Department of Epidemiology and Biostatistics, University at Albany School of Public Health, University at Albany Health Sciences Campus, GEC 119, One University Pl, Rensselaer, NY 12144. Email:
Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York.
Prev Chronic Dis. 2017 Aug 24;14:E71. doi: 10.5888/pcd14.160548.
Smoking and poor nutrition are 2 leading preventable causes of death. This study investigated associations between smoking and indicators of individual- and neighborhood-level food distress among racially and ethnically diverse urban adults.
We analyzed data from a health interview survey and a food environment assessment collected in 2013 and 2014 in Schenectady, New York. We constructed logistic regression models for current smoking with 6 indicators of food distress as exposure variables and sociodemographic characteristics, depression, anxiety, perceived stress, alcohol binge drinking, and disability as covariates.
The analytic sample consisted of 1,917 adults; 59.4% were female, more than half were racial/ethnic minorities (26.2% non-Hispanic black, 10.3% Hispanic, 10.9% Guyanese, 4.0% multiracial and other), and 37.1% were current smokers. All indicators of food distress remained in the parsimonious final model: consuming 0 or 1 serving of fruits and vegetables daily more than doubled the odds of smoking, compared with consuming 5 or more servings (odds ratio [OR], 2.05). Food insecurity (OR, 1.77), receiving Supplemental Nutrition Assistance Program benefits (OR, 1.79), using a food pantry (OR, 1.41), living in a neighborhood with low access to healthy food (OR, 1.40), and shopping for food often at a store with limited healthy food choices (OR, 1.38) were also associated with significantly higher odds of smoking.
Recognizing that smoking and food distress are independently associated would lead to innovative public health intervention strategies. We suggest stronger collaboration between tobacco and nutrition public health professionals to synergistically reduce tobacco use and improve nutrition behavior and food environments in communities.
吸烟和不良营养是导致死亡的两个主要可预防原因。本研究调查了在种族和民族多样化的城市成年人中,吸烟与个体和社区层面食物匮乏指标之间的关联。
我们分析了 2013 年和 2014 年在纽约斯克内克塔迪收集的健康访谈调查和食物环境评估的数据。我们构建了逻辑回归模型,将当前吸烟与 6 项食物匮乏指标作为暴露变量,并将社会人口统计学特征、抑郁、焦虑、感知压力、酗酒和残疾作为协变量。
分析样本包括 1917 名成年人;59.4%为女性,超过一半为少数民族(26.2%非西班牙裔黑人、10.3%西班牙裔、10.9%圭亚那人、4.0%多种族和其他),37.1%为当前吸烟者。所有食物匮乏指标都保留在简约的最终模型中:与每天食用 5 份或更多份水果和蔬菜相比,每天食用 0 份或 1 份水果和蔬菜使吸烟的可能性增加了一倍以上(比值比[OR],2.05)。食物不安全(OR,1.77)、获得补充营养援助计划(OR,1.79)、使用食品储藏室(OR,1.41)、居住在健康食品获取机会低的社区(OR,1.40)和经常在选择有限的健康食品的商店购买食物(OR,1.38)也与吸烟的可能性显著增加相关。
认识到吸烟和食物匮乏是独立相关的,将导致创新的公共卫生干预策略。我们建议烟草和营养公共卫生专业人员加强合作,以协同方式减少烟草使用,改善社区的营养行为和食物环境。