The Relationship between Disordered Eating and Cigarette Smoking among Adult Female Twins

Objective: While previous studies have shown a link between cigarette smoking and disordered eating (DE), it is less clear whether this association can be explained by attempts to control weight and/or temperament. This study had two aims: to examine weight/shape and DE symptomatology associated with weight control-related smoking and disordered eating; second, to investigate whether temperament-based factors explain the association between compensatory smoking and weight and shape-related characteristics, and disordered eating symptoms. Method: Female twins (N = 1,002) from the Australian Twin Registry, aged 28–39 years, were assessed by interview yielding lifetime diagnostic information of disordered eating and use of cigarette smoking for weight control. Self-report measures of temperament were available. Results: Women who had never smoked (50.6%, n = 495) or had smoked for reasons other than weight and shape control (42.5%, n = 415) were generally not differentiated with respect to indicators of disordered eating. Women who smoked for reasons primarily associated with weight and shape control (6.9%, n = 67) had significantly higher levels of disordered eating than non-smokers identified as being higher levels of purging (OR = 4.55, 95% CI = 2.41–8.59) and fasting (OR = 9.32, 94% CI = 4.43–19.90) but not objective binge episodes (OR = 1.69, 95% CI = 0.71–3.99). Of those women diagnosed with lifetime eating disorders, weight-control smokers had higher levels of purging (OR = 4.22, 95% CI = 1.13–15.80) than those who did not. There were no differences in temperament. Discussion: Results support co-occurrence of smoking for weight control and purging in both community and clinical groups, and indicate this association is related to weight control and not temperament.Kate Fairweather-Schmidt and Tracey D. Wad