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Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population

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Abstract

Food assistance recipients are at higher risk for poor cardiovascular health given their propensity to poor dietary intake and tobacco use. This study sought to evaluate the cardiovascular health status, and determine the impact of a low-intensity smoking cessation education intervention that connected mobile food pantry participants to state quit-smoking resources. A pre-post design with a 6-week follow-up was used to evaluate the impact of a 10–12 min smoking cessation education session implemented in five food pantries in Delaware. Baseline cardiovascular health, smoking behaviors and food security status were assessed. Smoking cessation knowledge, intention to quit and use of the state quit line were also assessed at follow-up. Of the 144 participants 72.3% reported having hypertension, 34.3% had diabetes, 13.9% had had a stroke. 50.0% were current smokers. The low-intensity intervention significantly increased smoking cessation knowledge but not intention to quit at follow-up. Seven percent of current smokers reported calling the quit line. Current tobacco use was five times more likely in food insecure versus food secure adults (OR 4.98; p = 0.006), even after adjustment for demographic factors. Systems based approaches to address tobacco use and cardiovascular health in low-income populations are needed. The extent to which smoking cessation could reduce food insecurity and risk for cardiovascular disease in this population warrants investigation.

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References

  1. Mello, J. A., Gans, K. M., Risica, P. M., Kirtania, U., Strolla, L. O., & Fournier, L. (2010). How is food insecurity associated with dietary behaviors? An analysis with low-income, ethnically diverse participants in a nutrition intervention study. Journal of the American Dietetic Association, 110(12), 1906–1911. doi:10.1016/j.jada.2010.09.011.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Jamal, A., Homa, D. M., O’Connor, E., et al. (2015). Current Cigarette Smoking Among Adults—United States, 2005–2014. MMWR. Morbidity and Mortality Weekly Report, 64(44), 1233–1240. doi:10.15585/mmwr.mm6444a2.

    Article  PubMed  Google Scholar 

  3. Lloyd-Jones, D. M., Hong, Y., Labarthe, D., et al. (2010). Defining and setting national goals for cardiovascular health promotion and disease reduction: The American Heart Association’s strategic Impact Goal through 2020 and beyond. Circulation, 121(4), 586–613. doi:10.1161/CIRCULATIONAHA.109.192703.

    Article  PubMed  Google Scholar 

  4. Burns, E. K., Deaton, E. A., & Levinson, A. H. (2011). Rates and reasons: Disparities in low intentions to use a state smoking cessation quitline. American Journal of Health Promotion: AJHP, 25(5 Suppl), 59–65. doi:10.4278/ajhp.100611-QUAN-183.

    Article  Google Scholar 

  5. Sheffer, C. E., Stitzer, M., Landes, R., Brackman, S. L., Munn, T., & Moore, P. (2012). Socioeconomic disparities in community-based treatment of tobacco dependence. American Journal of Public Health, 102(3), e8–e16. doi:10.2105/AJPH.2011.300519.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Reid, J. L., Hammond, D., Boudreau, C., Fong, G. T., Siahpush, M., & Collaboration ITC. Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: Findings from the International Tobacco Control Four Country Survey. Nicotine & Tobacco Research. 2010; 12 Suppl:S20–S33. doi:10.1093/ntr/ntq051.

  7. Fagan, P., Shavers, V. L., Lawrence, D., Gibson, J. T., & O’Connell, M. E. (2007). Employment characteristics and socioeconomic factors associated with disparities in smoking abstinence and former smoking among U.S. workers. Journal of Health Care for the Poor and Underserved, 18(4 Suppl), 52–72. doi:10.1353/hpu.2007.0119.

    Article  PubMed  Google Scholar 

  8. Addo, J., Ayerbe, L., Mohan, K. M., et al. (2012). Socioeconomic status and stroke: An updated review. Stroke; A Journal of Cerebral Circulation, 43(4), 1186–1191. doi:10.1161/STROKEAHA.111.639732.

    Article  Google Scholar 

  9. Gebreab, S. Y., Diez Roux, A. V., Brenner, A. B., et al. (2015). The impact of lifecourse socioeconomic position on cardiovascular disease events in African Americans: The Jackson Heart Study. Journal of the American Heart Association, 4(6), e001553. doi:10.1161/JAHA.114.001553.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hu, F. B., Rimm, E. B., Stampfer, M. J., Ascherio, A., Spiegelman, D., & Willett, W. C. (2000). Prospective study of major dietary patterns and risk of coronary heart disease in men. The American Journal of Clinical Nutrition, 72(4), 912–921.

    CAS  PubMed  Google Scholar 

  11. USDA. Food Security Status of U.S. Households in 2014. 2015. http://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-in-the-us/key-statistics-graphics.aspx-foodsecure. Accessed 5 Sept 2016.

  12. Armour, B. S., Pitts, M. M., & Lee, C. W. (2008). Cigarette smoking and food insecurity among low-income families in the United States, 2001. American Journal of Health Promotion: AJHP, 22(6), 386–392. doi:10.4278/ajhp.22.6.386.

    Article  PubMed  Google Scholar 

  13. Cutler-Triggs, C., Fryer, G. E., Miyoshi, T. J., & Weitzman, M. (2008). Increased rates and severity of child and adult food insecurity in households with adult smokers. Archives of Pediatrics and Adolescent Medicine, 162(11), 1056–1062. doi:10.1001/archpediatrics.2008.2.

    Article  PubMed  Google Scholar 

  14. Iglesias-Rios, L., Bromberg, J. E., Moser, R. P., & Augustson, E. M. (2015). Food insecurity, cigarette smoking, and acculturation among Latinos: Data from NHANES 1999–2008. Journal of Immigrant and Minority Health/Center for Minority Public Health, 17(2), 349–357. doi:10.1007/s10903-013-9957-7.

    Article  PubMed Central  Google Scholar 

  15. Fiore M, Jaén, C., Baker T.(2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: Department of Health and Human Services.

    Google Scholar 

  16. Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstrom, K. O. (1991). The Fagerstrom Test for Nicotine Dependence: A revision of the Fagerstrom Tolerance Questionnaire. British Journal of Addiction, 86(9), 1119–1127.

    Article  CAS  PubMed  Google Scholar 

  17. Centers for Disease C Prevention, Brener, N. D., et al. (2013). Methodology of the youth risk behavior surveillance system–2013. MMWR Recomm Rep. 62(RR-1):1–20.

    Google Scholar 

  18. Hager, E. R., Quigg, A. M., Black, M. M., et al. (2010). Development and validity of a 2-item screen to identify families at risk for food insecurity. Pediatrics, 126(1), e26–e32. doi:10.1542/peds.2009-3146.

    Article  PubMed  Google Scholar 

  19. Biener, L., & Abrams, D. B. (1991). The Contemplation Ladder: Validation of a measure of readiness to consider smoking cessation. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 10(5), 360–365.

    Article  CAS  Google Scholar 

  20. Johnson, N. B., Hayes, L. D., Brown, K., et al. (2014). CDC National Health Report: Leading causes of morbidity and mortality and associated behavioral risk and protective factors–United States, 2005–2013. MMWR Suppl, 63(4), 3–27.

    PubMed  Google Scholar 

  21. Writing Group M, Mozaffarian, D., Benjamin, E. J., et al. (2016). Executive Summary: Heart Disease and Stroke Statistics–2016 Update: A Report From the American Heart Association. Circulation, 133(4), 447–454. doi:10.1161/CIR.0000000000000366.

    Article  Google Scholar 

  22. Schauer, G. L., Malarcher, A. M., Zhang, L., Engstrom, M. C., & Zhu, S. H. (2014). Prevalence and correlates of quitline awareness and utilization in the United States: An update from the 2009–2010 National Adult Tobacco Survey. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 16(5), 544–553. doi:10.1093/ntr/ntt181.

    Article  Google Scholar 

  23. Griffin, J. L., Segal, K. S., & Nahvi, S. (2015). Barriers to telephone quitline use among methadone-maintained smokers. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 17(8), 931–936. doi:10.1093/ntr/ntu267.

    Article  Google Scholar 

  24. Nwankwo, T., Yoon, S. S., Burt, V., & Gu, Q. (2013). Hypertension among adults in the United States: National Health and Nutrition Examination Survey, 2011–2012. NCHS Data Brief. ; (133):1–8.

  25. Prevention CfDCa. (2014). National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: Department of Health and Human Services.

    Google Scholar 

  26. Centers for Disease C Prevention. (2012). Prevalence of stroke–United States, 2006–2010. MMWR. Morbidity and Mortality Weekly Report, 61(20), 379–382.

    Google Scholar 

  27. Centers for Disease C Prevention. (2011). Prevalence of coronary heart disease–United States, 2006–2010. MMWR. Morbidity and Mortality Weekly Report, 60(40), 1377–1381.

    Google Scholar 

  28. Comings, D. E., & Blum, K. (2000). Reward deficiency syndrome: Genetic aspects of behavioral disorders. Progress in Brain Research, 126, 325–341. doi:10.1016/S0079-6123(00)26022-6.

    Article  CAS  PubMed  Google Scholar 

  29. Verhagen, M., Kleinjan, M., & Engels, R. C. (2012). A systematic review of the A118G (Asn40Asp) variant of OPRM1 in relation to smoking initiation, nicotine dependence and smoking cessation. Pharmacogenomics, 13(8), 917–933. doi:10.2217/pgs.12.76.

    Article  CAS  PubMed  Google Scholar 

  30. Hoebel, B. G. (1985). Brain neurotransmitters in food and drug reward. The American Journal of Clinical Nutrition, 42(5 Suppl), 1133–1150.

    CAS  PubMed  Google Scholar 

  31. Anderson, P., Butcher K, Hoynes H, Schanzenbach D. Beyond Income: What else predicts very low foo dsecurity among children? Kentucky, USA: University of Kentucky Center for Poverty Research Discussion Paper Series 2014, Contract No.: DP2014–06.

  32. Bryant, J., Bonevski, B., & Paul, C. (2011). A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: A unique opportunity for reaching the disadvantaged. BMC Public Health, 11, 827. doi:10.1186/1471-2458-11-827.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Patterson, F., Zaslav, D. S., Kolman-Taddeo, D., et al. (2016). Smoking cessation in pulmonary care subjects: A mixed methods analysis of treatment-seeking participation and preferences. Respiratory Care. doi:10.4187/respcare.04958.

    PubMed  Google Scholar 

  34. Edin K, Boyd M, Mabli J, et al. (2013). SNAP food security in-depth interview study. Alexandria, VA: U.S. Department of Agriculture, Food and Nutrition Service.

    Google Scholar 

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Acknowledgements

The authors wish to thank Kai Inguito and Christina Brown for their assistance with data collection. They would also like to thank the staff at the Windsor Apartments, Brandywine Center for Counseling Services, Chelton Apartments, A.C.E. Peer Resource Center, and the Calvary Assembly of God Church for their cooperation in providing a venue for study implementation. Karen Murphy and Danielle Zack are acknowledged for their administrative support to this project.

Funding

Funding for this study was provided by the American Lung Association to the Food Bank of Delaware. Research reported in this publication was also supported by an Institutional Development Award (IDeA) Center of Biomedical Research Excellence from the National Institute of General Medical Sciences of the National Institutes of Health under Grant No. P20GM113125 (FP).

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Correspondence to Freda Patterson.

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The authors have no conflicts of interest to disclose.

Institutional Review Board

The Institutional Review Board at the University of Delaware approved this study.

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Written informed consent was obtained for all study participants.

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Perkett, M., Robson, S.M., Kripalu, V. et al. Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population. J Community Health 42, 605–611 (2017). https://doi.org/10.1007/s10900-016-0295-2

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