Food Insecurity and Psychological Distress Among Former and Current Smokers With Low Income

Purpose: To examine how food insecurity and psychological distress interact in its association with smoking and to explore how food insecurity and psychological distress are associated with quitting smoking using quit ratio estimates. Design: Cross-sectional study. Setting: Data from the 2015 California Health Interview Survey. Participants: A total of 3007 lower income adults who have ever smoked. Measures: Ever smoking was defined as smoking 100+ cigarettes in the entire lifetime, with current smoking defined as smoking "every day" or "some days" and former smoking defined as smoking "not at all." Psychological distress and food insecurity were measured by the 6-item K6 Psychological Distress Scale and the 6-item Food Security Survey Short Form, respectively. Analysis: Multiple logistic regression analysis was used to examine correlates of smoking status. Quit ratios (percentage of ever smokers who have quit) were calculated across study variables. Results: Reporting food insecurity with psychological distress was independently associated with lower odds of being a former smoker, compared to reporting food security without psychological distress. The quit ratio was lower among ever smokers reporting food insecurity with distress (41%) compared to ever smokers reporting food security without distress (63%). Conclusions: Specific conditions of impoverishment, such as food insecurity, interact with psychological distress in its association with continued smoking. Interventions to reduce socioeconomic disparities in smoking should consider the interacting role of food insecurity and psychological distress.