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020 ▼a 9781088309179
035 ▼a (MiAaPQ)AAI13810044
040 ▼a MiAaPQ ▼c MiAaPQ ▼d 247004
0820 ▼a 614.4
1001 ▼a Mayer, Margaret Elizabeth.
24510 ▼a Characterizing the Association Between Tobacco Use and Food Insecurity.
260 ▼a [S.l.]: ▼b Yale University., ▼c 2019.
260 1 ▼a Ann Arbor: ▼b ProQuest Dissertations & Theses, ▼c 2019.
300 ▼a 102 p.
500 ▼a Source: Dissertations Abstracts International, Volume: 81-03, Section: B.
500 ▼a Advisor: White, Marney A.
5021 ▼a Thesis (Ph.D.)--Yale University, 2019.
506 ▼a This item must not be sold to any third party vendors.
520 ▼a Background: Tobacco use is a major public health issue, killing hundreds of thousands of Americans each year. Although the field of tobacco control has experienced many victories in recent decades, the burden of tobacco use is disproportionately felt by groups with lower socioeconomic status. Food insecurity, too, is disproportionately experienced by these groups. Tobacco use and food insecurity are major risk factors for the chronic diseases most prevalent in the United States today, yet there are multiple knowledge gaps regarding the relationship between them, potentially limiting the impact of public health interventions and policies that target each factor separately.Methods: This dissertation includes three papers, which explore whether the association between tobacco use and food insecurity extends beyond cigarette use only, whether the association at the household level can be so severe as to affect child food security, and whether co-occurring cigarette use and food insecurity can put an individual at significantly increased risk for chronic diseases. For the first study (Chapter 2), we examined whether use of other tobacco products (i.e., cigars, electronic cigarettes, smokeless tobacco), use of any product, and concurrent use of multiple products were associated with food insecurity using National Health and Nutrition Examination Survey data from 1999-2014. For the second paper (Chapter 3), we used data from a randomized controlled study of kindergarten through eighth grade schools in New Haven, CT to evaluate whether there was an association between living with a smoker and child food insecurity at a later point in time. In the final study (Chapter 4), we used data from the New Haven Health Survey, a community health needs assessment conducted in New Haven, CT, to explore whether there was an epidemiologic interaction between cigarette smoking and food insecurity with respect to risk of four chronic conditions: high blood pressure, high cholesterol, diabetes, and asthma.Results: In the first study, we found that use of any tobacco product was associated with significantly increased odds of food insecurity, although this finding did not extend to all individual tobacco products. In addition, we found that there was a dose-response relationship between number of products used concurrently and odds of food insecurity. In the second study, we found that adolescents who reported a smoker in the home were more than twice as likely to report food insecurity two years later. In the final study, we found that there was a significant interaction between cigarette smoking and food insecurity with respect to risk of high blood pressure.Conclusions: Overall, we found evidence to support and extend the current body of literature on the relationship between tobacco use and food insecurity. Although we found that the association between tobacco use and food insecurity does not necessarily extend to all individual tobacco products, we conclude that using more than one product is associated with significantly increased odds of food insecurity. This supports causal mechanisms hypothesized in the literature, as it indicates that tobacco use may divert needed funds from household food. We also found that children who live with a smoker are more likely to experience food insecurity. This finding highlights the substantial influence of tobacco use, as children are typically shielded from experiencing household food insecurity. Finally, we found that there is potential for an epidemiologic interaction between cigarette smoking and food insecurity with respect to chronic disease risk. Both tobacco use and food insecurity are well characterized issues with existing public health programs and interventions. This work suggests that programs in these two areas could be integrated to maximize their impact.
590 ▼a School code: 0265.
650 4 ▼a Epidemiology.
690 ▼a 0766
71020 ▼a Yale University. ▼b Public Health.
7730 ▼t Dissertations Abstracts International ▼g 81-03B.
773 ▼t Dissertation Abstract International
790 ▼a 0265
791 ▼a Ph.D.
792 ▼a 2019
793 ▼a English
85640 ▼u http://www.riss.kr/pdu/ddodLink.do?id=T15490628 ▼n KERIS ▼z 이 자료의 원문은 한국교육학술정보원에서 제공합니다.
980 ▼a 202002 ▼f 2020
990 ▼a ***1008102
991 ▼a E-BOOK