Smoking or Overweight: (Don’t) Pick Your Poison

The combined effects of obesity and smoking during late adolescence on adult mortality are uncertain. Using data from a military draft registry, a national death registry, and a national census in Sweden, investigators analyzed the independent and combined effects of obesity and smoking during late adolescence (age range, 16–20 years) on adult mortality in 45,920 men born between 1949 and 1951. The median follow-up period was 38 years.

Risk for premature death among nonsmoking adolescents who were either overweight (BMI, 25.0–29.9 kg/m²) or obese (BMI, ≥30) at conscription was significantly higher than among nonsmoking, normal-weight adolescents (relative risk, 1.37 and 2.16, respectively) in analysis adjusted for muscle strength, socioecono…