Smoking and Obesity Paradox in North Sulawesi, Indonesia: A Cross-Sectional Study of Males Adult

Abstract.
Smoking and obesity are major global public health concerns, each linked to various adverse health effects. This study aims to explore the complex relationship between smoking and obesity among adult males in North Sulawesi Province, Indonesia. Using data from the 2018 Indonesia Basic Health Survey, we conducted a cross-sectional study involving 4,994 male participants aged 18 years and older. Smoking status was classified as regular, irregular, or former smokers based on the subjects' habits in the previous month. Multinomial logistic regression, analysis of variance, and chi-square tests were applied to examine the association between smoking and obesity. The results showed that ex-smokers had a higher likelihood of obesity compared to current smokers, with an adjusted relative risk ratio (RRR) of 1.63 (95% CI: 1.18–2.24). Irregular smokers were also more likely to be obese than regular smokers, with an adjusted RRR of 1.42 (95% CI: 1.11–1.88). However, no statistically significant association was found between smoking and being overweight. A positive association was observed between smoking and obesity, indicating that former smokers may face an increased risk of becoming obese.