Food insecurity and tobacco use are major public health issues in the U.S. with serious implications for population health and wellbeing. Food insecurity – or insufficient access to the amount of affordable, nutritious foods needed to live an active and healthy lifestyle – affects approximately 42.4 million people in the U.S. and can lead to poor health outcomes such as heart disease and diabetes. Despite a decline in rates in recent decades, tobacco use, especially cigarette smoking, remains a leading cause of death and preventable diseases in the U.S. Though they may seem unrelated, research suggests that these phenomena are intertwined 3, 4 and may be addressed more equitably and effectively if targeted together rather than separately. This report discusses the relationship between food insecurity and tobacco use including who they impact, how they impact health, and how upstream factors like transportation and housing can exacerbate their consequences. It then provides considerations for addressing these health concerns including: Bringing culturally relevant food and nutrition programs to people where they live in the community, Removing transportation barriers to address structural inequities, Addressing low socioeconomic position (SEP) to reduce food insecurity, Focusing on cultural sensitivity and the needs of diverse populations, and Providing access to tobacco cessation and healthcare. We use Worcester, Massachusetts as a case example to demonstrate what is possible and suggest strategies that policymakers and other stakeholders can implement to address upstream factors associated with food insecurity and tobacco use.