Gender, smoking and weight concerns: relationship to self-reported body mass index (BMI).

Concerns about weight have been identified as one motive for cigarette smoking among adolescents, especially females. In this paper we describe a study that links smoking related weight concerns with actual weight, testing if smoking adolescents' weight concerns are reflected in actual weight differences. We surveyed 1738 students (age 11-20) from 12 public schools in Kiel, Germany, assessing smoking status, weight concerns, body satisfaction as well as height and weight. Height and weight measures were transformed into age and sex adjusted body mass index (BMI percentiles). We confirmed a positive association between smoking and weight concerns as well as a profound gender difference in the absolute frequency of weight concerns, with female students having weight concerns almost 4-times as often as male students. However, we found no gender-specific association between smoking and weight concerns. In addition, smoking was completely unrelated to actual weight. If female students had no weight concerns, they were strongly biased towards reporting BMIs far below their respective age group. Unlike weight concerns of males, female weight concerns did not vary with actual deviations from the BMI norm. Together, this study indicates that females are less realistic than males regarding their weight appraisals. One supplementary strategy of preventing females from starting to smoke should be an adjustment of these weight appraisals.