Effect of food insecurity on smoking and quitting behaviours: a survey of food bank clients

Abstract

BackgroundRates of tobacco smoking among recipients of food aid are reported to be high (28–55%), yet whether food insecurity affects the smoking and quitting behaviour of this group remains unclear. We aimed to describe the effect of food insecurity on tobacco use among users of food banks. MethodsBetween Sept 4 and Nov 4, 2014, individuals attending two food banks in a large English city were invited to complete a survey assessing tobacco use and food security. Descriptive statistics were used to summarise the characteristics of food bank users and to provide data on the effect of food insecurity on smoking behaviours, including quitting. Since socioeconomic disadvantage can affect an individual's ability to access health services, we compared the provision of smoking cessation advice and ability to access smoking cessation services by respondents’ food security status using χ2 tests. Ethics approval was granted by the University of Nottingham Research Ethics Committee and participant consent was informed and implied through the return of a completed survey. Findings94 (93%) of 101 individuals completed the survey, of whom 62 (66%) were rated as food insecure and 32 (34%) food secure. Overall smoking prevalence was high (n=57, 61%), with little difference between food insecure respondents (39, 63%) and food secure respondents (18, 56%). Smokers experiencing food insecurity were more likely than food secure smokers to report purchasing illicit tobacco products (7 [19%] of 37 who answered this question vs none of 18) and decreases in their tobacco consumption (17 [65%] of 26 who provided a response vs 3 [43%] of 7). 36 (63%) of the 57 smokers reported receiving smoking cessation advice from a health professional; overall, quit motivation and confidence in making a successful quit attempt (rated out of 10 points) was moderate, with no significant differences between food insecure or food secure respondents (mean 4·7 [SD 2·8] vs 4·3 [3·1]). Of the 27 smokers (49%) who reported that they would experience difficulty in attending smoking cessation services as a result of their financial circumstances, 19 (70%) were food insecure compared with eight (20%) food secure. InterpretationHigh smoking rates and self-imposed reduction of tobacco consumption by respondents as a result of adverse financial circumstances suggest a potential unmet need to intervene to promote smoking cessation among this disadvantaged population. FundingUK Centre for Tobacco and Alcohol Studies.