Cigarettes or adequate food is a tough choice for some poor families, according to a new study from the Centers for Disease Control and Prevention (CDC).

The researchers found that of low-income families, those containing a household head or spouse who smoked cigarettes were at about 6 percent higher risk for being "food insecure" not always able to put enough food on the table.

Such families purchase, on average, 10 packs of cigarettes per week, spending around $33.70 enough to add two pounds of ground beef, two pounds of chicken breasts, 64 ounces of fresh orange juice and 10 pounds of frozen vegetables to the weekly menu, at current supermarket prices.

The study appears in the July/August issue of the American Journal of Health Promotion.

Brian Armour, Ph.D., led the researchers, who analyzed data from the 2001 Panel Study of Income Dynamics, a long-term study of U.S. men, women, and children and families. They looked at the connection between smoking and the lack of consistent and dependable access to nutritious food, while controlling for other socioeconomic factors and behavioral health choices.

The choice between smoking and having more food might seem like a no-brainer, but this is not the case, said Terry Pechacek, associate director of science for the CDC's Office on Smoking and Health. "Smoking is an addiction that gets established in adolescence, before individuals fully understand the long-term implications of their behavior," he said. "Poor families suffer the long-term health impact."

The results did not surprise Sonia Duffy, a research investigator for the VA Ann Arbor Healthcare System and University of Michigan Schools of Nursing and Medicine. "Our research has shown that poor health behaviors do cluster together," said Duffy, who was unaffiliated with the new study. However, she said that the study does not consider whether people in the study also suffered from depression, which is common in lower socioeconomic populations and could correlate with smoking.

"Providing access to cessation services will help people quit," Armour said. "The most important things are the health benefits associated with quitting, and a byproduct might be to free up funds to end food insecurity."

Armour BS, Pitts M, Lee C-W. Cigarette smoking and food insecurity among low-income families in the United States, 2001. Am J Health Promo 22(6), 2008.

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