The purpose was to elucidate the interplay between current smoking, anthropometric measurements, and endogenous hormone levels in women?=?40 years. Questionnaires on lifestyle and reproductive factors were completed by 269 healthy women from high-risk breast cancer families between 1996 and 2006 in Sweden. Blood samples for analyses of plasma testosterone, estradiol, androstenedione, sex hormone-binding globulin, and body measurements were obtained 5-10 days before predicted onset of the next menstrual period. Women without smoking status, who were currently breastfeeding, or using hormonal contraception other than combined oral contraceptives (OCs) were excluded (n?=?27). Current smokers (n?=?57) had larger waist circumference (adjp?=?0.004) and waist-to-hip ratio (WHR) (adjp?=?0.007) than non-smokers (n?=?185). In non-OC users, adjusted mean androstenedione levels were higher in current smokers compared with non-smokers (10.3 vs. 8.6 nmol/L; adjp?=?0.0002). While in current OC users estradiol levels were higher in smokers compared with non-smokers (22.5 vs. 17.4 pg/mL; adjp?=?0.012). In multivariable models, WHR was associated with both current smoking (adjp?=?0.016) and higher levels of androstenedione (adjp?=?0.05) or bioavailable testosterone (adjp?=?0.001). Among non-OC users, a more androgenic profile was observed in current smokers compared with non-smokers, but not in current OC users. Irrespective of OC use, current smoking was associated with increased waist circumference.