Comparing Trends Between Food Insecurity and Cigarette Smoking Among Adults in the United States, 1998 to 2011

PURPOSE: Previous studies have shown that cigarette smoking is associated with higher rates and severity of food insecurity but do not address how population-level smoking rates change in response to changes in food security. DESIGN: Trend analysis of serial cross-sectional data. SETTING: Data from a representative survey of US households. PARTICIPANTS: Adults within households participating in both the Food Security Supplement and Tobacco Use Supplement of the Current Population Survey during 5 overlapping administrations from 1998 to 2011. MEASURES: A "current smoker" is defined as someone who indicated that they currently smoke on "some days" or "every day." A household's food security is coded as "secure" or "insecure," according to responses to a food security scale, interpreted using a US Department of Agriculture standard. ANALYSIS: Descriptive comparison of the roughly triennial trends in the prevalence of food insecurity and current smoking from 1998 to 2011. RESULTS: The prevalence of food insecurity increased by 30% among adults overall versus 54% among current smokers, with most of the changes occurring following the economic recession of 2008 and 2009. Over this same period, the prevalence of current smoking declined by 33% among food-secure adults and only 14% among food-insecure adults. CONCLUSION: Food insecurity increased more markedly among adult smokers than nonsmokers, and the prevalence of smoking declined more slowly in food-insecure households, indicating that more low-income smokers are facing hunger, which may at least partly be due to buying cigarettes.