9.4 The relationship between tobacco smoking and financial stress

Tobacco use is both a contributor to and an outcome of financial stress.1

9.4.1 Spending on tobacco as a cause of financial stress

The Australian Bureau of Statistics (ABS) regular survey of household expenditure2 provides interesting data about the relationship between smoking and financial stress.

According to the ABS 2009–10 Household Expenditure Survey, households with lower-than-average income appear to spend (on average) slightly less on tobacco products per week than do higher-income households. However, average spending on tobacco products as a percentage of total weekly expenditure is higher among low-income households. In the lowest-income households expenditure on tobacco products as a proportion of total household weekly expenditure was over double that of the highest income households.3

Table 9.4.1
Average weekly expenditure on tobacco products among households in each income quintile, Australia, 2009–10, and as percentage of total household spending

Economic quintile

Average weekly amount spent
($*)

Spending as a % of
total household expenditure

Lowest†

8.03

1.4

Second

12.18

1.5

Third

15.22

1.3

Fourth

15.58

1.1

Highest

11.83

0.5

Source: Australian Bureau of Statistics 20113

* Current dollars: the price in the applicable year; no adjustment has been made for inflation

† Includes a high proportion of households comprising older single people on pensions, with a higher proportion of females than males

In households where the main source of income is government pensions and allowances, the reported weekly expenditure for those on disability or carer payments was $20.98; among those on study or unemployment benefits, $24.77; and $18.92 for households receiving family support payments. This represents 2.9%, 3.5% and 2.3% of total weekly household expenditure among these groups respectively.3

Expenditure on tobacco products in single parent households was on average $16.83 per week, and those in state/territory housing reported average expenditure of $17.67 per week.3

In coupled households, those with children under five years of age spent an average $7.80 per week on tobacco products and those with children aged 5–14 years spent an average $10.95. In comparison, couples (aged under 35 years) with no children spent an average $9.83 per week on tobacco in 2009–10.3

Research conducted on tobacco expenditure and its association with financial strain indicates that smokers are more likely to experience financial distress than non-smokers.1 Among smokers, factors like lower income, high nicotine addiction, a social circle of smokers and being of younger age are associated with a likelihood of experiencing an instance of 'smoking-induced deprivation'–whereby the smoker has reported spending money on tobacco rather than on household essentials.4 Being unable to afford enough food to maintain an active and healthy lifestyle (termed 'food insecurity') and its connection with low-income groups and high smoking prevalence has been shown in studies in the US population.5, 6

Borland and colleagues (2012) examined whether smokers who spend more money on cigarettes are more likely to experience financial burden. Collecting data on daily cigarette expenditure and using the outcomes 'smoking-induced deprivation' (SID)i and 'financial stress' (FS)ii, they found that those who spent more on cigarettes were more likely to experience SID. They did not find evidence of an association between daily cigarette expenditure and financial stress; however smoking-induced deprivation was predictive of financial stress.7

9.4.2 Financial stress and its influence on smoking abstinence

Research suggests that low-income smokers, or smokers experiencing financial stress, are less likely to quit and remain quit.8-10 Siahpush, Yong and colleagues (2009) used data from wave 4 of the International Tobacco Control Four-Country Survey to examine the association between financial stress and smokers' interest in quitting, their attempts to quit and remaining quit. Smokers experiencing financial stress were more likely than others to want to quit smoking, but at follow-up, they were less likely to have made an attempt to quit smoking. Among the smokers who had made a quit attempt, financial stress was associated with less chance of smoking abstinence at follow-up.11

In a study of adults in Denmark, smokers of low socio-economic status described differing motives for quitting and reasons for relapse than smokers of high socio-economic status.12

Partos, Borland and Siahpush (2012) used the Australian cohort of the International Tobacco Control Four-Country Survey to examine the contribution of area-level socio-economic disadvantage in predicting a quit attempt, and achieving one-month and six-month abstinence from smoking. Interestingly, they found that smokers living in low socio-economic areas were no less likely to make quit attempts than those in high socio-economic areas. Almost 40% made quit attempts and this was unrelated to area-level disadvantage.

The study found an independent association between area-level disadvantage and one month abstinence from smoking, but in a non-linear fashion. They also found evidence of an association with individual experience of smoking-induced deprivation and less probability of making quit attempts. The authors report that area-level disadvantage is not 'consistently related to making quit attempts nor to medium-term abstinence success'; so area-level disadvantage presents 'few barriers to smoking cessation'.13

9.4.3 Smoking cessation and the reduction of financial stress

Data from the HILDA study also reveal that if smokers do manage to quit, their odds of experiencing financial stress reduce substantially when compared with those of continuing smokers. Data from the first, second and third waves of the study indicated that, on average, a smoker who quits could be expected to have a 42% reduction in the odds of experiencing financial stress.14 Another study, which used data from four waves of HILDA, showed that the odds of experiencing financial stress were 25% smaller for quitters than continuing smokers, and there was strong evidence of enhanced material wellbeing.15

Recent news and research

For recent news items and research on this topic, click here (Last updated April 2016)      

 

i Smoking-induced deprivation (SID) defined as a time in the last six months when the money the respondent spent on cigarettes resulted in not having enough money for household essentials, such as food

ii Financial stress (FS) defined as in the last month unable to pay any important bills on time (e.g. electricity) because of a shortage of money

Recent news and research

For recent news items and research on this topic, click here (Last updated October 2016) 

 

References

1. Siahpush M, Borland R, and Scollo M. Smoking and financial stress. Tobacco Control. 2003;12(1):60–6. Available from: http://tobaccocontrol.bmj.com/cgi/content/full/12/1/60

2. Australian Bureau of Statistics. 6503.0 Household Expenditure Survey and Survey of Income and Housing: User Guide, 2009-10. Canberra: ABS, 2011. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/ProductsbyCatalogue/C571EA00F941140ECA2571880005BEE2?OpenDocument

3. Australian Bureau of Statistics. 6503.0 Household Expenditure Survey and Survey of Income and Housing: summary of results, 2009-10. Canberra: ABS, 2011. Available from: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6530.02009-10?OpenDocument

4. Siahpush M, Borland R, and Yong H. Socio-demographic and psychosocial correlates of smoking-induced deprivation and its effect on quitting: findings from the International Tobacco Control Policy Evaluation Survey. Tobacco Control. 2007;16:e2 Available from: http://www.tobaccocontrol.com/cgi/content/full/16/2/e2

5. Armour B, Pitts M, and Lee C-W. Cigarette smoking and food insecurity among low-income families in the United States, 2001. Working paper no 2007-19. Atlanta, Georgia: Federal Reserve Bank of Atlanta, 2008. Available from: http://healthpromotionjournal.com/publications/journal/ib2008-07.htm

6. Cutler-Triggs C, Fryer GE, Miyoshi TJ, and Weitzman M. Increased rates and severity of child and adult food insecurity in households with adult smokers. Archives of Pediatrics & Adolescent Medicine. 2008;162(11):1056–62. Available from: http://archpedi.ama-assn.org/cgi/content/full/162/11/1056

7. Siahpush M, Borland R, Yong HH, Cummings KM, and Fong GT. Tobacco expenditure, smoking-induced deprivation and financial stress: results from the International Tobacco Control (ITC) Four-Country Survey. Drug and Alcohol Review. 2012;[Epub ahead of print] . Available from: http://www.ncbi.nlm.nih.gov/pubmed/22404640

8. Hiscock R, Judge K, and Bauld L. Social inequalities in quitting smoking: what factors mediate the relationship between socioeconomic position and smoking cessation? Journal of Public Health. 2010;33(1):39-47. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21178184

9. Siahpush M, and Carlin JB. Financial stress, smoking cessation and relapse: results from a prospective study of an Australian national sample. Addiction. 2006;101(1):121–7. Available from: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1360-0443.2005.01292.x

10. Dobson R. Poor more likely to smoke and less likely to quit. British Medical Journal. 2004;328(7445):914. Available from: http://www.bmj.com/cgi/content/full/328/7445/914-e

11. Siahpush M, Yong H, Borland R, Reid J, and Hammond D. Smokers with financial stress are more likely to want to quit but less likely to try or succeed: findings from the International Tobacco Control (ITC) Four Country Survey. Addiction. 2009;104(8):1382–90. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2009.02599.x/full

12. Pisinger C, Aadahl M, Toft U, and Jorgensen T. Motives to quit smoking and reasons to relapse differ by socioeconomic status. Preventive Medicine. 2011;52(1):48-52. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21047525

13. Partos TR, Borland R, and Siahpush M. Socio-economic disadvantage at the area level poses few direct barriers to smoking cessation for Australian smokers: findings from the International Tobacco Control Australian Cohort Survey. Drug and Alcohol Review. 2012;[Epub ahead of print] . Available from: http://www.ncbi.nlm.nih.gov/pubmed/22385265

14. Siahpush M, Spittal M, and Singh G. Smoking cessation and financial stress. Journal of Public Health. 2007;29(4):338–42. Available from: http://jpubhealth.oxfordjournals.org/cgi/content/full/29/4/338

15. Siahpush M, Spittal M, and Singh GK. Association of smoking cessation with financial stress and material well-being: results from a prospective study of a population-based national survey. American Journal of Public Health. 2007;97(12):2281–7. Available from: http://www.ajph.org/cgi/content/abstract/97/12/2281

Recent references

Soderstrom, L., R. Perez-Vicente, S. Juarez, and J. Merlo, Questioning the causal link between maternal smoking during pregnancy and offspring use of psychotropic medication: a sibling design analysis. PLoS One, 2013. 8(5): p. e63420.Available from: http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0063420
http://www.ncbi.nlm.nih.gov/pubmed/23667614

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