Food insecurity, social needs, and smoking status among patients in a county hospital system

• Published in: Preventive medicine reports 2022-10, Vol.29, p.101963, Article 101963
• Main Authors: Kim-Mozeleski, Jin E., Chagin, Kevin M., Sehgal, Ashwini R., Misak, James E., Fuehrer, Susan M.
• Format: Article
• Language: English
• Subjects: Electronic health record; Health disparities; Regular; Social determinants of health; Social needs; Tobacco
• ISSN: 2211-3355; 2211-3355
• DOI: 10.1016/j.pmedr.2022.101963

Tobacco use in the U.S. is increasingly concentrated among populations with socioeconomic disadvantages such as food insecurity. Building on prior studies showing that food insecurity increases odds of cigarette smoking, the current study sought to examine how food insecurity and other social needs, particularly financial strain, transportation barriers, and housing/utility insecurity, were associated with smoking status among adult patients seen in a county hospital system. We analyzed data from the electronic health record of patients from The MetroHealth System (Cleveland, Ohio, USA), covering a two-year period since implementation of social determinants of health assessments (2019–2021; N = 45,151 patients). Logistic regression analyses were used to examine associations with smoking status. Compared to the overall smoking prevalence (21 %), smoking was higher among patients screening for transportation barriers (41 %), financial strain (39 %), food insecurity (34 %), and housing/utility insecurity (27 %). Each of these social needs was independently associated with increased odds of current smoking (all p