Gender as a Moderator in the Association of Body Weight to Smoking and Mental Health

Objectives. I sought to examine gender's role as a moderator in the association of relative body weight to smoking and mental health. Methods. Data came from the 2004-2005 Minnesota Survey on Adult Substance Use, a statewide telephone survey (N=16289). Current smoking and mental health problems were examined in relation to relative body weight across genders, with control for covariates. Results. Relative to their healthy-weight counterparts, overweight or obese men were less likely to smoke, whereas overweight women were more likely to smoke. Mental health problems were not related to relative body weight among men. However, overweight or obese women were more likely than were their healthy-weight counterparts to have a negative self-assessment of mental health, and obese women were more likely to have a mental health problem. In addition, underweight women had increased odds of being a smoker and having mental health problems. Conclusions. The results indicate that gender has a moderating role in the association between body weight and both smoking and mental health. Gender-specific analysis rather than adjustment for the impact of gender in analyses is a promising avenue for future research. (Am J Public Health. 2009;99:146-151. doi: 10.2105/AJPH.2007.132225)