Smoking, obesity, and their co-occurrence in the U.S. military veterans: results from the national health and resilience in veterans study.
BACKGROUND
Smoking and obesity are major public health concerns, though little is known about the mental and physical health burden of co-occurring obesity and smoking.


METHODS
Using a nationally representative sample of U.S. military veterans, we examined the prevalence of mental and physical co-morbidities, physical and mental functioning, and quality of life between obese only; smoking only; and obese smokers.


RESULTS
Among current smokers, 31.7% were obese; among obese veterans, 16.4% were current smokers; and in the total sample, 5.4% were obese and current smokers. Relative to the obese-only group, obese smokers were more likely to be younger, male, non-white, non-married, unemployed and VA-served, and have lower household incomes. These also reported higher levels of perceived stress and trauma and were more likely to endorsed current suicidal ideation and lifetime suicide attempts (odds ratio [OR]=2.0), medical (2.3<=OR<=3.9) and psychiatric (1.5<=OR<=2.9) comorbidities, and lower overall health status and quality of life. Compared to the smoking-only group, obese smokers were more likely to endorse current suicidal ideation (OR=2.0) and nicotine dependence (OR=1.5), and reported poorer physical health and overall quality of life. Analyses were adjusted for sociodemographic and military characteristics.


LIMITATIONS
The cross-sectional study design precludes causal inference.


CONCLUSIONS
These findings suggest that co-occurring obesity and smoking is associated with substantial mental and physical health burden in U.S. veterans. Collectively, they underscore the importance of multicomponent interventions targeting, obesity, smoking, and co-occurring issues, such as trauma and internalizing disorders, in this population.
['Stefanovics|Elina A|EA|', 'Potenza|Marc N|MN|', 'Pietrzak|Robert H|RH|']
D003430:Cross-Sectional Studies D006801:Humans D008297:Male D009765:Obesity D011788:Quality of Life D012907:Smoking D059020:Suicidal Ideation D014481:United States D014728:Veterans
Smoking Obesity Veterans Co-morbidity