Umam Shafeel, Razzak Rubaiya Binte, Munni Munniara Yesmin, Rahman Azizur
Department of Statistics and Data Science, Jahangirnagar University, Savar, Dhaka.
Department of Behavioral Science and Health Equity, College for Public Health and Social Justice, Saint Louis University, Missouri.
PLoS One. 2025 Jul 17;20(7):e0328109. doi: 10.1371/journal.pone.0328109. eCollection 2025.
Food insecurity and cigarette smoking are significant public health issues that disproportionately affect vulnerable populations. Previous research often overlooks daily smoking patterns, focusing instead on smoking status or cessation. This study seeks to fill that gap, hypothesizing that food insecurity is positively associated with higher daily cigarette consumption.
This study investigates the non-linear association between food security status and daily cigarette consumption using data from the 2022 National Health Interview Survey (NHIS). It introduces a novel statistical approach-the COM-Poisson Generalized Additive Model (CMP-GAM)-to capture the non-linear dynamics between these variables.
The CMP-GAM model was applied to a sample of 819 adults, controlling for key variables like age, body mass index (BMI), and mental health conditions (anxiety and depression severity). The results indicated that while food security status did not significantly affect daily cigarette consumption, the age of smoking initiation was a strong predictor, with earlier smoking onset leading to higher daily cigarette use. Subgroup analyses among participants with cardiovascular disease and diabetes also did not reveal a significant relationship between food insecurity and smoking frequency.
The findings suggest that targeted interventions aimed at preventing early smoking initiation may be more effective in reducing smoking prevalence and improving public health outcomes than addressing food security alone. This study highlights the need for further research into the complex interplay between socioeconomic factors and health behaviors like smoking.
粮食不安全和吸烟是重大的公共卫生问题,对弱势群体的影响尤为严重。以往的研究往往忽视日常吸烟模式,而是侧重于吸烟状况或戒烟。本研究旨在填补这一空白,假设粮食不安全与每日较高的香烟消费量呈正相关。
本研究利用2022年全国健康访谈调查(NHIS)的数据,调查粮食安全状况与每日香烟消费量之间的非线性关联。它引入了一种新颖的统计方法——COM-泊松广义相加模型(CMP-GAM)——来捕捉这些变量之间的非线性动态关系。
CMP-GAM模型应用于819名成年人的样本,控制了年龄、体重指数(BMI)和心理健康状况(焦虑和抑郁严重程度)等关键变量。结果表明,虽然粮食安全状况对每日香烟消费量没有显著影响,但开始吸烟的年龄是一个强有力的预测因素,吸烟开始时间越早,每日香烟使用量越高。心血管疾病和糖尿病参与者的亚组分析也未发现粮食不安全与吸烟频率之间存在显著关系。
研究结果表明,旨在预防早期吸烟的针对性干预措施可能比单独解决粮食安全问题在降低吸烟率和改善公共卫生结果方面更有效。本研究强调需要进一步研究社会经济因素与吸烟等健康行为之间的复杂相互作用。