Smoking and poor nutrition—2 of the leading preventable causes of death—are reciprocally linked in many ways, multiplying the public health challenges. For instance, smokers are less likely to eat healthful foods and food insecurity is independently associated with smoking. Researchers from the University at Albany, State University of New York, who conducted both a health interview survey and a food environment assessment with 1,917 adults, found that each indicator of food distress was significantly associated with current smoking. Respondents who consumed ≤ 1 serving of fruits and vegetables per day had significantly higher odds of current smoking, compared with those who consumed ≥ 5 servings. Similarly, the odds of current smoking were significantly higher among respondents who were food insecure, used a food pantry, and received Supplemental Nutrition Assistance Program benefits. Living in a neighborhood with low access to healthful food doubled the prevalence of smoking.
Respondents shopped for food often at a corner store (convenience store), dollar store, or drug store. That highlights one of the challenges: All the convenience stores, drug stores, and about 63% of the dollar stores also were tobacco retailers, and nearly all of those had tobacco advertising.
The researchers note that research on the link between smoking and food distress is “limited.” A common explanation for it, they say, is the “opportunity cost” argument. Smokers spend up to 24% of their income on cigarettes—leaving less money for food. Other research also has found that smokers tend to have less appetite than do nonsmokers (smoking may alter hunger-satiety sensation). On the other hand, chronic hunger, imbalanced diet and not having enough money to buy adequate food naturally may cause stress and anxiety and can increase dependence on nicotine. Moreover, food-insecure people may smoke to suppress hunger.
The researchers suggest ways to help solve the problem. One would be to disseminate smoking-related educational materials in food pantries and other community nutrition assistance resources. Another would be to prioritize smoking-cessation interventions for stores in “food deserts.” Only a few policy-based interventions exist, the researchers say. They point to a California city that enacted a citywide “healthy corner store” policy that rewards local small business for offering healthful foods and imposes tobacco-control measures, such as eliminating visible tobacco displays at checkout counters.