Living with smokers may
be associated with inadequate access to food
Children and adults living with adult
smokers appear less likely to have daily access to enough
healthy food compared with those living with non-smoking
adults, according to a report in the November issue of
Archives of Pediatrics & Adolescent Medicine, one
of the JAMA/Archives journals.
About 13 million U.S. children live in food-insecure
households, according to background information in the
article. "Food insecurity is the inability to access enough
food in a socially acceptable way for every day of the year.
In households with the most severe food insecurity, there
are multiple involuntary reductions in food intake and
disruptions of usual eating patterns." Studies have shown
that food insecurity is strongly associated with household
income. Since families with at least one smoker spend 2
percent to 20 percent of their income on tobacco, it
is likely that smokers are affecting the financial resources
needed to provide adequate food.
Cynthia Cutler-Triggs, M.D., of the New York
University School of Medicine and Bellevue
Hospital Center, and colleagues analyzed 8,817
households with children age 17 and younger from 1999 to
2002 to see if the presence or absence of adult smokers in
the household affected the food security of those living in
the home. Age, sex, race of the child and poverty index
ratios were also noted.
At least one smoker lived in 23 percent of the children's
households "and 32 percent of children in low-income
households lived with a smoker compared with 15 percent of
those in more affluent households." Fifteen percent of
adults and 11 percent of children reported having
experienced food insecurity within the last year, with 6
percent of adults and 1 percent of children experiencing
severe food insecurity.
"Food insecurity was more common and severe in children and
adults in households with smokers," the authors write. "Of
children in households with smokers, 17 percent were food
insecure vs. 8.7 percent in households without smokers,"
with rates of severe child food insecurity at 3.2 percent
and 0.9 percent, respectively. "For adults, 25.7 percent in
households with smokers and 11.6 percent in households
without smokers were food insecure, and rates of severe food
insecurity were 11.8 percent and 3.9 percent, respectively."
The highest rates of food insecurity were in children living
in low-income households with smokers. Additionally,
compared with white families, black and Hispanic families
had higher rates of child food insecurity in both smoking
and non-smoking homes.
"These data also demonstrate how pervasive this combination
of child health risks is in low-income families," the
authors conclude. "The burden of food insecurity is a
previously unrecognized danger of adult tobacco use to be
added to the ever-growing list of negative effects of adult
tobacco use on children in the United States."
Arch Pediatr Adolesc Med.
Smoking Cessation Could Increase Household
Resources Available for Spending on Food
Aside from spending
resources on cigarettes instead of healthy foods, cigarette
smoking also contributes to "lost productivity resulting
from diseases caused by smoking," further lowering incomes
and raising the likelihood of food insecurity, writes
Frank J. Chaloupka, Ph.D., of the University of
Illinois at Chicago, in an accompanying editorial.
"Comprehensive tobacco control policies and programs are
effective in reducing this burden, with higher taxes on
cigarettes and other tobacco products being particularly
effective in promoting cessation and reducing tobacco use
in low-income populations," Dr. Chaloupka continues.
"However, the potential for higher taxes to exacerbate food
insecurity in households that continue to smoke makes it
critical that at least some of the new revenues generated by
higher tobacco taxes be used to support programs targeting
low-income households, including those that further reduce
the health and economic burden caused by smoking on this
particularly vulnerable population. "
Arch Pediatr Adolesc Med.
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