People who smoke are more likely to experience financial stress than people who do not smoke,1-3 and research shows that tobacco use is both a contributor to, and an outcome of, financial stress.4
9.4.1 Spending on tobacco as a cause of financial stress
According to the ABS 2015–16 Household Expenditure Survey, households with lower-than-average disposable incomes tend to spend (on average) similar amounts on tobacco products as higher income households. Estimated spending on cigarettes showed a similar pattern, where the lowest and highest income quintile households spent similar amounts on cigarettes each week. However, low-income households spent more than twice as much on ‘other tobacco’—which would predominantly but not exclusively include roll-your-own tobacco—compared to the highest income households. Further, 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 more than three times that of the highest income households—See Table 9.4.1.5 In households where the main source of income was government pensions and allowances, the reported weekly expenditure on tobacco products was $11.58, representing 1.7% of total household expenditure. Looking at household wealth (also known as net worth; the value of assets, such as property and investments, minus liabilities such as loans and credit card debts), spending on tobacco products comprised 1.7% of household spending among low wealth households, compared with 0.3% among high wealth households.
However, it is important to note that the ABS figures above include both households with and without people who smoke. When isolating households with one or more people who smoke, the proportion of income spent on cigarettes among the lowest income group—and the gap between income groups—is substantially higher.
Australian research published in 20256 using data from the ABS 2015–16 Household Expenditure Survey examined the relationship between household tobacco expenditure and financial stress. Specifically, the study looked at: the prevalence of financial stress among Australian tobacco-purchasing households and the association between tobacco expenditure as a share of total expenditure and financial stress. The study also sought to estimate the prevalence of specific financial stress indicators among people who smoke. Findings showed that financial stress was more prevalent among households that purchased tobacco (45%), compared to households that did not purchase tobacco (25%), regardless of the amount spent. That is, all levels of tobacco expenditure were found to be significantly associated with higher financial stress. Moreover, all nine financial stress indicators (e.g. not able to raise $2000 for something important within a week, could not pay bills on time, or household spend more money than they get weekly) were found to be significantly more prevalent among households purchasing tobacco, compared to households not purchasing tobacco.6
Earlier Australian research similarly shows how spending on tobacco can contribute to financial stress. For example, an analysis in NSW found that in 1998–99, the poorest households with one or more people who smoke spent an average of over 18 per cent of their income on tobacco, while households with one or more people who smoke in the top income quintile spent only three per cent of their total income on tobacco.7 An Australian study in 2012 of socioeconomically disadvantaged people who smoke, more than half of whom lived below the poverty line (i.e., earned less than A$300/week), found that they spent an average of A$56.07 on tobacco each week.8 A survey of Aboriginal and Torres Strait Islander peoples who smoke in 2012–13 found that four in five (81%) reported spending too much money on cigarettes.9
International research shows similar disproportionate spending, as a percentage of household expenditure, on tobacco among disadvantaged groups and the exacerbation of poverty from the financial stress, and health effects, associated with smoking.10-12 A 2025 US study on tobacco spending among low-income older adults (65+ years) from 2021 to 2023, found that, among those who smoked, expenditure on tobacco and nicotine products (including cigarettes, e-cigarettes, cigars, chewing tobacco, and pipes) accounted for an average of 8% of their total budget.13 In the UK, a 2019 study found that among social housing tenants, one in seven lived in poverty due to the impact of smoking on their finances, with tobacco taking up about one eighth of their disposable income.14 A 2021 UK report concluded that while about one million, or one in five (21%), households with one or more people who smoke were living below the poverty line, when tobacco expenditure was included in the assessment of poverty this increased to nearly a third (32%), equivalent to 1.5 million households. That is, the inclusion of tobacco costs moves an extra half a million households into poverty.15 Smoking can also exacerbate financial deprivation for children; research in the UK found that nearly half of all children in relative poverty in 2012 had at least one parent that smoked, and about 432,000 additional children would be classed as being in poverty if parental tobacco expenditure were subtracted from household income.16
For information on smoking and intergeneration poverty see Section 9.5.
9.4.1.1 Tobacco expenditure and the crowding-out effect
The ‘crowding-out effect’ is a behavioural economic term wherein spending on the consumption of one good or service displaces spending on other important goods and services within one’s budget.17 Factors such as lower income, high nicotine addiction, a social circle of people who smoke, and being of younger age are associated with a likelihood of experiencing an instance of ‘smoking-induced deprivation’—whereby the person who smokes has reported spending money on tobacco rather than on household essentials.18
Australian research published in 2026,19 using waves 13, 15 and 17 (2013-2017) of the Household Income and Labour Dynamics in Australia (HILDA) survey, found significant differences in spending habits between those who did and did not smoke, and these relationships also varied depending on the person’s level of psychological distress. At low and moderate levels of psychological distress, those who smoke spent significantly more on alcohol and rent, and significantly less on health practitioners, meals out, medicines and insurance, than those who have quit smoking. At low levels of psychological distress, those who smoke spent less on clothing, groceries and fuel, than those who have quit smoking. At high and very high levels of psychological distress, spending habits were similar regardless of smoking status except for spending on education, which those who smoked spent less on at all levels of psychological distress. Overall, for people experiencing psychological distress, spending habits were generally more beneficial among those who had quit smoking.19
In low- and middle-income countries, research has shown that daily tobacco use is associated with lower household expenditure in significant categories such as education and healthcare.20 While common across all income levels that smoke the effects were more pronounced in low- income households. The crowding out of these goods and services (education and healthcare) particularly affects opportunities for children and young people,21 potentially entrenching intergenerational poverty. Research from Colombia, however, showed no evidence of the crowding-out of education or healthcare due to tobacco expenditure, as basic education and access to universal health insurance, the researchers note, is provide for by social welfare.22
In addition to spending on tobacco crowding out essential expenditures in people’s budget, research has found that people who use tobacco spend a significantly greater portion of their budget on alcohol, compared to people that do not use tobacco.13,17,21 Researchers have referred to this as the ‘crowding-in’ of other addictive behaviours. Australian research has found that cessation of smoking is also associated with reduced expenditure on alcohol.23 Therefore, quitting smoking could see a joint health and financial improvement for those who smoke and are experiencing financial stress.
9.4.1.1.1 Food insecurity
Food insecurity is defined as being unable to afford or access adequate food24 and is experienced more commonly among people who smoke.25-32 Among financial stress indicators, food insecurity represents a more severe level of financial stress compared to other indicators.6
Australian research found that, among people who are highly disadvantaged, people who smoke are more likely than people who do not smoke to report going without meals.2 Another Australian study, using data from the ABS 2015–16 Household Expenditure Survey, found that 6% of households with tobacco expenditure reported going without meals, compared to 2% of households with no tobacco expenditure.6
In one study researchers found that past-year food insecurity was significantly associated with daily but not non-daily smoking, independent of sociodemographic characteristics and alcohol use.33 Another study found that higher nicotine dependence predicted financial stress related to affording food, housing, and living within one's income.34
This relationship between tobacco use and food insecurity has been shown to be bidirectional, such that people who are food insecure are more likely to take up smoking and vice versa.29,35,36 However, a 2026 study among mothers in the US37 found that this relationship may be partly explained by poverty and mental health (i.e. those with poorer mental health and those experiencing poverty were more likely to smoke and experience food insecurity), highlighting the importance of policies that address broader contextual factors.37
Researchers in this area have noted that both smoking and food insecurity are inextricably linked to socioeconomic and structural disadvantage.38 Qualitative research highlights how the experience of food insecurity among people who smoke is shaped by intersecting structural factors including housing insecurity (resulting in challenges accessing food storage and cooking facilities), lack of reliable or affordable transportation (making accessing and transporting food supplies difficult), relying on government benefits, and the challenges of navigating food assistance programs and other bureaucracy relevant to poverty while attempting to make ends meet.38,39
Qualitative research has also examined how people who both smoke and who are experiencing food insecurity rationalise spending money on tobacco that could instead go towards food for their household. A 2025 qualitative study24 on tobacco dependence among food-insecure adults in North East England noted that the participants framed their relationship with tobacco in individual terms, while their struggle to afford food was framed as a household and community issue. Other qualitative research24,38 has also helped explain the ways in which people perceive tobacco as helpful for managing their food insecurity, including: suppressing their appetite; allowing them to ignore hunger, skip meals or eat less; reducing stress and anxiety; and increasing calmness. Another theme in multiple qualitative studies24,38,39 was participants citing smoking as a way to avoid potential weight gain, which some believed could exacerbate health problems more so than smoking (see Section 7.1.11).
Tobacco expenditure minimising strategies:
Australian research notes that while economic insecurity is associated with a higher likelihood of smoking, it is also associated with decreased total expenditure on tobacco, perhaps due to price-minimising strategies among people who smoke.40
In qualitative research on the experience of food insecurity and tobacco dependence in the UK, participants mentioned a number of strategies they used to extend their supply of tobacco while under financial stress, including: limiting the amount or number of tobacco products smoked per day; smoking half of a cigarette and saving the other half for later; borrowing from friends or family; and purchasing illegal tobacco.24 In a similar qualitative study but in the US, participants adopted cost saving strategies including: switching to cheaper brands; switching from factory made to roll-your-own tobacco; buying cigarettes by the carton; and driving to neighbouring US states where tobacco taxes were lower.38
These price minimising strategies are similar to those reported in Australian research examining product use and purchasing behaviours in Australia following tax increases on tobacco products, see Section 13.8.5.1. Although tobacco taxes have been criticised as disproportionately affecting disadvantaged people who smoke, tobacco taxes are the single most effective strategy to reduce tobacco use and therefore reduce the financial burden of smoking—see Section 13.11.
Tobacco use and employment:
Employment status may also be an important factor in the relationship between smoking and financial stress, with smoking being a significant risk factor for unemployment,41 and unemployment being a significant risk factor for smoking.
Australian research published in 2021 found that the odds of smoking were 32% higher when a person’s household was unemployed compared to times when the household was securely employed.40 (see also Section 9.1).
A 2016 study from California found that people who smoked struggled to gain employment compared to people who did not smoke, and that those who smoked were paid less than those who did not smoke. Even after controlling for factors such as sex, stable housing, reliable transportation, criminal history, and prior treatment for alcohol or drug use, people who did not smoke were 24% more likely to be re-employed at one year relative to people who smoked.42 Similarly, a Danish study in 2022 found smoking to be associated with a lower chance of gaining employment, a higher risk of sickness absence from work, and a higher risk of becoming unemployed, compared to those who do not smoke. Current heavy smoking was also associated with a lower chance of returning to work after being unemployed.41
Moreover, research shows that being both a person who smokes and a person who drinks heavily in early adulthood is negatively related to long-term earnings and employment later in life.43 A 2021 study estimated that continued heavy smoking in young adulthood results in a wage penalty at age 30 of 15.9% for women and 15.2% for men.44
A 2020 systematic review and meta-analysis found that smoking was associated with a 31% higher risk of having to take sick leave from work, compared to employees who did not smoke. Employees who smoked took around three more sick leave days per year than employees who did not smoke.45
9.4.2 Financial stress and its influence on smoking abstinence
Some research suggests that low-income people who smoke, or those who smoke and are experiencing financial stress, are less likely to quit and remain quit.46-49 More severe withdrawal symptoms50 and higher levels of psychological distress51,52 among those with financial stress may promote smoking and negatively impact quitting.
Data from wave 4 of the International Tobacco Control (ITC) Four-Country Survey showed that those who smoked and were 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 those who had made a quit attempt, financial stress was associated with less chance of smoking abstinence at follow-up,53 a finding backed by other research showing financial stress can increase rates of relapse among those who have quit smoking.54 Longitudinal research from the US in 2024 found that after adjusting for nicotine dependence and measures of socioeconomic position, financial strain was associated with increased relapse risk, perhaps due to stress and coping processes, with the highest risk of relapse being in the period immediately following cessation.55
Looking only at the Australian cohort from the ITC survey, a 2012 study found that experiencing smoking-induced deprivation was associated with a lower likelihood of making quit attempts.56 However, a study in the US found that people who smoked and experienced financial strain made more quit attempts over one year, but they were no more successful in maintaining cessation, than those without financial strain.57 Research among older adults in the US found that becoming food insecure or becoming unemployed was associated with higher odds of smoking cessation.58
9.4.3 Smoking cessation and the reduction of financial stress
Research using data from the Household Income and Labour Dynamics in Australia (HILDA) survey, an Australian household-based longitudinal study which began in 2001, show that if people who smoke do manage to quit, their odds of experiencing financial stress reduce substantially when compared to those who continue to smoke. Data from the first, second and third waves (2001-2004) of the study indicated that, on average, a person who smokes who quits could be expected to have a 42% reduction in the odds of experiencing financial stress.59 Data from waves one to four (2001-2005) of HILDA, showed that the odds of experiencing financial stress were 25% smaller for those who quit smoking than those who continued to smoke, and there was strong evidence of enhanced material wellbeing.60 Research published in 202223 using seven waves (2012-2018) of HILDA survey data, showed that smoking cessation leads to reallocation of spending across all socioeconomic groups. Within the lowest socioeconomic groups (SEIFA quintile 1 and 2), those who had quit smoking were able to allocate more money to meals out, education, motor fuel, insurance, groceries, medicine and health practitioners than those who continued to smoke.
Longitudinal research in the US similarly found that among people who smoked and were experiencing financial strain, those who quit were less likely to still be experiencing financial strain at follow-up.57 In a 2023 US population-based study, findings suggested that quitting smoking was associated with improvement in food security—one of the more severe indicators of financial stress.61
For more on cessation intervention for low socioeconomic groups see Section 9.6. See also InDepth 9A for a discussion of cessation interventions for highly disadvantaged and other priority groups in Australia, and Section 7.17.3 Efficacy among priority populations for information about the efficacy of financial incentives for quitting smoking among disadvantaged groups including socio-economically disadvantaged and low-income groups.
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References
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