Journal of Consulting and Clinical Psychology 1998, \bl. 66, No. 6, 987-99.1 Copyright 1998 by the Amer an Psychological Association, Inc. 0022-006X/98/S3.00 The Prospective Relationships Between Smoking and Weight in a "Vbung, Biracial Cohort: The Coronary Artery Risk Development in Young Adults Study Robert C. Klesges, Kenneth D. Ward, and JoAnne W. Ray University of Memphis Prevention Center Gary Cutter AMC Cancer Research Center David R. Jacobs, Jr. University of Minnesota Lynne E. Wagenknecht Bowman Gray School of Medicine This study examined the relationship between smoking status and weight change from baseline to Year 7 in a large biracial cohort, the Coronary Artery Risk Development in Young Adults study. Unadjusted for covariates, only male smokers weighed less than nonsmokers, with no effect among women. Adjusted for covariates, male and female smokers weighed less than nonsmokers at baseline, adjusted for age, total energy intake, alcohol intake, and physical fitness. Over the 7-year follow-up, all smoking status groups gained weight, including continuous smokers and initiators. Weight gain was greatest among those who quit smoking. Weight gain attributable to smoking cessation was 4.2 kg for Whites and 6.6 kg for Blacks. Smoking had a small weight-attenuating effect on Blacks. No such effects, however, were observed among Whites. These results suggest, at least in younger smokers, that smoking has minimal impact on body weight. Cigarette smoking is recognized as the single most prevent- able cause of death and disease in the United States (United States Department of Health and Human Services [DHHS], 1987). Although the negative health consequences associated with cigarette smoking and the health benefits of quitting smok- ing are well established, approximately 26% of all adults in the United States continue to smoke (DHHS, 1987). One of the many reasons that individuals smoke (particularly young people and women) is the perception that smoking helps control body weight. For example, one study indicated that almost one third of smokers in a university sample reported using smoking to maintain or lose weight (Klesges & Klesges, 1988). In the only prospective study to date to evaluate the effects of weight concerns on risk for smoking onset, French, Perry, Leon, and Fulkerson (1994) surveyed high school stu- Robert C. Klesges, Kenneth D. Ward, and JoAnne W. Ray, Department of Psychology, University of Memphis Prevention Center; Gary Cutter, AMC Cancer Research Center, Denver, Colorado; David R. Jacobs, Jr., Division of Epidemiology/School of Public Health, University of Minne- sota; Lynne E. Wagenknecht, Bowman Gray School of Medicine, Wake Forest University. JoAnne W. Ray is now at the Psychology Service, Veterans Affairs Medical Center, Tuskegee. This study was supported by Grants HL45057, HL46352, and HL50723 from the National Heart, Lung and Blood Institute. Support was also received from a Centers of Excellence grant awarded by the state of Tennessee. Correspondence concerning this article should be addressed to Robert C. Klesges, University of Memphis Prevention Center, 5350 Poplar Ave- nue, Suite 430, Memphis, Tennessee 38119. Electronic mail may be sent to bklesges@cc.memphis.edu. dents (N - 1,705) at baseline and 1 year later. After adjustment for potential confounders (grade, body mass index [BMI], and socioeconotnic status), girls (but not boys) who reported having tried to lose weight in the past year, having two or more eating disorder symptoms, or constantly thinking about weight were more than twice as likely to initiate smoking as those who did not report these weight concerns. Thus, weight-conscious women, particularly White women, may be initiating smoking in an attempt to control their body weight, believing that smok- ing has strong anorexic effects (Camp, Klesges, & Relyea, 1993). Although there is documented evidence that a lifetime of smoking is associated with a 2.3- to 3.2-kg difference in body weight (compared with nonsmokers), the available prospective data between smoking initiation and body weight generally do not support the perception that smoking has a dramatic or even minimal immediate impact on body weight (Klesges, Meyers, Klesges, & LaVasque, 1989). In a cohort of more than 2,500 men and women with a mean age of 38 years at baseline, weight gain over 2 years did not differ between those who initiated smoking and those who had never smoked (French, Jeffery, et al., 1994). Similar negative findings were reported for the 55,000 female participants in the Nurses Health Study who were followed for 8 years (Colditz et al., 1992). Participants who began smoking ( n = 611) gained an average of 4.2 kg compared with 3.7 kg among "never smokers" (n = 31,632), 5.1 kg among current smokers of 1 to 24 cigarettes per day (n = 14,165), and 5.4 kg among current smokers of 25 or more cigarettes per day (n — 5,040). In contrast, in a cohort of 38- to 60-year-old women who were followed for an average of 6 years, those who initiated smoking (n = 26) dropped 0.37 BMI 987 This document is copyrighted by the American Psychological Association or one of its allied publishers. This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.