Financial insecurity may increase the desire to quit smoking but decrease the chances of succeeding.

A study published in the journal Addiction examined the financial difficulties associated with cigarette spending in Canada, the United States, England, and Australia between 2016 and 2024.[1]. The study shows that people who report lacking money for basic necessities due to tobacco purchases (the principle of "smoking-induced deprivation") are more likely to try to quit smoking, but less likely to succeed. These difficulties particularly affect young adults, low-income individuals, and the most dependent smokers. The study calls for maintaining tax increases while strengthening support for those most vulnerable to quitting.

A study conducted in four countries between 2016 and 2024

The research team used data from five waves of the International Tobacco and Vaping Survey (ITC), conducted in 2016, 2018, 2020, 2022, and 2024. The analysis focused on 26,888 adults who smoked at least once a month and had participated in at least one of these surveys. The data were weighted to better reflect the characteristics of the smoking population in each country. The researchers studied a form of deprivation directly attributed to cigarette spending. Participants were asked to indicate whether, in the past six months, money spent on tobacco had prevented them from having sufficient resources for essential household needs, such as food. This indicator therefore does not measure all financial hardship; it is based on the link that respondents make between their cigarette purchases and a lack of money for essential expenses.

A longitudinal analysis also examined quit attempts among 8,484 participants followed between two consecutive waves. Of these, 3,848 had tried to quit smoking and were included in the analysis of quit success. Success was defined as reporting having completely stopped smoking at the time of the next survey, without specifying a minimum abstinence period.

Financial difficulties were more frequent in 2024 than in 2016.

Across all four countries, the weighted proportion of smokers reporting a lack of money for basic needs due to cigarette spending increased from 9.5 % in 2016 to 14.6 % in 2022, before falling back to 13.6 % in 2024. Despite this recent decline, the level observed at the end of the period remains higher than that at the beginning of the study.

Trends vary across countries. In Australia, the proportion rose from 12 per 100,000 adults in 2016 to 22.7 per 100,000 adults in 2022, and then to 18.3 per 100,000 adults in 2024. The country maintains the highest level of the four territories studied, with 10.6 per 100,000 adults reporting daily smoking in 2022, according to the Australian Bureau of Statistics. In England, it reached 15.7 per 100,000 adults in 2022 before decreasing to 14.3 per 100,000 adults in 2024; the prevalence of smoking among adults there was 10.4 per 100,000 adults in 2024, according to the Office for National Statistics. In Canada, it fell from 11.4 % in 2016 to 9.8 % in 2018, then gradually increased to reach 13 % in 2024; Statistics Canada, however, indicates that 11.4 % of adults smoked daily or occasionally in 2023, compared to 12.5 % in 2022. In the United States, it remained relatively stable between 2016 and 2020, around 8.4 % to 8.6 %, before reaching 10.4 % in 2024; the Centers for Disease Control and Prevention estimated the prevalence of current adult smoking at 11.6 % in 2022, while the most recent national indicator places it at 10.1 % in 2024.

These results pertain to individuals who continue to smoke, not the entire adult population. The authors emphasize that smoking prevalence decreased in all four countries during the study period. Taking this trend into account, they estimate that the proportion of adults experiencing these deprivations remains below 3% in each country. It even decreased in Canada and the United States, despite the observed increase among smokers.

Deprivation disproportionately affects young adults, low-income individuals, and those with severe dependencies.

After accounting for other factors, difficulties related to cigarette expenses are more frequently reported by young adults, low-income individuals, and those with a high level of tobacco addiction. A low level of education is also associated with these financial hardships, but the association is less pronounced. Researchers also observed associations with reported tobacco purchases, which may originate from the illicit market as well as co-consumption: the use of e-cigarettes among individuals who continue to smoke. These results do not establish that these practices cause financial difficulties. They may, in particular, reflect spending reduction strategies or smoking cessation efforts, hypotheses that require further research.

A high motivation to quit, but also increased difficulties.

Participants experiencing financial hardship related to cigarette expenses are more likely to report wanting to quit soon. However, they express less confidence in their ability to succeed. Follow-up between two survey waves confirms this tension between motivation and quitting effectiveness. In the longitudinal observations presented by the authors, 49.6% of those reporting these financial hardships had attempted to quit smoking before the next survey, compared to 41.9% of those not reporting such difficulties. After adjustment, the association with quitting attempts remains modest and is at the limit of statistical significance.

However, the gap in success rates is more pronounced. Among those who attempted to quit, 15.9% of those who reported experiencing deprivation indicated that they had completely stopped smoking in the following survey, compared to 32% in the other group. This lower success rate persists even after accounting for several factors, including age, income, education level, and tobacco dependence. The authors suggest that these results may encourage people to try to quit while also highlighting additional obstacles to cessation for these individuals. They advocate for enhanced support for smokers facing financial hardship, in addition to tax increases. Indeed, If an increase in taxation and consequently in prices is a recognized lever for reducing consumption, as recommended by the WHO, it must be accompanied by effective access to weaning aids, so that economic constraints do not exacerbate social inequalities in health.

The role of prices and the economic context remains to be clarified.

The study observes an association between higher cigarette prices, adjusted for purchasing power differences between countries, and a greater frequency of deprivation. This association is statistically significant in England and Australia, but not in Canada or the United States. The researchers also mention the consequences of the Covid-19 pandemic and the rising cost of living to interpret the observed trends. However, their analysis does not allow them to isolate the respective contribution of these factors. The decline recorded after 2022 in Australia and England could, in particular, reflect the use of less expensive products or sources of supply. In Australia, the authors hypothesize a role for the supply of low-priced illicit tobacco. In England, they mention cross-border purchases and a reduction in cigarette consumption. These are possible explanations, not mechanisms demonstrated by the study.

Several limitations call for caution. The results are based on self-reporting, surveys spaced approximately two years apart may have missed some attempts to stop participation, and the loss of participants during follow-up could introduce bias. Certain particularly disadvantaged populations, notably the homeless, are not represented. The study, being observational and not publicly pre-recorded, should therefore be interpreted as exploratory: it highlights associations without establishing a cause-and-effect relationship.

©Generation Without Tobacco

AD

[1]Ara Cho et al., Smoking‐induced deprivation and subsequent smoking cessation among adults who smoke in four high‐income countries: Trends, correlates and longitudinal associations, 2016–2024, Addiction, published on September 27, 2026, accessed on October 13, 2026

National Committee Against Smoking |