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Comment & Response
June 2017

When to Adjust for Potentially Confounding Variables—Reply

Author Affiliations
  • 1Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, Maryland
JAMA Intern Med. 2017;177(6):892. doi:10.1001/jamainternmed.2017.1086

In Reply We thank Dr Lehner for his interest in our article.1 As described previously, in both articles cited by Dr Lehner2,3 and elsewhere, cigarette smoking has a complex relationship with body weight, body mass index (BMI), body fat distribution, and their metabolic consequences.4 For example, smokers tend to have a lower BMI than nonsmokers. Quitting smoking has also been linked to weight gain in a number of different studies.5 Furthermore, having a high BMI may reflect quite different physiologic states among smokers and nonsmokers.4

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