A network analysis of appetite and dietary behaviour patterns: differences between smokers and non-smokers

Smoking is associated with differences in appetite and dietary behaviours, but how these behaviours are interrelated within smokers and non-smokers remains unclear. This study used network analysis to compare group-specific associations of appetite and dietary behaviour patterns in Chinese adults.

A cross-sectional analysis of the 2023 Psychological and Behavioural Investigation of Chinese Residents (PBICR) was conducted, including 30,054 adults (4,938 current smokers and 25,116 non-smokers). Appetite and dietary behaviour variables, along with sociodemographic and psychological factors, were included as nodes in mixed graphical models. Conditional association networks were estimated separately for smokers and non-smokers, with comparisons of overall network structure, global connectivity, and node-level centrality.

The global network structure and overall connectivity did not differ significantly between smokers and non-smokers. At the node level, smokers exhibited higher expected influence for behaviours such as frequent eating out, consumption of highly processed foods, and fast eating, while node strength for these behaviours was lower compared with non-smokers. Sociodemographic factors, including sex and occupational status, were associated with variations in network patterns. Stability analyses indicated acceptable robustness of node strength and expected influence estimates (CS-coefficient = 0.75 in both groups).

Global network structures were similar between smokers and non-smokers, but differences were observed in the centrality of specific dietary behaviours, including frequent eating out, consumption of highly processed foods, and fast eating. Sociodemographic factors, such as sex and occupational status, were associated with network patterns. These findings describe group-specific associations and should be interpreted as exploratory rather than causal, highlighting potential focal points for dietary guidance and behavioural assessment, and informing future research on smoking-related dietary behaviours.