Abstract

PURPOSE: We hypothesized that living with a smoker would be positively associated with general and central adiposity among middle-aged and older women. DESIGN: Prospective across up to 8 years. SETTING: Women's Health Initiative Observational Study. SAMPLE: A total of 83 492 women (age 50-79 at baseline). MEASURES: The predictor was living with a smoker at baseline. Outcomes were clinic-assessed obesity and high waist circumference, examined cross-sectionally at baseline and prospectively at year 3 and (for self-reported obesity) year 8. ANALYSIS: All analyses used logistic regression and controlled for sociodemographic factors and participants' current smoking; prospective analyses also adjusted for baseline obesity or high waist circumference. RESULTS: Living with a smoker was associated (1) cross-sectionally with obesity (n = 82 692, odds ratio [OR] = 1.38, <i>P</i> &lt; .001) and a high waist circumference (n = 83 241, OR = 1.41, <i>P</i> &lt; .001) and (2) prospectively with obesity (n = 68 753, OR = 1.22, <i>P</i> &lt; .001) and a high waist circumference (n = 68 947, OR = 1.22, <i>P</i> &lt; .001) 3 years later and obesity (n = 38 212, OR = 1.21, <i>P</i> &lt; .001) 8 years later. CONCLUSION: These results document an essentially unrecognized health risk associated with living with a smoker. For practitioners, these findings underscore the need for innovative household-level interventions for families living with a smoker integrating established smoking and obesity prevention efforts.