Cigarette Smoking among Women Who Are Homeless or Unstably Housed: Examining the Role of Food Insecurity
Cigarette Smoking among Women Who Are Homeless or Unstably Housed: Examining the Role of Food Insecurity
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DOI：
10.1007/s11524-017-0166-x
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发表时间：
2017-08-01
影响因子：
6.6
通讯作者：
Riley, Elise D.
中科院分区：
文献类型：
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作者：
Kim, Jin E.;Flentje, Annesa;Riley, Elise D.
无家可归者的吸烟率仍然很高，部分原因是与无家可归有关的压力。除了住房无保障之外，无家可归还涉及经济压力和无法满足的生存需求。特别是，粮食无保障会造成不利的健康结果和其他健康风险。本研究探讨了加州旧金山弗朗西斯科无家可归和边缘居住的妇女之间的粮食不安全的严重程度和吸烟之间的关联。我们使用了来自纵向队列研究的247名女性的数据。根据2009年至2012年五个半年评估点的数据，使用广义估计方程估计研究因素与吸烟之间的纵向关联。与没有食物不安全的人相比，严重食物不安全的人吸烟的纵向调整几率更高（AOR = 1.68，95% CI [1.02，2.78]），而与其他研究因素的关联，包括人口统计学，时间，HIV状态，心理健康和物质使用（大麻使用除外），没有达到显著水平。当食物不安全是因变量，吸烟是自变量时，观察到了类似的调整后的纵向结果，表明可能存在双向关联。考虑到未满足的需求，如食物和饥饿，可能会改善针对主流烟草控制工作尚未有效的个人的全面戒烟策略。同样，在努力解决无家可归者的粮食不安全问题时，应考虑提供更好的戒烟资源。
Smoking prevalence remains high among individuals who are homeless, partly due to stressors related to homelessness. Beyond housing insecurity, homelessness involves financial stresses and unmet subsistence needs. In particular, food insecurity contributes to negative health outcomes and other health risks. This study examined associations between food insecurity severity and smoking among homeless and marginally housed women in San Francisco, California. We used data from 247 women from a longitudinal cohort study. Generalized estimating equations were used to estimate longitudinal associations between study factors and smoking based on data from five biannual assessment points between 2009 and 2012. The longitudinal adjusted odds of smoking were higher among severely food insecure individuals compared to those who were not food insecure (AOR = 1.68, 95% CI [1.02, 2.78]), while associations with other study factors, including demographics, time, HIV status, mental health, and substance use (except marijuana use), did not reach levels of significance. Similar adjusted longitudinal results were observed when food insecurity was the dependent variable and smoking an independent variable, suggesting the possibility of a bidirectional association. Considering unmet needs, such as food and hunger, may improve comprehensive smoking cessation strategies targeting individuals for whom mainstream tobacco control efforts have not been effective. Similarly, offering improved access to smoking cessation resources should be considered in efforts to address food insecurity among individuals experiencing homelessness.