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Puffs versus pounds

February 24, 2009

Pop quiz for teenagers: Are you more likely to die from smoking more than 10 cigarettes a day or from being obese?

That’s a trick question. According to a new study from the British Medical Journal, it’s a tie.

Swedish researchers studied the health records of 45,920 men who were drafted by the Swedish Army in 1969 and 1970 at an average age of 18 years and 8 months. The Army collected information on their height and weight, along with their smoking habits.

The researchers used those records to classify the men as underweight, normal, overweight or obese according to their body mass index. They also categorized them as nonsmokers, light smokers (if they smoked one to 10 cigarettes a day) and heavy smokers (if they smoked more than 10 cigarettes a day).

Then they consulted Sweden’s national cause of death registry and found that 2,897 of them had died as of Sept. 1, 2007.

It turned out that compared to having a healthy BMI of 18.5 to 24.9, being overweight (BMI of 25 to 29.9) increased the risk of death by 35%, and being obese (BMI above 30) boosted it by a factor of 2.25. Compared to nonsmokers, light smokers were 55% more likely to die and heavy smokers increased their risk of death by a factor of 2.18.

Not surprisingly, the people most likely to die were obese heavy smokers –- their risk of death was nearly five-fold higher than for nonsmokers of healthy weight. The researchers, from the Karolinska Institute in Stockholm and Uppsala University Hospital, had expected to find that smoking and excess weight ganged up to make both more deadly, but the interaction wasn’t statistically significant.

In the United States, smoking and poor diet and exercise habits are the two leading causes of death, according to the Centers for Disease Control and Prevention. But teens –- and their parents –- may not appreciate that extra pounds can be as dangerous as tobacco.

“You would want to intervene right away if you knew your child was smoking,” said Carolyn Landis, a pediatric psychologist who treats overweight and obese kids at Rainbow Babies & Children’s Hospital in Cleveland. If your child is overweight or obese, she said, “take it seriously.”

-- Karen Kaplan

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