Clustering of Lifestyle Behaviors: The Relationship between Cigarette Smoking, Alcohol Consumption, and Dietary Intake

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Abstract
Purpose.: To examine relationships between cigarette smoking, alcohol use, and dietary intake. Design.: Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals, a nationwide probability sample conducted from January 1994 through January 1997 (n = 23,602; response rate = 80%), were selected. Adults ages 19 years and older were grouped according to their smoking and drinking habits. Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared. Setting.: In-home interviews were conducted in the 50 states and the District of Columbia. Subjects.: The selected sample (n = 6745) included 3229 nonsmokers, 1701 former smokers, and 1808 current smokers, and 2284 abstainers, 2713 occasional drinkers, 1000 moderate drinkers, and 748 liberal drinkers. Measures.: Responses to standard questionnaires were examined by Student's t-test, χ2, one-way analysis of variance, and univariate and multivariate analyses of covariance. Results.: Men were more likely than women to be current smokers and liberal drinkers (64% vs. 40% and 62%) vs. 38%). For both, the use of cigarettes and alcohol was closely related. An additive relationship was observed between smoking/drinking classification and lower food group servings and nutrient intakes. Although cigarette and alcohol use may have been underreported, these findings support previous ones showing poor food choices along with lower nutrient intakes as smoking and drinking increase. Conclusions.: Smoking and drinking habits may alter individuals' food selections and nutrient intakes. Future interventions for health promotion may achieve greater success by targeting multiple risk factors simultaneously or sequentially.