This study examined the relationships among intermediary determinants, structural determinants, and adult smoking status and quit attempts.
Design:
Secondary data analysis of cross-sectional data.
Setting:
Data come from the 2015 Behavioral Risk Factor Surveillance System (BRFSS), Social Context module. A national, representative sample from 12 US states (Alabama, Arkansas, Delaware, District of Columbia, Georgia, Louisiana, Minnesota, Mississippi, Missouri, Rhode Island, Tennessee, and Utah).
Participants:
A total of 64 053 noninstitutionalized US adults aged ≥18 years.
Measures:
Smoking status and quit attempts were outcome variables. Individual-level structural determinants (age, sex, race/ethnicity, marital status, education, and employment status) and intermediary determinants (housing insecurity, food insecurity, health insurance, binge drinking, and general health mental health) from BRFSS.
Current smoking was greater among men, respondents aged between 35 to 64 and 55 to 64, adults who reported food insecurity, housing insecurity, frequent mental distress, binge drinking, and who were unemployed. Current smokers had higher odds of making quit attempts in the past 12 months if they were non-Hispanic Black, graduated college, and reported food and housing insecurity.
Conclusion:
Multifaceted smoking cessation interventions that address food and housing needs also incorporate screening for potential comorbidities such as mental distress and/or hazardous alcohol use and may be needed to enhance smoking cessation rates among racially diverse adults.
JamelAKingBANeffLJWhitmillJBabbSDGraffunderCM. Current cigarette smoking among adults—United States, 2005-2015. MMWR Morb Mortal Wkly. 2016;65(44):1205–1211.
2.
US National Cancer Institute. A Socioecological Approach to Addressing Tobaco-Related Health Disparities. National Cancer Institute Tobacco Control Monograph 22. NIH Publication No.17-CA-8035A. Bethesda, MD. US Departemnt of Health and Human Services, National Institutes of Health, National Cancer Institute; 2017.
3.
KushiLHDoyleCMcCulloughM; American Cancer Society 2010 Nutrition and Physical Activity Guidelines Advisory Committee. American cancer society guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62(1):30–67.
4.
SiahpushMBorlandRYongHHCummingsKMFongGT. Tobacco expenditure, smoking-induced deprivation and financial stress: results from the international tobacco control (ITC) four-country survey. Drug Alcohol Rev. 2012;31(5):664–671.
5.
RogersESDaveDMPozenAFahsMGalloWT. Tobacco cessation and household spending on non-tobacco goods: results from the US Consumer Expenditure Surveys. Tob Control. 2018;27(2):209–216.
6.
GuillaumierABonevskiBPaulC. ‘Cigarettes are priority’: a qualitative study of how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices. Health Educ Res. 2015;30(4):599–608.
7.
ArmourBSPittsMMLeeCW. Cigarette smoking and food insecurity among low-income families in the United States, 2001. Am J Health Promot. 2008;22(6):386–392.
8.
Centers for Disease Control and Prevention. Quitting smoking among adults—United States, 2001-2010. MMWR Morb Mortal Wkly. 2011;60(44):1513–1519.
9.
PiaseckiTM. Relapse to smoking. Clin Psychol Rev. 2006;26(2):196–215.
10.
YiZMayorgaMEHassmiller LichKPearsonJL. Changes in cigarette smoking initiation, cessation, and relapse among U.S. adults: a comparison of two longitudinal samples. Tob Induc Dis. 2017;15:17.
11.
ReidJLHammondDBoudreauCFongGTSiahpushM; ITC Collaboration. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the international tobacco control four country survey. Nicotine Tob Res. 2010;12(suppl):S20–S33.
12.
SolarOIrwinA. A Conceptual Framework for Action on the Social Determinants of Health: Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva, Switzerland: World Health Organization; 2010.
13.
ArcayaMGlymourMMChristakisNAKawachiISubramanianSV. Individual and spousal unemployment as predictors of smoking and drinking behavior. Soc Sci Med. 2014;110:89–95.
14.
StahreMVanEenwykJSiegelPNjaiR. Housing insecurity and the association with health outcomes and unhealthy behaviors, Washington state, 2011. Prev Chronic Dis. 2015;12:E109.
15.
Iglesias-RiosLBrombergJEMoserRPAugustsonEM. Food insecurity, cigarette smoking, and acculturation among Latinos: data from NHANES 1999-2008. J Immigr Minor Health. 2015;17(2):349–357.
16.
PoghosyanHBellJFJosephJGCooleyME. The association between having a first-degree family history of cancer and smoking status. Prev Med. 2014;66:12–16.
17.
PoghosyanHDarwishSAKimSSCooleyME. The association between social support and smoking status in cancer survivors with frequent and infrequent mental distress: results from 10 US states, 2010. J Cancer Surviv. 2016;10(6):1078–1088.
18.
DubeSRCaraballoRSDhingraSS. The relationship between smoking status and serious psychological distress: findings from the 2007 Behavioral Risk Factor Surveillance System. Int J Public Health. 2009;54(suppl 1):68–74.
19.
McClaveAKDubeSRStrineTWKroenkeKCaraballoRSMokdadAH. Associations between smoking cessation and anxiety and depression among U.S. adults. Addict Behav. 2009;34(6-7):491–497.
20.
JamalAKingBANeffLJWhitmillJBabbSDGraffunderCM. Current cigarette smoking among adults-United States, 2005-2015. MMWR Morb Mortal Wkly. 2016;65(44):1205–1211.
21.
Centers for Disease Control and Prevention. Behavioral Risk Factor Surveillance System. 2015 summary data quality report. United States Department of Health and Human Services. 2015. https://www.cdc.gov/brfss/annual_data/2015/pdf/2015-sdqr.pdf. Accessed March 14, 2017.
22.
US Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.
Centers for Disease Control and Prevention. State-specific prevalence of cigarette smoking and quitting among adults—United States, 2004. MMWR Morb Mortal Wkly Rep. 2005;54(44):1124–1127.
25.
NelsonDEHoltzmanDBolenJStanwyckCAMackKA. Reliability and validity of measures from the Behavioral Risk Factor Surveillance System (BRFSS). Soz Praventivmed. 2001;46(suppl 1):S3–S42.
26.
MowlsDSCheruvuVKZulloMD. Clinical and individual factors associated with smoking quit attempts among adults with COPD: do factors vary with regard to race?Int J Environ Res Public Health. 2014;11(4):3717–3727.
27.
LiuYNjaiRSGreenlundKJChapmanDPCroftJB. Relationships between housing and food insecurity, frequent mental distress, and insufficient sleep among adults in 12 US states, 2009. Prev Chronic Dis. 2014;11:E37.
28.
SciamannaCNSmythJMDoerksenSE. Physical activity mode and mental distress in adulthood. Am J Prev Med. 2017;52(1):85–93.
29.
HaasJSLinderJAParkER. Proactive tobacco cessation outreach to smokers of low socioeconomic status: a randomized clinical trial. JAMA Intern Med. 2015;175(2):218–226.
30.
McClaveAKDubeSRStrineTWMokdadAH. Associations between health-related quality of life and smoking status among a large sample of U.S. adults. Prev Med. 2009;48(2):173–179.
31.
MinichinoABersaniFSCaloWK. Smoking behaviour and mental health disorders--mutual influences and implications for therapy. Int J Environ Res Public Health. 2013;10(10):4790–4811.
32.
WeinbergerAHGbedemahMGoodwinRD. Cigarette smoking quit rates among adults with and without alcohol use disorders and heavy alcohol use, 2002-2015: a representative sample of the United States population. Drug Alcohol Depend. 2017;180:204–207.
33.
CooneyJLCooperSGrantC. A randomized trial of contingency management for smoking cessation during intensive outpatient alcohol treatment. J Subst Abuse Treat. 2017;72:89–96.
34.
CooneyNLLittMDSevarinoKA. Concurrent alcohol and tobacco treatment: effect on daily process measures of alcohol relapse risk. J Consult Clin Psychol. 2015;83(2):346–358.
35.
ApollonioDPhilippsRBeroL. Interventions for tobacco use cessation in people in treatment for or recovery from substance use disorders. Cochrane Database Syst Rev. 2016;11:CD010274.
36.
HenkelD. Unemployment and substance use: a review of the literature (1990-2010). Curr Drug Abuse Rev. 2011;4(1):4–27.
37.
McCarthyMSiahpushMShaikhRASikora KesslerATibbitsM. Social disparities in unaided quit attempts among daily current and former smokers: results from the 2010-2011 tobacco use supplement to the current population survey. Nicotine Tob Res. 2016;18(8):1705–1710.
38.
KulakJACorneliusMEFongGTGiovinoGA. Differences in quit attempts and cigarette smoking abstinence between whites and African Americans in the United States: literature review and results from the international tobacco control US survey. Nicotine Tob Res. 2016;18(suppl 1):S79–S87.
39.
BenowitzNAhijevychKHallS. Biochemical verification of tobacco use and cessation. Nicotine Tob Res. 2002;4(2):149–159.
40.
HolbenDHMylesW. Food insecurity in the United States: its effect on our patients. Am Fam Physician. 2004;69(5):1058–1060, 1063.
