Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA.
Department of Health Promotion and Policy, School of Public Health and Health Sciences, Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, USA.
J Psychoactive Drugs. 2021 Apr-Jun;53(2):177-184. doi: 10.1080/02791072.2020.1845419. Epub 2020 Nov 3.
In the U.S., cigarette smoking is increasingly concentrated in disadvantaged and vulnerable populations, such as populations with lower income and with mental health needs. Food insecurity is linked with psychological distress and is an independent risk factor for smoking. We prospectively examined how cigarette smoking, food insecurity, and psychological distress operate as risk factors for one another in a 2-year longitudinal analysis of U.S. adults from the 2015 and 2017 Panel Study of Income Dynamics, a nationally representative household survey (N = 7946). Using cross-lagged panel analysis, cross-lagged regression coefficients were estimated simultaneously with direct-effect paths, controlling for covariates. Results showed significant bidirectional associations between smoking and food insecurity: 2015 smoking predicted 2017 food insecurity, and 2015 food insecurity predicted 2017 smoking. Food insecurity and psychological distress also had significant bidirectional associations. However, the association between smoking and psychological distress was unidirectional: 2015 psychological distress predicted 2017 smoking, but not vice versa. The findings suggest a cyclical possibility that smoking exacerbates food insecurity, food insecurity exacerbates psychological distress, and psychological distress exacerbates smoking. There is a need to replicate with more timepoints, but our results highlight the importance of examining the overlapping health burdens of smoking, food insecurity, and psychological distress.
在美国，吸烟越来越集中在处于不利和弱势地位的人群中，例如收入较低和有心理健康需求的人群。粮食不安全与心理困扰有关，是吸烟的一个独立风险因素。我们前瞻性地研究了在 2015 年和 2017 年收入动态小组研究中，来自美国成年人的 2 年纵向分析中，吸烟、粮食不安全和心理困扰如何相互作用，这是一项具有全国代表性的家庭调查（N=7946）。使用交叉滞后面板分析，同时估计交叉滞后回归系数和直接效应路径，控制协变量。结果显示，吸烟和粮食不安全之间存在显著的双向关联：2015 年的吸烟预测了 2017 年的粮食不安全，而 2015 年的粮食不安全预测了 2017 年的吸烟。粮食不安全和心理困扰也存在显著的双向关联。然而，吸烟和心理困扰之间的关联是单向的：2015 年的心理困扰预测了 2017 年的吸烟，但反之则不然。研究结果表明，吸烟可能会加剧粮食不安全，粮食不安全可能会加剧心理困扰，心理困扰可能会加剧吸烟，从而导致一种循环的可能性。需要用更多的时间点进行复制，但我们的研究结果强调了研究吸烟、粮食不安全和心理困扰重叠健康负担的重要性。
