1. ^*Department of Psychology, Vanderbilt University, Nashville, Tennessee
2. ^†National Center for Optimal Health, Nashville, Tennessee
3. ^‡Department of Family and Community Medicine, Meharry Medical College, Nashville, Tennessee
4. ^§Department of Surgery, Meharry Medical College, Nashville, Tennessee

Correspondence: David G. Schlundt 301 Wilson Hall, Department of Psychology, Vanderbilt University, Nashville, TN 37203. E-mail: David.Schlundt@Vanderbilt.Edu

^**The costs of publication of this article were defrayed, in part, by the payment of page charges. This article must, therefore, be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Received 7 August 2006; Accepted 29 March 2007.

Abstract

Objective: Seatbelt use among obese persons may be reduced because seatbelts are uncomfortable. We investigated the association between obesity and seatbelt use with data from the 2002 Behavioral Risk Factor Surveillance System Survey.

Research Methods and Procedures: Multivariable logistic regression was used to calculate odds ratios and 95% confidence intervals (CIs) for seatbelt use among overweight (BMI, 25.0 to 29.9), obese (BMI, 30.0 to 39.9), and extremely obese (BMI 40.0) persons, relative to a non-overweight/non-obese reference group (BMI 24.9), adjusted for age, race, gender, education, and state seatbelt law.

Results: Adjusted odds ratios for seatbelt use were 0.89 (95% CI, 0.85 to 0.93) for overweight, 0.69 (0.66 to 0.73) for obese, and 0.45 (95% CI, 0.40 to 0.50) for extremely obese persons. Interaction effects were evident for all covariates, with stronger associations between increasing BMI and decreasing seatbelt use for women, increasing age, higher education, and residence in states with a secondary seatbelt law. There was a linear decrease in seatbelt use with increasing BMI for all subgroups except persons 18 to 24 years old.

Discussion: Lack of seatbelt can be added to the list of risk factors associated with obesity. Effective preventive interventions are needed to promote seatbelt use among overweight and obese persons.