Examining the Bidirectional Relationship Between Food Insecurity and Cigarette Smoking: Evidence from a Cross-Lagged Panel Analysis

PurposeTo explore the bidirectional relationship between food insecurity and cigarette smoking.DesignSecondary data analysis.SettingLarge U.S. cities.SampleMothers from the Future of Families and Child Wellbeing Study (FFCWS) Waves 3 and 4 (N = 2394) cohort.MeasuresFood insecurity (USDA 18-item Household Food Security Survey Module) and smoking (past-month cigarette use).AnalysisUnadjusted and adjusted cross-lagged panel analyses were conducted to examine bidirectional relationships between baseline (Wave 3) food insecurity and follow-up (Wave 4) smoking, and baseline smoking and follow-up food insecurity. Post-hoc exploratory models tested each covariate separately.ResultsThe unadjusted model showed significant bidirectional relationships between smoking and food insecurity (food insecurity to smoking: β = 0.045, p = .021; smoking to food insecurity: β = 0.073, p = .010). In the adjusted model, these relationships became non-significant. Exploratory models yielded mixed findings. When controlling for race alone, relationships remained significant (p = .012 and p = .008) but were non-significant when controlling for poverty or mental health.ConclusionFindings suggest complex interrelationships between food insecurity, smoking, poverty, and mental health. Bidirectional relationships between food insecurity and smoking may be explained by poverty and mental health, warranting consideration of contextual factors. Policies and interventions addressing food insecurity and smoking should integrate strategies that also address poverty and mental health.