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Food insecurity, limited nutrition options tied to smoking

Akiko S. Hosler

A person’s access to healthy food choices may be a factor in whether he or she smokes, according to a report published in Preventing Chronic Disease.

“Smoking and poor nutrition are the No. 1 and No. 2 preventable causes of death in the United States, but very few studies existed to examine their direct association,” Akiko S. Hosler, PhD, told Healio Family Medicine.

To gather more data, Hosler and Isaac H. Michaels, MPH, both of the department of epidemiology and biostatistics at the University of Albany School of Public Health, built logistic regression models for current smoking with six indicators of food distress as exposure variables and sociodemographic characteristics. Alcohol binge drinking, anxiety, depression, disability, perceived stress and sociodemographic characteristics were covariates.

Researchers then utilized the models on 1,917 adults, 59.4% of whom were women, 51.4% were members of an ethnic minority and 37.1% were current smokers. All participants had completed food environment assessments and health interview surveys in upstate New York in 2013 and 2014.

The researchers found that those who ate zero or one serving of fruits and vegetables daily more than doubled the odds of smoking, compared with those who ate five or more such servings per day (OR = 2.05). In addition, receiving Supplemental Nutrition Assistance Program benefits (OR = 1.79), food insecurity (OR = 1.77), using a food pantry (OR = 1.41), living in a neighborhood with low access to healthy food (OR = 1.4) and shopping frequently at a store with limited healthy food choices (OR = 1.38) were also associated with significantly higher odds of smoking.

Hosler said tobacco and nutrition public health professionals working together would improve nutrition habits and lower tobacco use.

“In public health, there are well-established programs for smoking prevention and control, as well as various programs for improving nutrition and preventing nutrition-related health consequences, most notably obesity. However, the two groups of experts seldom work together,” she said in the interview. “My hope is that smoking and nutrition experts increase collaboration, in health education and in the improvement of community and in-store environments, to tackle the sources of two leading preventable causes of death together in a synergistic manner.”

Hosler also encouraged medical professionals to draw a parallel between food and tobacco when conducting office visits.

“Physicians may look at nutrition issues and smoking as separate entities, but they are likely to be related, and I would think some coordinated effort to address both should be needed,” she said. – by Janel Miller