The present study is part of a nationwide, cross-sectional epidemiological study conducted from February 2003 to June 2003.This study was designed to estimate obesity prevalence in Greek children and adults and to identify factors associated with obesity indices. One such factor is smoking habits . 1st National Epidemiological Large Scale Survey on the
  3. 3. 3 Subjects and Methods (a)• Sample selection: Data were collected by a questionnaire from all members of households, through their children aged 13-19 years, who had direct measurements at the secondary schools. The method used for school selection was that of proportionate stratified random sampling.• Procedure: Gym instructors were trained on anthropometric techniques in order to help the children taking measurements at school, and explain them how to help their relatives to take the appropriate measurements. 1st National Epidemiological Large Scale Survey on the
  4. 4. 4 Subjects and Methods (b)• Questionnaire: Households received a sealed envelope with instructions and with a questionnaire seaking information on factors associated with obesity (socioeconomic status, dietary habits, physical activity status, smoking habits, etc)1st National Epidemiological Large Scale Survey on the
  5. 5. 5 Subjects and Methods (c) Male Female (8090) (9313) age 44.6±10.5 41.5±11.11st National Epidemiological Large Scale Survey on the
  6. 6. 6 Subjects and Methods (d) • Weight (kg) Calculation of BMI (kg/m2) • Height (m) • Waist circumference(cm) Calculation of WHR • Hip circumference (cm) (waist-to-hip ratio) Statistical analysis used SPSS version 11.5.Results on BMI, WC and WHR were calculated as mean±SD. Comparisons were made by student’s t-test and non-parametric tests. Proportions were compared using the X2 test. Multiple regression analysis was applied to estimate the contribution of various factors on the prediction of obesity indices. 1st National Epidemiological Large Scale Survey on the
  7. 7. 7 WHO definitions for BMI <18.5: underweight18.5-24.9: normal weight25.0-29.9: overweight >30.0: obese >40.0: morbidly obese1st National Epidemiological Large Scale Survey on the
  8. 8. 8 Cut-off points of Waist Circumference <94cm: low risk94-102cm: increased risk For men >102cm: substancially increased risk <80cm: low risk For 80-88cm: increased risk women >88cm: substancially increased risk1st National Epidemiological Large Scale Survey on the
  9. 9. 9 Results % smoking and non-smoking in males and females 100 39,1 80 67,5 non-smokers 60 smokers 40 60,9 32,5 20 0 males (8090) females (9313) X2=1409.4, p=0.0001st National Epidemiological Large Scale Survey on the
  10. 10. % smoking and non-smoking in males in the 3 main 10 age groups 100 35,9 44,3 80 48,7 male non-smokers 60 male smokers 40 64,1 51,3 55,7 20 Age 20-35 0 X2=52.4, p=0.000 age 20-35 age 35-50 age >50 Age 35-50 X2=1023, p=0.000 % smoking and non-smoking in females in the 3 main age groups Age >50 X2=520, p=0.000 100 80 62,8 65,6 87,8 female non-smokers 60 female smokers 40 20 37,2 34,4 12,2 0 age 20-35 age 35-50 age >501st National Epidemiological Large Scale Survey on the
  11. 11. 11 Waist circumference and BMI in male and female smokers and non-smokers (statistically significant difference) Smokers Non-smokers p Waist 95.65± 15.63 94.66± 15.84 0.000Male BMI 27.38± 4.75 27.23± 4.92 0.037 Waist 84.63± 13.89 85.85± 14.79 0.000Female BMI 25.42± 5.02 25.87± 5.28 0.000 1st National Epidemiological Large Scale Survey on the
  12. 12. Males: Waist circumference in smokers and non- smokers 12 in the 3 different age groups (non-significant difference) NS NS } } 98 96,45 96,74 96,13 95,79 96 94 92 NS } Waist 90 circumference 87,66 86,9 Smokers 88 Non-smokers 86 84 82 80 20-35 35-50 >50 Age groups1st National Epidemiological Large Scale Survey on the
  13. 13. 13 Males: BMI in smokers and non-smokers in the 3 different age groups (non-significant difference) NS NS } } 28 27,58 27,54 27,66 27,61 27 NS 26 } BM I 25,27 25,17 Smokers 25 Non-smokers 24 23 20-35 35-50 >50 Age groups1st National Epidemiological Large Scale Survey on the
  14. 14. Females : Waist circumference in smokers and non- 14 smokers in the 3 different age groups (non-significant difference) NS } 94,69 94,71 96 94 92 90 NS } 88 NS 85,03 84,97 Waist 86 } circumference 84 81,76 82,11 Smokers 82 Non-smokers 80 78 76 74 20-35 35-50 >50 Age groups1st National Epidemiological Large Scale Survey on the
  15. 15. 15 Females: BMI in smokers and non-smokers in the 3 different age groups (non-significant difference) NS } 30 28,94 28,75 28 NS } NS 25,66 25,69 26 } BMI 24,41 24,13 Smokers 24 Non-smokers 22 20 20-35 35-50 >50 Age groups1st National Epidemiological Large Scale Survey on the
  16. 16. 16 Multiple regression analysis in males Dependent variable= BMI Independent variables= age, walking habits, marital status, smoking beta p Age 0.016 0.166 Walking habits -0.021 0.061 Marital status 0.124 0.000 Smoking habits 0.004 0.716 (F=32.563, sig=0.000)1st National Epidemiological Large Scale Survey on the
  17. 17. 17 Multiple regression analysis in females Dependent variable= BMI Independent variables= age, walking habits, marital status, smoking beta p Age 0.255 0.000 Walking habits 0.020 0.058 Marital status 0.028 0.007 Smoking habits 0.001 0.898 (F=150.8, sig=0.000)1st National Epidemiological Large Scale Survey on the
  18. 18. 18 Multiple regression analysis in males Dependent variable= Waist circumference Independent variables= age, BMI, walking habits, marital status, smoking beta p Age 0.014 0.199 BMI 0.510 0.000 Walking habits - 0.015 0.143 Marital status 0.081 0.000 Smoking habits 0.015 0.150 (F=515.162, sig=0.000)1st National Epidemiological Large Scale Survey on the
  19. 19. 19 Multiple regression analysis in females Dependent variable= Waist circumference Independent variables= age, BMI, walking habits, marital status, smoking beta p Age 0.112 0.000 BMI 0.592 0.000 Walking habits -0.200 0.023 Marital status -0.003 0.750 Smoking habits 0.005 0.608 (F=1021.658, sig=0.000)1st National Epidemiological Large Scale Survey on the
  20. 20. 20 Multiple regression analysis in male smokers Dependent variable= BMI Independent variables= age, cigarettes/day, walking habits, marital status beta p Age 0.079 0.000 Cigarettes/day 0.011 0.435 Walking habits -0.033 0.025 Marital status 0.078 0.000 (F=22.257, sig=0.000)1st National Epidemiological Large Scale Survey on the
  21. 21. 21Multiple regression analysis in males smokers Dependent variable= Waist circumference Independent variables= age, BMI, cigarettes/day, walking habits, marital status beta p Age 0.039 0.008 BMI 0.497 0.000 Cigarettes/day 0.038 0.004 Walking habits -0.017 0.216 Marital status 0.050 0.001 (F=294.101, sig=0.000)1st National Epidemiological Large Scale Survey on the
  22. 22. 22Multiple regression analysis in female smokers Dependent variable= BMI Independent variables= age, cigarettes/day, walking habits, marital status beta p Age 0.201 0.000 Cigarettes/day 0.014 0.463 Walking habits 0.027 0.144 Marital status 0.018 0.339 (F=32.347, sig=0.000)1st National Epidemiological Large Scale Survey on the
  23. 23. 23Multiple regression analysis in female smokers Dependent variable= Waist circumference Independent variables= age, BMI, cigarettes/day, walking habits, marital status beta p Age 0.073 0.000 BMI 0.614 0.000 Cigarettes/day 0.004 0.795 Walking habits 0.004 0.799 Marital status -0.013 0.423 (F=334.007, sig=0.000)1st National Epidemiological Large Scale Survey on the
  24. 24. 24 Conclusions• Greek males are greater smokers than females on the whole and in the three main age groups.• Contrary to general belief, smoking habits are not correlated to obesity indices, with the exception of waist circumference in male smokers which seems to be related to the number of cigarettes smoked per day.• Age is a confounding factor when estimating the relationship between obesity indices and smoking habits: Males of the middle age, who happen to be greater smokers, are more obese, while younger women, who happen to be thinner, are the ones that smoke more.1st National Epidemiological Large Scale Survey on the
  25. 25. 25 Discussion (a) A widely held but poorly documented view is that tobacco smoking may reduce body weight and certain obesity indicators:• Animal studies have shown that nicotine decreases appetite and energy intake• However, epidemiological studies in adults have shown that the habitual intake of smokers is equal to or greater than nonsmokers and that the diet of smokers is more energy dense than that of nonsmokers.• Concerning energy expenditure, cigarette smoking increases Resting Metabolic Rate: Nicotine increases sympathetic nervous system activity and increases thermogenesis in adipose tissue, at least in rodent studies. 1st National Epidemiological Large Scale Survey on the
  26. 26. 26 Discussion (b) Different studies on the relationship between smoking habits and obesity come to conflicting results, mainly because of the many confounding factors: alcohol consumption (that usually goes with heavy smoking), socioeconomic status, psychological profil, age, initial reason for taking up smoking, health problems that lead to restraining from smoking etc. However, the most common finding is that smokers are leaner than nonsmokers, but among smokers, smoking intensity is positively related to obesity, mainly of central distribution. According to our results, smoking habits are not in any way correlated to obesity indices with the exception of waist circumference in male smokers, which seems to be related to the number of cigarettes smoked per day. 1st National Epidemiological Large Scale Survey on the
  27. 27. 271st National Epidemiological Large Scale Survey on the
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