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January 2024

The Intersection Between Food Insecurity, Tobacco Use, and Upstream Factors:

Where Can We Go From Here?

A New Psychiatry Issue Brief

Food insecurity and tobacco use are major public health issues in the U.S. with serious implications for population health and well-being. Food insecurity – or insufficient access to the amount of affordable, nutritious foods needed to live an active and healthy lifestyle – affects approximately 42.4 million people in the U.S. and can lead to poor health outcomes such as heart disease and diabetes. Despite a decline in rates in recent decades, tobacco use, especially cigarette smoking, remains a leading cause of death and preventable diseases in the U.S. Though they may seem unrelated, research suggests that these phenomena are intertwined and may be addressed more equitably and effectively if targeted together rather than separately.


This report discusses the relationship between food insecurity and tobacco use including who they impact, how they impact health, and how upstream factors like transportation and housing can exacerbate their consequences.


It then provides considerations for addressing these health concerns including:


  • Bringing culturally relevant food and nutrition programs to people where they live in the community
  • Removing transportation barriers to address structural inequities
  • Addressing low socioeconomic position (SEP) to reduce food insecurity Focusing on cultural sensitivity and the needs of diverse populations
  • Providing access to tobacco cessation and healthcare


We use Worcester, Massachusetts as a case example to demonstrate what is possible and suggest strategies that policymakers and other stakeholders can implement to address upstream factors associated with food insecurity and tobacco use.

Read / Download the Brief

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Who We Are

As a MA Department of Mental Health Research Center of Excellence, we are here to help the MA DMH workforce with any Technical Assistance (TA) needs they may have by providing information based on research. iSPARC can provide expertise and information on a wide range of mental health-related topics. We provide Basic TA (e.g., tip sheets, brief phone consultation, etc.) at no cost and can provide more intensive TA (e.g., policy development, training, etc.) which requires approval of your area director or deputy commissioner, or for a fee.

The Implementation Science and Practice Advances Research Center is a part of the Department of Psychiatry at UMass Chan Medical School (formerly the University of Massachusetts Medical School). 


iSPARC is a Massachusetts Department of Mental Health (DMH) Center of Excellence (COE) for Public Mental Health Services and Implementation Research that aims to improve the mental and behavioral health of all citizens of Massachusetts and beyond. iSPARC is committed to transferring knowledge and insights gained through rigorous research to improve the lives of people with lived mental health experience.


We conduct Participatory Action Research, an all-inclusive approach that ensures that every aspect of our research incorporates the voices of those with lived mental health experience.

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