Overweight and hypertension profiles among young smokers: a secondary data analysis of the Indonesian National Health Survey 2023

Abstract Background Tobacco use among young people remains a major public health concern in Indonesia, where smoking prevalence is high and metabolic risk factors such as overweight and hypertension are increasing. Evidence linking smoking behavior, particularly e-cigarette use, to early cardiometabolic risk in low- and middle-income countries is still limited. This study examined overweight and hypertension profiles among young smokers using nationally representative data from Indonesia. Methods This secondary analysis used data from the Indonesian Health Survey 2023. Participants were young adults aged 18–25 years with complete information on smoking status, anthropometry, and blood pressure (n = 12,770). Smoking status was categorized as conventional smokers, e-smokers, and dual smokers. Outcomes included overweight/obesity (BMI ≥23 kg/m 2 ), central obesity (waist circumference ≥90 cm for men and ≥80 cm for women), and hypertension (≥130/80 mmHg). Logistic regression models estimated adjusted odds ratios (AOR) controlling for age, gender, smoking duration, residence, and socioeconomic proxy variables. Results Most respondents were conventional smokers (94%), followed by dual smokers (4%) and e-smokers (2%). E-smokers showed higher mean BMI and the greatest prevalence of overweight/obesity (40%) and central obesity (18%). After adjustment, e-smokers and dual smokers had higher odds of overweight/obesity (AOR = 1.37 and 1.41, respectively) and central obesity (AOR = 1.47 and 1.53, respectively) compared with conventional smokers. Hypertension prevalence (11–13%) did not differ significantly across smoking categories. Conclusion Among young Indonesian smokers, e-cigarette and dual use were associated with higher odds of overweight and central obesity but not hypertension. These findings highlight the importance of integrating tobacco control with early metabolic risk prevention strategies targeting youth.