Correlates of smoking during COVID-19 in the LGBTQI + cancer survivor population.

PURPOSE: Stressors brought on by the pandemic may have further encouraged lesbian, gay, bisexual, transgender, queer, and intersex plus (LGBTQI +) cancer survivors to smoke. The purpose of this study is to examine factors associated with smoking among LGBTQI + cancer survivors during the pandemic. METHODS: We used a secondary data analysis of OUT: The National Cancer Survey. We conducted logistic regression analysis to examine the associations between psychological distress, binge drinking, and socio-demographic factors with ever use and current use of cigarettes, other tobacco, and nicotine products. RESULTS: Of the 1629 participants in our sample, 53% used in their lifetime and 13% reported current use. Correlates of increased ever use included being of older age (AOR = 1.02; 95% CI: 1.01, 1.03) and binge drinking (AOR = 2.47; 95% CI: 1.17, 5.20) while correlates of decreased ever use were among those with a graduate or professional degree (AOR = 0.40; 95% CI: 0.23, 0.71). Correlates of increased current use included being of Latine descent (AOR = 1.89; 95% CI: 1.07, 3.36), binge drinking (AOR = 3.18; 95% CI: 1.56, 6.48), without health insurance (AOR = 2.37; 95% CI: 1.10, 5.10), and being disabled (AOR = 1.64; 95% CI: 1.19, 2.26) while correlates of decreased current use were among cisgender women (AOR = 0.30; 95% CI: 0.12, 0.77), being of younger age (AOR = 0.98; 95% CI: 0.96, 0.99), and having a graduate or professional degree (AOR = 0.33; 95% CI: 0.15, 0.70). CONCLUSIONS: Our findings demonstrate that a proportion of LGBTQI + cancer survivors continue to smoke during the pandemic despite the increased risk involved with smoking. Furthermore, individuals with intersecting marginalized identities experience additional stressors that may have been further exacerbated by the conditions of the pandemic that encourage them to smoke. IMPLICATIONS FOR CANCER SURVIVORS: Quitting smoking after a cancer diagnosis can decrease the chances of recurrence and a new primary malignancy. In addition, practitioners and researchers should advocate towards examining and addressing systemic forms of oppression in institutions that LGBTQI + cancer survivors navigate during the pandemic.

The Case for a National SNAP Fruit and Vegetable Incentive Program

Supplemental Nutrition Assistance Program (SNAP) enrollment has increased dramatically during the COVID19 economic crisis. Currently, one in three households with children experiences food insecurity, the greatest prevalence in modern times.1 SNAP effectively reduces poverty and improves food insecurity,2 and the current recession has increased many US households' reliance on federal nutrition programs. These new developments have intensified ongoing public debate about the most effective program designs for promoting food security and dietary quality.SNAP fruit and vegetable (FV) incentives aim to improve diet quality for participants by providing matching funds for FVs purchased with electronic benefit transfer (EBT). SNAP incentives encourage healthy eating behaviors by subsidizing FV purchase and consumption. FV incentives have been piloted nationwide, providing important evidence than can inform optimal program design. However, incentives are not uniformly available to all SNAP participants, and there are currently insufficient federal resources appropriated to expand incentives nationwide. We review the scientific evidence base for FV incentives and their correlation with healthy eating behaviors, highlight potential challenges for scaling FV incentive programs, and explain the public health opportunity associated with nationwide expansion of evidencebased FV incentives.