Short Communication Associations of diet behaviours and intention to eat healthily with tobacco use among motor freight workers L.M. Quintiliani a, * , A.M. Stoddard b , C.B. Ebbeling c , L.K. Pereira a , G. Sorensen a a Department of Society, Human Development and Health, The Harvard School of Public Health, Center for Community-Based Research Dana-Farber Cancer Institute, 44 Binney St, LW 703, Boston, MA 02115, USA b Center for Statistical Analysis and Research, New England Research Institutes, Watertown, MA, USA c Department of Pediatrics, Division of Endocrinology, Children’s Hospital Boston and Harvard Medical School, Boston, MA, USA article info Article history: Received 2 January 2009 Received in revised form 5 June 2009 Accepted 29 June 2009 Available online 31 July 2009 Tobacco use and unhealthy dietary patterns are both indepen- dent chronic-disease-related risk factors. Despite these indepen- dent roles, addressing tobacco and diet together may provide several benefits. First, it may be possible to maximize risk reduction if multiple behaviours are improved simultaneously. In addition, changing related behaviours may be mutually reinforcing; for example, avoiding settings where alcohol is served may reduce smoking that is usually done in conjunction with drinking. The benefits of multiple behaviour change are therefore reflected in guidance from several international health agencies, such as the National Institute for Health and Clinical Excellence. While the bulk of research indicates that tobacco users have less healthy diets compared with non-users, 1 less is known about these relationships in blue-collar working populations, particularly motor freight workers whose occupations include extended driving hours, night driving and periods of time away from home. 2 These aspects of the job pose multiple obstacles to healthy eating, such as restricted food options on the road and at the terminal. The study sample of motor freight workers represented three main job categories: over- the-road truck drivers who transport goods between cities; pick-up and delivery truck drivers who deliver packages within a defined area; and dockworkers who load and unload cargo from vessels. Gaining a better understanding of the dietary behaviours of tobacco users and non-users could help to inform the design of more effective multiple health behaviour change interventions targeting dietary patterns and tobacco cessation in this population. In this study, it was hypothesized that healthy dietary behaviours and intention to eat more healthily would be lower for tobacco users compared with non-users. This paper presents an analysis of data from a self-administered baseline survey conducted in 2005–2006 that was part of an intervention study that targeted tobacco use and weight manage- ment. Participants were unionized motor freight workers. Recruitment took place in eight trucking terminals selected at random from 17 eligible terminals employing 75–150 workers in four states in the Eastern region of the USA. Eligible workers were permanent employees who worked 15 hours/week and who were not out on workers’ compensation for more than 2 weeks. Of 697 eligible workers, 542 completed the baseline survey (response rate 78%). Informed consent for survey participation was acquired prior to the survey, when workers were informed that participation was voluntary and confidential. All study procedures were approved by the Cancer Center’s Institutional Review Board. Current tobacco use in the last 7 days was measured by self-report using standard measures. 3 Participants completed a validated seven- item screener to measure daily servings of fruits and vegetables, 4 excluding fried potatoes, as well as three single-question items that measured frequency of daily intake of sugary drinks, sugary snacks and fast food meals. For each behaviour, 10 frequency response options were converted to times per day. Intention to eat more healthily was measured with two questions indicating if participants were seriously thinking about trying to eat healthily every day either within the next 30 days or 6 months. 5 Responses to these questions formed three categories: preparation (thinking about eating healthily within the next 30 days), contemplation (thinking about eating healthily within the next 6 months), and pre-contemplation (no indication of intent within the next 30 days or 6 months). Bulleted examples of healthy eating preceded these questions. Data analysis was conducted on the 531 (98%) participants for whom tobacco use status was known. Tobacco users and non-users were compared with regard to dietary behaviours using the Wil- coxin rank sum test for continuous/non-normally distributed vari- ables, t-test for continuous/normally distributed variables, and the Chi-squared test for categorical variables. All analyses were carried out using SAS statistical software (SAS Institute, Inc., Cary, NC, USA). All respondents were male. Overall, 40.7% used some form of tobacco and 25.6% used cigarettes but no other form of tobacco. * Corresponding author. Tel.:þ1 617 582 7462; fax:þ1 617 632 4858. E-mail address: lisa_quintiliani@dfci.harvard.edu (L.M. Quintiliani). Contents lists available at ScienceDirect Public Health journal homepage: www.elsevierhealth.com/journals/pubh 0033-3506/$ – see front matter Ó 2009 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.puhe.2009.06.017 Public Health 123 (2009) 565–567