Year of Publication



Public Health

Date Available


Degree Name

Master of Public Health (M.P.H.)

Committee Chair

Katherine Eddens, MPH, PhD

Committee Member

Linda Alexander, Ed.D.

Committee Member

Robin Vanderpool, DrPH, CHES



We evaluated the influence of financial strain and perceived stress on smoking status among United Way Missouri 2-1-1 callers of predominantly low socioeconomic status.


Data for this study were collected as part of a randomized, controlled intervention trial integrating cancer control referrals into regular United Way 2-1-1 Missouri services. Those who consented, completed the assessment and had at least one cancer control need were invited to participate in a longitudinal study that included completing the baseline assessment used in this study. We conducted chi-square analyses to assess the bivariate relationships between each financial strain variable and smoking status, perceived stress and smoking status, and the financial strain variables and perceived stress.


Smoking and high perceived stress were significantly associated in bivariate analyses. Participants with high-perceived stress (a perceived stress score greater than or equal to 10) have 65% (OR=1.65, 95% CI 1.37, 2.00; Table 1) higher odds of smoking than those who scored less than 10 on perceived stress. Although there was not a significant relationship between smoking and either financial strain variable, these financial strain variables are significantly associated with high stress.


Participants with financial stress were likely to report high-perceived stress, yet the financial strain variables alone had minimal direct impact on the odds of a respondent being a current smoker. The odds of smoking were consistently higher for study respondents identified as having an education level of less than the completion of high school, male gender, experience high-perceived stress (PSS score >=10), and reported self-rated poor health. Our findings highlight the impact of high stress and financial strain on smoking status and the need to address these variables of interest in smoking cessation interventions.

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