Evidence Hub

A look into the lives of adults in the North East of England who struggle with both not having enough food and being addicted to tobacco. 

Quick-read summary

This research explores what life is like for adults in North East England who face food insecurity (not always having enough food or reliable access to food) and who are also dependent on tobacco.

The researchers wanted to understand how these two challenges interact; how the struggle to get enough food shapes people’s experiences with smoking, quitting, and daily stress, and how smoking in turn affects their financial and health decisions.

They interviewed 19 adults recruited through two food aid organisations in the region. Topics discussed included their history of tobacco use, past attempts to quit, current challenges and stresses, how they manage limited budgets, how they view their health, and how their food situation influences their smoking behaviour.

Key findings:

• Many participants had tried to quit smoking in the past but had relapsed due to life stressors (for example financial worries, illness, or caring responsibilities)
• Food insecurity forced people to make trade-offs in their budgets. Some said they would skip meals, shop in cheaper stores, or rely on food banks, but often still allocate a portion of their limited money to buy tobacco (most times cheaper, illegal tobacco) because smoking was seen as a stress reliever or coping mechanism.
• Despite knowing the harms of smoking, participants described tension between their desire to quit and the immediate pressures and anxieties of daily life. For some, smoking served as a ‘treat’ and quitting felt impossible when life felt overwhelming.

Overall, the study highlights that for people juggling food scarcity and tobacco dependence, quitting smoking is rarely just a matter of willpower. It’s deeply embedded in the financial, emotional, and social challenges they face.

The research suggests that efforts to help people quit should take into account their food insecurity, stress, and other life realities – and not treating tobacco dependence in isolation.

Who is this evidence useful for?

This research is useful for anyone working to support people facing poverty, food insecurity, or tobacco dependence.

That includes healthcare professionals, stop-smoking services, food banks, social workers, local councils, and charities.

By understanding how food insecurity and tobacco dependence are linked, these groups can offer more joined-up support that meets people’s needs. It can also help policymakers design services and policies that tackle both issues together, instead of treating them separately.

Detailed summary

What is the issue?

This research looks at the complex challenges faced by people who don’t always have enough food and also with tobacco dependence. These issues affect both physical and mental health, including higher risks of illness, stress and poor nutrition.

Research summary

• The research focused on adults in North East England who were both food insecure and tobacco dependent
• 19 participants were interviewed in depth to hear about their personal experiences, challenges and perspectives
• Participants were recruited through food aid organisations, helping to reach people were are often underrepresented in research
• Interviews covered topics like smoking habits, quitting attempts, food access, financial pressures, and coping strategies
• A qualitative approach was used, meaning the focus was on hearing people’s stories in their own words rather than collecting numbers or statistics
• The study explored how food insecurity and smoking are linked in people’s day-to-day lives, something that hasn’t been widely studied before
• What’s unique about this research is that it looks at smoking and food insecurity together, rather than treating them as separate issues. It also gives a voice to people who are often left out of health research, helping to show how poverty shapes health choices.

What did the research find?

• Smoking was used as a key coping tool for dealing with stress, hunger, mental health issues, and difficult life circumstances. Many participants felt smoking helped them get through the day, even if they knew it was harmful
• Food insecurity and poverty made quitting smoking feel impossible. People often had to choose between essentials like food, heating or tobacco, and smoking was seen as a necessary comfort or stress reliever
• Participants often prioritised spending on tobacco over food, especially when under extreme stress. Some reported skipping meals or using food banks, while still buying tobacco
• Many had tried to quit smoking multiple times, but life pressures often led to relapse

Why is this important?

• These findings matter because they show that smoking and food insecurity are deeply connected in people’s everyday lives.
• For people living in poverty, smoking isn’t just a habit, it’s often a way of coping with stress, hunger, and mental health challenges.
• Traditional stop smoking services may not work well for people in these situations, because they don’t always understand the wider struggles people face.
• The study also shows how limited finances, lack of support and daily pressures make it harder for people to quit smoking or eat well.
• It highlights the need for health and social care services to work together and understand the wider circumstances that affect people’s choices.

How were people involved in this work?

This study involved four public partners who had lived experience of either food insecurity or tobacco dependence. Three public partners remained engaged throughout the study, helping to shape the study, the study materials, helped analyse the data, and are co-authors on the academic paper and help co-develop the infographic (shown above).

Recommendations for policy and practice

This research can help shape more effective policies and services by ensuring that stop smoking services need to be tailored to people facing poverty, food insecurity and stress.

What happens next?

This work has led to additional quantitative research exploring the link between food insecurity, tobacco dependence and alcohol use.

Read the full research paper

Published in BMJ Public Health, October 2025: Exploring the perspectives and experiences of food-insecure adults who are also tobacco dependent: a qualitative study in North East England | BMJ Public Health

Read a blog about this work: What is it like to be tobacco dependent whilst experiencing food insecurity? – ARC

Contact for further information

Lead Researcher Dr Kerry Brennan-Tovey, ARC NENC

[email protected]

Acknowledgements

This work was funded by the National Institute for Health and Care Research (NIHR) Applied Research Collaborations (ARCs) Early Career Researcher Funding call.

It was supported by ARC East of England and ARC Wessex