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Volume 2: No. 2, April 2005
SPECIAL TOPICS
ORIGINAL RESEARCH: FEATURED
ABSTRACT FROM THE 19TH NATIONAL CONFERENCE ON CHRONIC DISEASE
PREVENTION AND CONTROL
Is Food Insecurity a Price of Smoking Among the Poor?
Brian Armour, M. Melinda Pitts, Chung-won Lee, Trevor Woollery, Ralph Caraballo
Suggested citation for this article: Armour B, Pitts MM, Lee
C, Woollery T, Caraballo R. Is food
insecurity a price of smoking among the poor? [abstract]. Prev Chronic Dis [serial online] 2005 Apr [date
cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2005/
apr/04_0142z.htm.
PEER REVIEWED
Track: Social Determinants of Health Inequities
The objective of this study was to estimate the share of
income that families spend on cigarettes and to determine the
association between food insecurity, smoking, and poverty.
Cigarette smoking prevalence is higher among adults living below
the poverty level. The opportunity cost of smoking (the goods and
services smokers forgo to purchase cigarettes) will be
proportionately higher among poor families than nonpoor families
since a larger share of their income will go toward the purchase
of cigarettes. No study has documented what these opportunity
costs might be. This study shows an association between food
insecurity and the share of income spent on cigarettes. Evidence
supporting this association suggests that state-sponsored smoking
cessation programs targeting poor smokers may have an added
benefit of reducing food insecurity.
Data from the 2001 Panel Study of Income Dynamics (PSID) were used to identify smokers
and families that were food insecure and to determine the share of families’
income spent on cigarettes. The PSID is a nationally representative longitudinal
study of U.S. families that collects economic,
health, and social behavior data on 7406 families. T tests and
chi-square tests were used to assess univariate differences
between continuous and categorical variables. Multivariate
logistic regression models were used to assess the association
between food insecurity, smoking, and poverty.
Approximately 7.6% of families lived in poverty, 6.1% were
food insecure, and 26.1% had at least one family member who
smoked in 2001. Poor families were more likely to have a family
member who smoked cigarettes than nonpoor families (33.3%, poor families vs
22.5%, nonpoor families; P < .001). The share of income spent on
cigarettes was significantly higher for poor families than
nonpoor families (12.0%, poor families vs 2.0%, nonpoor families; P < .001). Results from
the multivariate logistic regression analysis revealed that the
odds of being food insecure increased as share of income spent on
cigarettes increased (adjusted odds ratio, 1.72; 95% confidence interval,
1.66–1.79).
Having an average annual income of $8624 and average annual
cigarette expenditures of $857, poor families with a family
member who smokes spend a large share of their income on
cigarettes. This study suggests that in addition to the adverse
health consequences linked to smoking, poor families may also pay
a price of food insecurity.
Corresponding Author: Brian S. Armour, PhD, Health Scientist,
Centers for Disease Control and Prevention, National Center for
Chronic Disease Prevention and Health Promotion, Office on
Smoking and Health, 4770 Buford Hwy NE, Mail Stop K-50, Atlanta, GA
30341. Telephone: 770-488-5718. Email: barmour@cdc.gov.
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