Children and adult members of smoking households are more likely to be underfed, according to a new study published in the November 3 issue of the journal Archives of Pediatrics & Adolescent Medicine.

Researchers at the New York University School of Medicine and Bellevue Hospital Center analyzed data on 8,817 households with children age 17 and younger for a period of 3 years. They found 15 percent of adults and 11 percent of children reported food insecurity within the past year. More than that, 6 percent of adults and 1 percent of children experienced severe food insecurity.

The researchers defined the concept of “food insecurity” as “the inability to access enough food in a socially acceptable way for every day of the year.” They used the US Department of Agriculture Food Security Survey Module to evaluate food insecurity. This scale measures how many times a household cannot give children the food they want, how many meals they skip, how often they go to bed hungry.

Dr. Michael Weitzman, chairman of pediatrics at New York University School of Medicine and colleagues monitored these households to see if the presence of adult smokers affected food security of children and adult family members living in the same home.

The study found that 23 percent of households with children had at least one smoker. The percentage was higher in low-income households (32 percent).

“Food insecurity was more common and severe in children and adults in households with smokers,” the researchers wrote. To be more precise, 17 percent of children living in households with smokers were food insecure, compared to only 8.7 percent in households without smokers. The rate of severe child food insecurity was 3.2 percent in households with smokers and 0.9 percent in those without smokers. Black and Hispanic families had higher rates of child food insecurity compared to white families.

25.7 percent of adults living in households with smokers were food insecure, compared to 11.6 percent in households without smokers. Rates of severe food insecurity were 11.8 percent vs. 3.9 percent, respectively, according to the study. Families with at least one smoker spend an estimated 2 percent to 20 percent of their income on tobacco and this habit drains the money needed to provide healthy food. They tend to buy less healthy food because it is cheaper.

Previous studies have shown that in families where at least one parent smokes, children have a level of cotinine (a toxic metabolite of nicotine) five times higher than normal. Exposure to second-hand smoke may lead to several nicotine withdrawal symptoms, including trouble sleeping, anxiety, depression and trouble concentrating.

“The burden of food insecurity is a previously unrecognized danger of adult tobacco use to be added to the ever-growing list of negative effects of adult tobacco use on children in the United States,” the study’s authors conclude.