Objectives: In recent decades, obesity reached epidemic proportions in western countries, while cigarette smoking decreased. Traditionally, smoking is associated with lower relative weight (body mass index, BMI) but high abdominal obesity (waist-hip ratio, WHR). However, several recent studies suggest that BMI is higher among today’s smokers compared with non-smokers. Therefore, the present study examined whether the relationship between smoking and each of the body measures, BMI and WHR, has changed over time.

Material and Methods: Data were collected from 5907 male and female residents of Gothenburg, Sweden, aged 25-65 years, and drawn randomly in four sequential cross-sections (1985, 1990, 1995, 2002) from the city’s population register. The study used general linear models to test trends over time, and adjusted all differences for age.

Results: The data reported here showed higher WHR in both male and female smokers compared with non-smokers. BMI was lower in female smokers compared with female non-smokers, but did not differ significantly between male smokers and male non-smokers. Among female participants, differences in WHR between smokers and non-smokers increased significantly throughout the study. Although male participants showed a similar tendency, the differences were not significant. Adjustment for educational level did not affect the results.

Conclusions: WHR was higher among smokers compared with non-smokers; this difference increased over time. Thus, concern for obesity does not provide a valid reason to continue smoking; on the contrary, it may be a reason to quit.