Purpose: Previous studies have shown that cigarette smoking is associated with higher rates and severity of food insecurity but do not address how population-level smoking rates change in response to changes in food security.
Design: Trend analysis of serial cross-sectional data.
Setting: Data from a representative survey of US households.
Participants: Adults within households participating in both the Food Security Supplement and Tobacco Use Supplement of the Current Population Survey during 5 overlapping administrations from 1998 to 2011.
Measures: A "current smoker'' is defined as someone who indicated that they currently smoke on "some days'' or "every day.'' A household's food security is coded as "secure'' or "insecure,'' according to responses to a food security scale, interpreted using a US Department of Agriculture standard.
Analysis: Descriptive comparison of the roughly triennial trends in the prevalence of food insecurity and current smoking from 1998 to 2011.
Results: The prevalence of food insecurity increased by 30% among adults overall versus 54% among current smokers, with most of the changes occurring following the economic recession of 2008 and 2009. Over this same period, the prevalence of current smoking declined by 33% among food-secure adults and only 14% among food-insecure adults.
Conclusion: Food insecurity increased more markedly among adult smokers than nonsmokers, and the prevalence of smoking declined more slowly in food-insecure households, indicating that more low-income smokers are facing hunger, which may at least partly be due to buying cigarettes.