Families where one or more parent uses tobacco not only suffer more immediate financial stress (see Section 9.4), but also less long-term financial security and a greater likelihood of poverty.
Spending on tobacco products, absenteeism from work and school, and loss of income due to smoking-related disease and premature death of breadwinners substantially reduce the capacity of a household to accumulate assets such as a family home, to insure against losses, to save for retirement, and to pass on assets to the next generation (Figure 9.5.1).
9.5.1 Spending on tobacco products and its impact on financial security and wealth accumulation
Higher rates of smoking and longer average times until cessation2 mean that lower socio-economic status (SES) people who smoke are more likely to suffer both financial stress and compromised living standards than those who are more advantaged; smoking both causes and exacerbates financial stress and poverty.3,4 A UK report concluded that while about one million, or one in five (21%), smoking households were living below the poverty line, when tobacco expenditure was included in the assessment of poverty this increased to nearly one-third (32%), equivalent to 1.5 million households. That is, the inclusion of tobacco costs moves an extra half a million households into poverty.3
Spending on tobacco can create ‘smoking-induced deprivation’—whereby the person who smokes has reported spending money on tobacco rather than on household essentials.5,6 Being unable to afford or access adequate food (termed ‘food insecurity’) is also more common among people who smoke,7-14 and may be reduced among people who quit smoking.15 Research in the US found that children exposed to secondhand and thirdhand smoke at home were at increased odds of having financial insecurity, food insecurity, and receiving government assistance.16 Households where one or more adults smoke are also less likely to have funds for discretionary spending on items such as house and contents insurance, motor vehicle insurance, and health insurance.17,18 Australian data shows that people living in the most disadvantaged areas who have quit smoking spend more on eating out, education, motor vehicle fuel and insurance (quintiles 1 and 2) and more on groceries, medicine and health practitioners and less on alcohol (quintile 2) than people who smoke, highlighting the health and economic benefits of cessation.19 Another Australian study also showed that expenditure on health-risk behaviours are more likely in smoking households— the odds of reporting expenditure on alcohol, drinking at licensed premises, and gambling were 100%, 50%, and 40% greater for smoking than for non-smoking households.18
Multiple studies have found associations between smoking, financial stress, and housing insecurity.20,21 Further, low-income families where at least one person smokes are less likely to be able to save a house deposit, so they are much less likely to own their own home.22 This is likely increasingly the case as the price of tobacco products has increased (see Section 13.3) alongside decreasing housing affordability.23 Data from the Household Income and Labour Dynamics in Australia survey showed an association between being a smoking household (defined as having one person who smokes in the household) and having inadequate housing.24 Issues of poor housing quality—including pest infestations, water leaks, lack of air conditioning or heating, and mould—are also common among low-income people who smoke, and can compound poor mental and physical health outcomes for these households.25
Low-income families where one or more adults smoke may also be less likely to invest in superannuation, life insurance, and insurance against loss of income.17 This translates to less security of income in older age, and less wealth to financially assist or leave inheritance for adult children. People who smoke are also more likely to report a higher level of perceived income inequality, lower perception of relative material wellbeing, and living in a community with a lower degree of trust and safety.26
9.5.2 The long-term effects of smoking during pregnancy for children
Smoking during pregnancy and exposure to secondhand smoke increases the risk of a range of poor health outcomes for pregnant women and their infants. This heightened risk of health problems continues throughout childhood and adolescence, with potential lifelong consequences (see Sections 3.7–3.8 and 4.16–17). As smoking during pregnancy and exposure to secondhand smoke are more common among those experiencing disadvantage (see Section 7.11), children from these households are more likely to experience both poor short- and long-term health concerns, which further compound long-term financial insecurity.
9.5.3 Exposure to secondhand smoke and school absence
Children who suffer asthma and frequent respiratory disease (which can be caused or exacerbated by exposure to secondhand smoke—see Chapter 4) miss more time at school than healthier children. Exposure to secondhand smoke reduces school attendance27 and in turn decreases the productivity of parents who need to miss work to care for children.28 Poor school attendance is a strong predictor of academic failure.29
Exposure to secondhand smoke may still reduce academic performance even where it does not affect school attendance. A longitudinal analysis of educational achievement in children in the UK found that young people exposed to secondhand smoke at home were more likely to fail standardised achievement tests.30 This finding held regardless of prenatal exposure, school attendance, and SES.
9.5.4 Parental example and smoking uptake: the cycle continues
Children who grow up in households where adults smoke are more likely to take up smoking. As discussed in detail in Chapter 5, smoking by one or both parents is a strong predictor of uptake among children,31,32 while parents’ smoking cessation reduces the chances of children taking up smoking.33 Research in the UK suggests that the relationship between disadvantage and smoking uptake can largely be explained by parental modelling of smoking. That is, reducing disadvantaged children’s exposure to smoking may largely reduce future disparities in tobacco use.34
Consistent with trends in other countries,35,36 Australian teenagers are much more likely to experiment and to smoke regularly if at least one of their parents smoke than if neither of their parents smoke. Figure 9.5.2 shows smoking status among secondary school students in 2022–23 in Victoria according to parental smoking status, with the likelihood of having ever smoked and having smoked in the past month higher among students who have at least one parent who smokes.
The effects of parental smoking on their children’s smoking appear to be lasting. Among Australian secondary school students interviewed in 1985, compared to their peers who reported neither parent smoking, younger teenage boys who reported that both parents smoked were 50% more likely and younger teenage girls were 100% more likely to still be smoking 20 years later.32
Both genetic and environmental influences can increase the risk of smoking uptake in adolescent children of parents who smoke. Parenting style and attitudes, parental supervision, and smoking bans in the home can all affect the likelihood that a young person will take up smoking—see Section 5.7 for a detailed discussion.
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References
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