An Empirical Analysis of the Association Between Cigarette Smoking and Participation in the Supplemental Nutrition Assistance Program.
OBJECTIVE
To examine the association between smoking and participation in Supplemental Nutrition Assistance Program (SNAP) among low-income families.


METHODS
A quasi-experimental design using pooled cross-sectional data from the Bureau of Labor Statistics' Consumer Expenditure Diary Survey.


METHODS
A national, representative sample of US households from 2005 through 2012.


METHODS
A total of 19 395 low-income households.


METHODS
US poverty thresholds were used, in conjunction with household income, to create a sample of families at 130% of the federal poverty level and below. Expenditures on cigarettes and self-reported enrollment in SNAP were used to measure smoking behavior and program participation, respectively.


METHODS
Estimation of a maximum likelihood model was used to predict the probability of smoking given participation in SNAP.


RESULTS
The SNAP participation among low-income households was associated with a 30% ( P < .01) increase in the likelihood of a household containing at least 1 smoker, relative to low-income non-SNAP households. Among smokers, SNAP households do not spend more money on tobacco products than non-SNAP households.


CONCLUSIONS
Given the strong association found between SNAP participation and smoking, connecting program participants who smoke to effective smoking cessation programs could be an effective tool in reducing the prevalence of smoking among the low-income population. States have a unique opportunity to use SNAP-Education programs to integrate tobacco prevention and cessation into curriculum for direct client impact.
1 Department of Health Policy and Management, University of Georgia, Athens, GA, USA.
Grace Bagwell
GB
Adams
D000328:Adult; D000368:Aged; D000073865:Cigarette Smoking / Q000523:psychology*; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D063105:Food Assistance / Q000706:statistics & numerical data*; D015438:Health Behavior; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D014481:United States
low-income population; nutrition policy; tobacco