Intended for healthcare professionals

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Research

Smoking, obesity, and their co-occurrence in the United States: cross sectional analysis

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.38840.608704.80 (Published 29 June 2006) Cite this as: BMJ 2006;333:25

Rapid Response:

A comprehensive anaysis could be performed with the available data.

Editor,

This is with respect to the article analyzing the co-occurrence of smoking
and obesity in the United States. Smoking and obesity are major public
health issues faced by the world countries. It has become a major social
problem and the funds spent by Governments to have a check on these issues
are massive. This study attempts extraordinarily to bring about the
relationship between not only the major issues like smoking and obesity
but also goes a bit further to explore the underlying social factors
influencing a person to be a smoker or to be obese.

The prevalence of people who smoke and are obese in United States was
found to be 9 million. Although this represents only about 4.7% of the
total population, the stratification performed according to age yields
very meaningful results. The authors could have potentially taken this
analysis a bit further to observe the outcome of combination of the
different study factors. For instance an analysis to include smokers, who
are white, their educational status and income levels would have given a
much more detailed view about the existing social and health conditions in
different population groups. Although complex, this kind of data would
have provided with more compelling information regarding actual effect of
the different social and economic environment on one’s smoking or dietary
behavior.

Hence it would be prudent to undertake longitudinal studies to monitor the
effects of smoking on a person’s health and the effect of diet related
behavior on one’s smoking habits. This study is striving to bring about a
new relationship between the two independent factors. But from the
outlook, it appears to have a very weak association. This is further
ascertained by the results when out of 23.5 % of the overall obese people
and 22.7% of the overall smokers; only 4.7% of them were continuing with
both behaviors. But the health effect on people who are both smokers and
are obese is enormous. For instance the risk of cancer, premature ageing,
myocardial infarction and even endometrial cancer have been analyzed and
documented by various studies.

The higher prevalence of smokers who are obese among the African-
Americans raises a question whether there is any other external factors
apart from socio-economic condition and educational status that is
influencing the current observation.

Hence a longitudinal study to follow up on the present result to observe
the association between these two factors with other social and economic
environment would give health care providers comparitively strong evidence
to predict to a certain extent one’s health outcome given a person is both
a smoker and is obese.

Competing interests:
None declared

Competing interests: No competing interests

10 October 2006
Dorairajan Kulandaivel
Dentist and Public Health professional.
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