Weight loss behaviors and body image as risk factors for cigarette use in college females

While the initiation of cigarette use as a weight loss strategy has been studied in adolescent populations, there is a paucity of literature examining this weight loss strategy among college females who face unique pressures in the college environment to obtain an ideal body. To examine this population, a secondary analysis of data from the Spring 2008 National College Health Assessment-II survey was conducted to examine the relationship between cigarette use, body image, and dieting/weight loss in college undergraduate females. Initial tests of association on cigarette use with body image and weight loss variables were conducted to determine appropriate variables to include regression models. Logistic regression was then conducted to predict current cigarette smoker status as well as ever-use of cigarettes. Participants who reported engaging in unhealthy dieting behaviors were 2.4 times more likely to have ever smoked cigarettes (95% CI [2.05, 2.86]) and 2.3 times more likely to be current smokers (95% CI [1.89, 2.72]) compared to those who did not report engaging in unhealthy dieting behaviors. Specifically, white females had a higher odds of both ever cigarette use (OR=1.64, CI [1.47, 1.83]) and current cigarette use (OR=1.64, 95% CI [1.42, 1.89]). These findings indicate undergraduate females may view cigarette smoking as a potential behavior to aid in weight loss. In particular, college females with poor self-body image may be attracted to unhealthy dieting behaviors including smoking. Health professionals should include perceived body image and dieting behaviors when implementing cigarette smoking prevention and cessation efforts targeting this population.