Promoting Smoking Cessation among Individuals With Food Insecurity

项目摘要/摘要 尽管吸烟的流行率总体上有所下降，但吸烟仍然是导致 可预防的疾病和死亡。吸烟率也不成比例地集中在人群中。 经济上处于不利地位的群体，造成与烟草相关的健康负担不均 有问题。烟草使用方面的社会经济差异持续存在，主要是因为经济上处于不利地位 吸烟者戒烟成功的可能性低于非经济上处于不利地位的吸烟者。许多 经济上处于不利地位的吸烟者有戒烟的动机，但各种生活压力构成了巨大的障碍 为了停止。贫困经历中压力最大的情况之一是粮食不安全，或者说没有能力 负担得起足够和适当的食物，以过上活跃和健康的生活。流行病学研究 已经证明，粮食不安全独立地与吸烟几率的增加有关。然而， 将食物不安全和吸烟联系起来的近邻因素还没有被很好地理解，研究也没有扩大 这种联系是为了通知戒烟。现存的文献表明，有共同的心理 (例如，压力)和生理(例如，饥饿)因素，这些因素可能使食物不安全的吸烟者倾向于 在戒烟方面遇到困难。这项提案的总体目标是建立候选人的 研究食品不安全、吸烟和戒烟的交叉路口的专业知识。该奖项将支持 应聘者作为社会和健康心理学家的职业发展，其研究针对社会 促进社会经济弱势人群戒烟的健康决定因素。 职业发展计划包括(1)社会流行病学方面的高级培训和指导，(2) 定性研究方法，(3)食物不安全与营养政策，(4)戒烟干预 研究。拟议研究的目标1将确定粮食不安全的经历是否与 在具有全国代表性的低收入吸烟者样本中继续吸烟，使用现有的 来自2001-2013年收入动态小组研究的纵向数据。目标2将瞄准当地的一个子集 有粮食不安全的人口--通过补充营养寻求联邦粮食援助的个人 加州旧金山援助计划(SNAP)-就以下问题进行调查和深入采访 食物不安全的生活经历及其与吸烟行为和戒烟的关系。AIM 3将会发展 并对一项戒烟推广计划进行试点测试，该计划向100名食品不安全的吸烟者提供服务 SNAP的背景，为戒烟和促进健康研究提供了新的场所。已被占用 总而言之，这项研究和培训计划将为有计划的以社区为基础的随机 针对食品不安全家庭的戒烟干预对照试验。这部作品具有 为减少与烟草有关的健康差距提供信息的可能性。

PROJECT SUMMARY/ABSTRACT Despite overall declines in the prevalence of cigarette smoking, smoking remains the leading cause of preventable disease and death. Smoking prevalence is also disproportionately concentrated among population groups that are economically disadvantaged, contributing to an uneven burden of tobacco-related health problems. Socioeconomic disparities in tobacco use persist largely because economically disadvantaged smokers are less likely to succeed in quitting than non-economically disadvantaged smokers. Many economically disadvantaged smokers are motivated to quit, but various life stressors pose significant barriers to cessation. One of the most stressful conditions in the experience of poverty is food insecurity, or the inability to afford adequate and appropriate foods needed to live an active and healthy life. Epidemiological studies have demonstrated that food insecurity is independently associated with increased odds of smoking. However, proximal factors linking food insecurity and smoking are not well understood, and research has not extended this association towards informing cessation. Extant literature suggests that there are shared psychological (e.g., stress) and physiological (e.g., hunger) factors that may predispose food insecure smokers to encountering difficulties with quitting smoking. The overall goal of this proposal is to build the candidate's research expertise on the intersection of food insecurity, smoking, and quitting. This award will support the candidate's career development as a social and health psychologist whose research addresses social determinants of health to promote smoking cessation among socioeconomically disadvantaged populations. The career development plan includes advanced training and mentorship in (1) social epidemiology, (2) qualitative research methods, (3) food insecurity and nutrition policy, and (4) smoking cessation intervention research. Aim 1 of the proposed study will determine whether the experience of food insecurity is associated with continued smoking among a nationally representative sample of low-income smokers, using extant longitudinal data from the 2001-2013 Panel Study of Income Dynamics. Aim 2 will target a subset of the local population with food insecurity—individuals seeking federal food assistance through the Supplemental Nutrition Assistance Program (SNAP) in San Francisco, California—to conduct surveys and in-depth interviews on the lived experience of food insecurity and its association with smoking behaviors and quitting. Aim 3 will develop and pilot test a smoking cessation outreach program that is delivered to 100 smokers with food insecurity in the context of SNAP, which provides a novel venue for smoking cessation and health promotion research. Taken together, this research and training plan will lay the foundation for a planned community-based randomized controlled trial of a smoking cessation intervention targeting households with food insecurity. This work has the potential to inform reductions in tobacco-related health disparities.