OBJECTIVES: To investigate the association of current smoking with body mass index (BMI) and perceived body weight among high school students in the United States. METHODS: We analyzed data from the 1999-2005 Youth Risk Behavior Survey. RESULTS: Perceived body weight and BMI were associated with adolescents' current smoking. Adjusted odds ratios of current smoking for overweight and at-risk-of-overweight BMI groups continued to increase over the entire survey years. The more recent the cohort, the stronger the link of current smoking with BMI and perceived body weight. CONCLUSIONS: The relationship between body weight and current smoking strengthened over time.