OBJECTIVES: Recent evidence suggests a higher risk of diabetes following smoking cessation possibly related to the expected weight gain.  Quitting smoking, however, remains recommended.  The objective was to examine differences of smoking cessation medication prescribing among smokers with different body weight levels using the Health and Nutritional Examination Survey (NHANES) data. METHODS: A retrospective cross-sectional study was conducted using the NHANES data from 1999 to 2008.  The study included adults aged ≥ 18 years who self-reported currently using tobacco.  The outcome variable was receiving a cessation medication (Bupropion or Varenicline) vs. not.  The independent variables included body mass index (BMI), gender, age, race, education, marital status, family income, insurance type, poverty income ratio (PIR), and health status.  Multivariate logistic regression analyses were conducted to assess the association between the main independent variable (BMI) as well as socio-demographic and general health status characteristics with the outcome variable. RESULTS: A total of 7743 adult smokers were included.  Among normal weight smokers, 2.72% were prescribed cessation medication, while 1.57% and 2.54% among overweight and obese smokers were prescribed cessation medication, respectively.  Logistic regression results showed that smokers who were overweight were less likely to be prescribed cessation medications than those with normal weight (OR: 0.441, 95% CI: 0.212-0.915).  Male smokers, white race, having government insurance, college degree or above, PIR above average, were significant factors of receiving a cessation medication.  CONCLUSIONS: The study documented a lower rate of smoking cessation medication use among overweight smokers compared to normal weight smokers.  Whether this finding is related to physician or patient preferences remains uncertain.  Future studies should investigate the reasons for this discrepancy and develop effective interventions to aid overweight smokers in quitting.