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Pike Moore S, Gunzler DD, Spears CA, Shaikh NI, Kim-Mozeleski JE. Longitudinal experience of food insecurity & cigarette use in the early COVID-19 Pandemic, United States. Prev Med Rep 2024; 38:102624. [PMID: 38375176 PMCID: PMC10874846 DOI: 10.1016/j.pmedr.2024.102624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/21/2024] Open
Abstract
Food insecurity is associated with cigarette smoking, yet little is known about how variability in the experience of food insecurity may relate to patterns of cigarette use. We sought to examine patterns of food insecurity and cigarette use during the COVID-19 pandemic (April 2020-March 2021). We analyzed longitudinal survey data from a nationally representative panel of adults in the United States (N = 7,880) from the Understanding Coronavirus in America Study. The primary independent variable was ten trajectories of food insecurity. Our dependent variable was past 7-day cigarette use (count of days used cigarettes). Poisson regression using generalized estimating equations was run controlling for key covariates. The prevalence of cigarette use on at least one day in the past week was lowest (17.5 %) for those who Remained Food Secure, and highest (57.9 %) among those who Became Fully Food Insecure, a group characterized by having high probability of becoming food insecure during the study period. Among those who reported at least one day of cigarette use in the past week, fewer than half (40.1 %) reported sustained use across all waves of the study. Those who Became Fully Food Insecure had an incidence rate ratio (IRR) of 1.73 (95 % CI: 1.18, 2.54) compared to those who Remained Food Secure with respect to number of smoking days. While different patterns of food insecurity are related to cigarette smoking at the population level, these results highlight that food insecurity, a key social need, may represent a novel strategy for informing reduction of tobacco use disparities.
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Affiliation(s)
- Stephanie Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH, USA
| | - Claire A. Spears
- Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Nida I. Shaikh
- Department of Nutrition, Byrdine F. Lewis College of Nursing & Health, Georgia State University, Atlanta, GA, USA
| | - Jin E. Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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Kim-Mozeleski JE, Castele MC, Nambiar P, Chagin KM, Pike Moore S, Hardy P, Cook K, Sehgal AR. A Randomized Trial to Address Food Insecurity and Promote Smoking Cessation Among Low-Income Adults. J Prim Care Community Health 2024; 15:21501319241245275. [PMID: 38584453 PMCID: PMC11003330 DOI: 10.1177/21501319241245275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 03/12/2024] [Accepted: 03/13/2024] [Indexed: 04/09/2024] Open
Abstract
Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke.
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Affiliation(s)
| | | | | | - Kevin M. Chagin
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | | | - Patricia Hardy
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | - Karen Cook
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
| | - Ashwini R. Sehgal
- The Institute for H.O.P.E.™, The MetroHealth System, Cleveland, OH, USA
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Kim-Mozeleski JE, Smell A, Castele MC, Ogden E, Trapl ES. Assessing the Feasibility of Conducting Smoking Cessation Outreach in Food Pantries: A Pilot Intervention Study. Nicotine Tob Res 2024; 26:46-53. [PMID: 37531409 PMCID: PMC10734382 DOI: 10.1093/ntr/ntad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 07/25/2023] [Accepted: 07/31/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Smoking prevalence is high among US adults with food insecurity. This study examined how food assistance settings, namely food pantries, can serve as a community-based venue to reach food insecure adults who smoke for smoking cessation. METHODS Partnering with a local hunger relief organization, we conducted surveys and focus groups of food pantry clients in Greater Cleveland, Ohio, followed by food pantry-based outreach events to connect people who smoke to the Ohio Tobacco Quit Line. RESULTS The survey included 132 participants who visited a food pantry (M age = 47; 74% women; 39% Black/African American), of whom 35% were using tobacco and 31% were smoking cigarettes. Among those currently smoking (M cigarettes/day = 9), 76% intended to quit in the next 6 months, and 82% had not used nor heard of the quitline. Informed by focus group themes, we conducted a total of 22 outreach events at four pantries. Among those interested in smoking cessation resources from the outreach events (n = 54), 78% were able to be subsequently contacted. Of them, 74% provided consent for quitline referral. The remainder either declined or were unable to participate. CONCLUSIONS While it was feasible to leverage food pantries for smoking cessation outreach, the overall reach was low. Despite high interest in quitting, there was limited effectiveness of outreach efforts without adaptations to each pantry setting and in recognition of the immediate food needs and with challenges related to the COVID-19 pandemic. There remains a critical need to address high rates of smoking among populations experiencing food insecurity. IMPLICATIONS Tobacco cessation services are increasingly recognizing the need to address food insecurity and other social needs that commonly occur in populations who use tobacco at higher rates. This research underscores both the value and the challenges related to leveraging food pantries as a community-based venue for smoking cessation outreach. In addition to improvements in outreach models, long-term investments in structural interventions are also needed to address underlying poverty and socioeconomic disadvantage that ultimately drive disparities in smoking and in food insecurity.
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Affiliation(s)
- Jin E Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Adrianna Smell
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Madeline C Castele
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Erin Ogden
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Erika S Trapl
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Kim-Mozeleski JE, Pike Moore SN, Trapl ES, Perzynski AT, Tsoh JY, Gunzler DD. Food Insecurity Trajectories in the US During the First Year of the COVID-19 Pandemic. Prev Chronic Dis 2023; 20:E03. [PMID: 36657063 PMCID: PMC9856052 DOI: 10.5888/pcd20.220212] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this study was to characterize population-level trajectories in the probability of food insecurity in the US during the first year of the COVID-19 pandemic and to examine sociodemographic correlates associated with identified trajectories. METHODS We analyzed data from the Understanding America Study survey, a nationally representative panel (N = 7,944) that assessed food insecurity every 2 weeks from April 1, 2020, through March 16, 2021. We used latent class growth analysis to determine patterns (or classes) of pandemic-related food insecurity during a 1-year period. RESULTS We found 10 classes of trajectories of food insecurity, including 1 class of consistent food security (64.7%), 1 class of consistent food insecurity (3.4%), 5 classes of decreasing food insecurity (15.8%), 2 classes of increasing food insecurity (4.6%), and 1 class of stable but elevated food insecurity (11.6%). Relative to the class that remained food secure, other classes were younger, had a greater proportion of women, and tended to identify with a racial or ethnic minority group. CONCLUSION We found heterogeneous longitudinal patterns in the development, resolution, or persistence of food insecurity during the first year of the COVID-19 pandemic. Experiences of food insecurity were highly variable across the US population, with one-third experiencing some form of food insecurity risk. Findings have implications for identifying population groups who are at increased risk of food insecurity and related health disparities beyond the first year of the pandemic.
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Affiliation(s)
- Jin E. Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Stephanie N. Pike Moore
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Erika S. Trapl
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Adam T. Perzynski
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
| | - Janice Y. Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
| | - Douglas D. Gunzler
- Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio
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Joshi K, Caspi CE, Briggs FBS, Gunzler DD, Kim-Mozeleski JE, Trapl ES. Food Banking during COVID-19 Pandemic: Food Sourcing and Food Quality across 3 Food Banks in Minnesota. Journal of Hunger & Environmental Nutrition 2022. [DOI: 10.1080/19320248.2022.2078683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Kakul Joshi
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Caitlin E. Caspi
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Farren B. S. Briggs
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
| | - Douglas D. Gunzler
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Center for Health Care Research & Policy, MetroHealth Medical Center, Cleveland, Ohio, USA
| | - Jin E. Kim-Mozeleski
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Prevention Research Center for Healthy Neighborhoods, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Erika S. Trapl
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, Ohio, USA
- Prevention Research Center for Healthy Neighborhoods, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
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Abstract
Limited studies have examined the role of a parent's involvement in their child's daily life as it relates to cigarette smoking among adolescents in low- and middle-income countries (LMICs). We examined the role of parental involvement with current smoking among 6,105 adolescents using a nationally representative sample from the 2015- 2016 Global School-based Students Health Survey in Nepal. Using the adolescents' perceptions of daily parental involvement, a composite variable was created to include parents (a) checking to see if the child's homework was done, (b) understanding the child's problems and worries, and (c) knowing what the child was doing with their free time. Our analysis utilized a multiple logistic regression to calculate adjusted odds ratios (aOR) accounting for significant covariates. Overall, an increase in parental involvement was associated with a 15% less (aOR = 0.86) likelihood of their child smoking. Additionally, being 15 years or older (aOR =1.55), being bullied (aOR =1.72), drinking alcohol (aOR =20.63), and having missed school without permission (aOR =2.29) were all associated with cigarette smoking. Further, girls were almost 70% less (aOR = 0.33) likely to be cigarette smokers than boys. Future longitudinal studies should examine parental involvement as a protective factor against cigarette smoking.
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Affiliation(s)
- Gaurav Dangol
- Department of Biostatistics & Epidemiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Krishna C Poudel
- Department of Health Promotion & Policy, University of Massachusetts Amherst, Amherst, MA, USA.,Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, USA
| | - Jin E Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
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Guan A, Kim-Mozeleski JE, Vyas P, Stewart SL, Gildengorin G, Burke NJ, Ma K, Pham AT, Tan J, Lu Q, McPhee SJ, Tsoh JY. Neighborhood Ethnic Composition and Self-rated Health Among Chinese and Vietnamese American Immigrants. J Immigr Minor Health 2021; 23:574-582. [PMID: 32617753 PMCID: PMC8208464 DOI: 10.1007/s10903-020-01041-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Immigrants tend to live in areas with higher co-ethnic density, and the effect of neighborhood ethnic composition could be particularly salient for health. This study explored associations between neighborhood ethnic composition and self-rated health among Asian immigrants. We analyzed data collected at baseline from 670 Chinese and Vietnamese immigrants enrolled in a lifestyle intervention trial. Residential addresses were geocoded and combined with neighborhood socio-demographic profiles based on census data. We used generalized estimating equations to examine neighborhood ethnic composition and self-rated health. Independent of individual-level factors, living in neighborhoods more densely populated by whites was associated with poor/fair self-rated health. Neighborhood household income and density of participants' own ethnic group were not associated with poor/fair self-rated health. More research is warranted to disentangle reasons why Chinese and Vietnamese immigrants living in white-concentrated neighborhoods reported poorer self-rated health, including investigating effects of discrimination, relative deprivation, and availability of social resources.
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Affiliation(s)
- Alice Guan
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA.,Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Jin E Kim-Mozeleski
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Priyanka Vyas
- Center for Tobacco Research and Education, University of California San Francisco, San Francisco, CA, USA
| | - Susan L Stewart
- Department of Public Health Sciences, School of Medicine, University of California Davis, Davis, CA, USA
| | - Ginny Gildengorin
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nancy J Burke
- Department of Public Health, University of California Merced, Merced, CA, USA.,Asian American Research Center on Health, San Francisco, CA, USA
| | - Kris Ma
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Amber T Pham
- Department of Psychology, DePaul University, Chicago, IL, USA
| | - Judy Tan
- Division of Prevention Science, Center for AIDS Prevention Studies, University of California San Francisco, San Francisco, CA, USA
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen J McPhee
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, 401 Parnassus Avenue, San Francisco, CA, 94143, USA. .,Asian American Research Center on Health, San Francisco, CA, USA.
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Abstract
Cigarette smoking is increasingly concentrated in socioeconomically disadvantaged groups, and food insecurity also disproportionately affects lower-income groups. Recent studies have suggested that smoking and food insecurity operate as risk factors for one another, but there is limited understanding of their intersection. This scoping review aimed to synthesize the published literature on the association between food insecurity and tobacco use across population groups in the United States and Canada. We searched PubMed, Web of Science, and PsycINFO using key words. Studies included were published in English between 2008 and 2018, reported empirical findings, measured both tobacco use and food insecurity, and considered either variable as a study outcome. Nineteen articles were identified; 6 examined tobacco use as an outcome variable and 13 examined food insecurity as an outcome variable. Most articles were of studies using cross-sectional designs. Study samples ranged from general populations, clinical samples, and underserved populations. For each article, we extracted information including specific findings related to the association between food insecurity and tobacco use. We synthesized the current research by formulating a model by which food insecurity and tobacco use are bidirectionally associated. This scoping review concludes that the co-occurrence of food insecurity and tobacco use exists across populations in the United States and Canada. As the evidence is largely from cross-sectional investigations, there is a need for longer term, comprehensive assessments of relationships between tobacco use and food insecurity. Such investigations can inform policies and interventions aimed toward addressing the inequitable burden of tobacco use and of food insecurity among disadvantaged populations.
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Kim-Mozeleski JE, Poudel KC, Tsoh JY. Examining Reciprocal Effects of Cigarette Smoking, Food Insecurity, and Psychological Distress in the U.S. J Psychoactive Drugs 2020; 53:177-184. [PMID: 33143564 DOI: 10.1080/02791072.2020.1845419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the U.S., cigarette smoking is increasingly concentrated in disadvantaged and vulnerable populations, such as populations with lower income and with mental health needs. Food insecurity is linked with psychological distress and is an independent risk factor for smoking. We prospectively examined how cigarette smoking, food insecurity, and psychological distress operate as risk factors for one another in a 2-year longitudinal analysis of U.S. adults from the 2015 and 2017 Panel Study of Income Dynamics, a nationally representative household survey (N = 7946). Using cross-lagged panel analysis, cross-lagged regression coefficients were estimated simultaneously with direct-effect paths, controlling for covariates. Results showed significant bidirectional associations between smoking and food insecurity: 2015 smoking predicted 2017 food insecurity, and 2015 food insecurity predicted 2017 smoking. Food insecurity and psychological distress also had significant bidirectional associations. However, the association between smoking and psychological distress was unidirectional: 2015 psychological distress predicted 2017 smoking, but not vice versa. The findings suggest a cyclical possibility that smoking exacerbates food insecurity, food insecurity exacerbates psychological distress, and psychological distress exacerbates smoking. There is a need to replicate with more timepoints, but our results highlight the importance of examining the overlapping health burdens of smoking, food insecurity, and psychological distress.
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Affiliation(s)
- Jin E Kim-Mozeleski
- Prevention Research Center for Healthy Neighborhoods, Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Krishna C Poudel
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, Institute for Global Health, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
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Kim-Mozeleski JE, Yen IH, Buchanan DR, Tsoh JY. Linking food insecurity and smoking cessation: In response to "Food insecurity transitions and smoking behavior among older adults who smoke". Prev Med 2019; 129:105811. [PMID: 31739907 DOI: 10.1016/j.ypmed.2019.105811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
This Letter to the Editor raises questions regarding a recently published article, "Food insecurity transitions and smoking behavior among older adults who smoke."
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Affiliation(s)
- Jin E Kim-Mozeleski
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA.
| | - Irene H Yen
- Public Health, School of Social Sciences, Humanities & Arts, University of California Merced, Merced, CA, USA
| | - David R Buchanan
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
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Kim-Mozeleski JE, Pandey R, Tsoh JY. Psychological distress and cigarette smoking among U.S. households by income: Considering the role of food insecurity. Prev Med Rep 2019; 16:100983. [PMID: 31516816 PMCID: PMC6734047 DOI: 10.1016/j.pmedr.2019.100983] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/08/2019] [Accepted: 08/29/2019] [Indexed: 11/06/2022] Open
Abstract
Psychological distress and tobacco use are known to co-occur for many reasons, including vulnerabilities associated with socioeconomic disadvantage. Food insecurity-a stressful condition due to inconsistent food access-is linked with increased psychological distress and is also an independent risk factor for smoking. We investigated the association between psychological distress and cigarette smoking, examining distress occurring with or without food insecurity, and variations in the associations by socioeconomic status. We analyzed data from the 2015 U.S. Panel Study of Income Dynamics (n = 9048). A four-category variable was constructed based on responses to validated measures of psychological distress and of food insecurity: no distress and no food insecurity; food insecurity without distress; distress without food insecurity; and distress with food insecurity. Weighted, robust Poisson regression analysis examined associations with current smoking, with analyses stratified by socioeconomic status. Smoking prevalence was highest among respondents experiencing psychological distress with food insecurity (39%). Results showed that respondents with food insecurity alone had higher smoking prevalence (33%) than respondents with psychological distress alone (20%). Only among respondents above poverty, psychological distress without food insecurity was significantly associated with current smoking (prevalence ratio = 1.44; 95% CI [1.25, 1.65]). For respondents at/below poverty, psychological distress without food insecurity was not significantly associated with current smoking. Further examining how socioeconomic stressors, such as food insecurity, intersect with psychological distress is needed to address continued socioeconomic disparities in cigarette smoking and develop effective population-based interventions.
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Affiliation(s)
- Jin E. Kim-Mozeleski
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Rajshree Pandey
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y. Tsoh
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
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Nagayama Hall GC, Kim-Mozeleski JE, Zane NW, Sato H, Huang ER, Tuan M, Ibaraki AY. Cultural Adaptations of Psychotherapy: Therapists' Applications of Conceptual Models with Asians and Asian Americans. Asian Am J Psychol 2019; 10:68-78. [PMID: 30854159 PMCID: PMC6402600 DOI: 10.1037/aap0000122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Although conceptual models of cultural adaptations of psychotherapy have been developed, little is known about how therapists apply these models in clinical practice. The purpose of the current study was to examine, using a directed content analysis, how therapists culturally adapt cognitive-behavioral therapy (CBT), one of the most widely used evidence-based approaches, for application with clients of Asian ancestry. The study also examined if there were major differences in adaptation strategies between therapists who practice in the United States (N = 9), a predominantly individualistic society as opposed to those who practice in Japan (N = 6), a predominantly collectivistic society. Semi-structured, open-ended interviews revealed that interdependent conceptualizations of the self and indirect communication were addressed by therapists in both countries, and therapist credibility issues were addressed only by therapists in the United States. These results imply that when culturally adapting psychotherapy, therapists incorporate elements of conceptual models that are relevant to their clients' cultures.
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Kim-Mozeleski JE, Seligman HK, Yen IH, Shaw SJ, Buchanan DR, Tsoh JY. Changes in Food Insecurity and Smoking Status over Time: Analysis of the 2003 and 2015 Panel Study of Income Dynamics. Am J Health Promot 2018; 33:698-707. [PMID: 30463414 DOI: 10.1177/0890117118814397] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE To examine whether food insecurity longitudinally affects smoking status. DESIGN Population-based prospective study. SETTING Data from the 2003 and 2015 Panel Study of Income Dynamics (PSID). PARTICIPANTS Four thousand five hundred sixty-three adults who were smokers and nonsmokers, participating in the 2003 (current study baseline) and 2015 (current study follow-up) waves of PSID. MEASURES Based on self-reported smoking status at baseline and follow-up, respondents were categorized as continued smoking, stopped smoking, started smoking, and continued nonsmoking. Similarly, respondents were categorized as stayed food secure, stayed food insecure, became food insecure, and became food secure based on responses to the Food Security Survey at baseline and follow-up. ANALYSIS Two logistic regression analyses to examine (1) among smokers at baseline the odds of stopping versus continuing smoking by follow-up and (2) among nonsmokers at baseline the odds of starting versus continuing nonsmoking by follow-up. In both models, change in food insecurity status was the primary independent variable, controlling for demographics including poverty. RESULTS Among smokers at baseline, becoming food insecure (vs staying food secure) was independently associated with lower likelihood of stopping smoking by follow-up (odds ratio [OR] = 0.66). Among nonsmokers at baseline, becoming food insecure (vs staying food secure) was independently associated with higher likelihood of starting smoking by follow-up (OR = 3.77). CONCLUSIONS Food insecurity is a risk factor for smoking, which has significant implications for developing interventions to reduce smoking prevalence, especially among low-income groups.
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Affiliation(s)
- Jin E Kim-Mozeleski
- 1 Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, MA, USA
| | - Hilary K Seligman
- 2 Departments of Medicine and of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA
| | - Irene H Yen
- 3 Public Health, School of Social Sciences, Humanities & Arts, University of California-Merced, Merced, CA, USA
| | - Susan J Shaw
- 1 Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, MA, USA
| | - David R Buchanan
- 1 Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts-Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- 4 Department of Psychiatry, University of California-San Francisco, San Francisco, CA, USA
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Abstract
Food insecurity is a key social and health issue among persons living with HIV (PLHIV). Food insecurity oftentimes co-occurs with substance use, but little is known about the relationship between tobacco use and food insecurity particularly among PLHIV. In this study, we prospectively examined the association of cigarette smoking with food insecurity in a cohort of 108 individuals seeking vocational rehabilitation services. Over the 12-month study period, smokers at baseline reported consistently higher levels of food insecurity compared to non-smokers. Smoking remained an independent risk factor for greater food insecurity, controlling for sociodemographic characteristics and known confounders (e.g., substance use, depression). Food insecurity is a key structural and socioeconomic barrier that may partially explain HIV-related health disparities observed among smokers. Further research is needed to characterize the bio-behavioral mechanisms linking smoking and food insecurity as well as test whether smoking cessation can reduce food insecurity in PLHIV who smoke.
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Affiliation(s)
- Jin E Kim-Mozeleski
- Department of Health Promotion and Policy, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | | | | | - Sheri D Weiser
- Division of HIV, ID and Global Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Adam W Carrico
- Division of Prevention Science and Community Health, Department of Public Health Sciences, University of Miami, 1120 NW 14th St., Miami, FL, 33136, USA.
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Abstract
PURPOSE To examine how food insecurity and psychological distress interact in its association with smoking and to explore how food insecurity and psychological distress are associated with quitting smoking using quit ratio estimates. DESIGN Cross-sectional study. SETTING Data from the 2015 California Health Interview Survey. PARTICIPANTS A total of 3007 lower income adults who have ever smoked. MEASURES Ever smoking was defined as smoking 100+ cigarettes in the entire lifetime, with current smoking defined as smoking "every day" or "some days" and former smoking defined as smoking "not at all." Psychological distress and food insecurity were measured by the 6-item K6 Psychological Distress Scale and the 6-item Food Security Survey Short Form, respectively. ANALYSIS Multiple logistic regression analysis was used to examine correlates of smoking status. Quit ratios (percentage of ever smokers who have quit) were calculated across study variables. RESULTS Reporting food insecurity with psychological distress was independently associated with lower odds of being a former smoker, compared to reporting food security without psychological distress. The quit ratio was lower among ever smokers reporting food insecurity with distress (41%) compared to ever smokers reporting food security without distress (63%). CONCLUSIONS Specific conditions of impoverishment, such as food insecurity, interact with psychological distress in its association with continued smoking. Interventions to reduce socioeconomic disparities in smoking should consider the interacting role of food insecurity and psychological distress.
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Affiliation(s)
- Jin E Kim-Mozeleski
- 1 Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Janice Y Tsoh
- 2 Department of Psychiatry, University of California, San Francisco, CA, USA
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