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Health Psychol. 2010 Sep;29(5):521-8. doi: 10.1037/a0020854.

Tobacco use moderates the association between major depression and obesity.

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  • 1Department of Preventive Medicine, Division of Health Behavior Research, University of Southern California Keck School of Medicine, 2250 Alcazar Street, Los Angeles, CA 90033, USA. adam.leventhal@usc.edu



Based on a maladaptive coping explanation, the relationship between major depression (MD) and obesity could be strong among nonsmokers, who may engage in unhealthy eating and sedentary behavior to cope with depression. By contrast, the MD-obesity association could be weak among smokers, who can use tobacco (instead of food or sedentary behavior) to cope with mood symptoms. This study examined smoking status and tobacco dependence as moderators of the MD-obesity link.


Correlational, cross-sectional population-based survey of 41,654 U.S. adults.


Obesity (body mass index [BMI] ≥30 kg/m2) and quantitative BMI value.


Current smoking status moderated the association between past-year MD and current obesity, as well as the link between MD and BMI value (ps ≤ .0001). MD predicted obesity and BMI among nonsmokers (ps < .0001) but did not do so in smokers (ps ≥ .10). Similar findings emerged with tobacco dependence as the moderator. Each finding persisted after accounting for demographics, psychiatric variables, and potential confounds.


Tobacco use characteristics appear to moderate the MD-obesity association in the U.S. population. These findings may shed light on the mechanisms linking MD and obesity and have implications for identifying which individuals may benefit most from obesity interventions that target depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

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