Tobacco use and poor nutrition continue to be the underlying causes of the greatest number of preventable deaths in the United States.
A new study from the University at Albany School of Public Health finds the two may be connected.
The study, led by Dr. Akiko Hosler and Mr. Isaac Michaels, researchers in the department of epidemiology and biostatistics at UAlbany, analyzed health interview surveys and food environment assessments of just under 2,000 adults in Schenectady, NY.
It found that individuals who ate zero or one serving of fruits and vegetables daily more than doubled their odds of smoking, compared with those who ate five or more servings per day. In addition, those receiving Supplemental Nutrition Assistance Program (SNAP) benefits, using a food pantry, living in a neighborhood with low access to healthy food and/or shopping for food at stores with limited healthy food choices were also associated with significantly higher odds of smoking.
Findings were released in the Aug. 24 edition of Preventing Chronic Disease.
“Smoking and poor nutrition are the two leading preventable causes of death, but their association has not been extensively investigated,” said Dr. Hosler, an associate professor at UAlbany. “The objective of this study was to investigate whether current smoking has independent associations with individual- or neighborhood-level indicators of food distress in a sample of racially and ethnically diverse adults residing in an urban community. Recognizing this connection has significant implications in the public health community.”
The study’s sample consisted of 1,197 adults; 59.4 percent female, average age of 45.5 years old. More than half were racial/ethnic minority respondents, including non-Hispanic black, Guyanese, Hispanic and multiracial/other race respondents. 37.1 percent had smoked at least 100 cigarettes in their lifetime.
The five neighborhoods with the lowest access to health food were clustered within the inner part of the city. Eight of nine of the city’s food pantries were in those neighborhoods. Corner stores, dollar stores, and drug stores were spread fairly evenly across the city and its outer areas; these types of stores were associated with high levels of tobacco products and tobacco advertising.
Prevalence of smoking differed significantly within subgroups based on sociodemographic, health, behavioral and food distress variables.
“The independent association between living in a neighborhood with low access to healthy food and smoking is an intriguing finding,” said Michaels, a DrPH student in epidemiology. “A poor neighborhood food environment might be an additional source of stress, anxiety, and hunger that would intensify nicotine addiction. It could also be a manifestation of poor dietary behavior and a low demand for healthy food aggregated among residents.”
Dr. Hosler and Mr. Michaels believe their findings can lead discussions to help minimalize pro-tobacco environments.
“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,” said Dr. Hosler, in an interview with Healio. “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.”