Abstract
BackgroundFinancial stress is a barrier to successful smoking cessation and a key predictor of relapse. Little is known about the financial situation of low-income Australian daily smokers. This study aims to describe and investigate associations between the financial functioning, tobacco use and quitting behaviours of low income daily smokers.MethodsLow-income Australian adult smokers in the ‘Financial Intervention for Smoking Cessation Among Low-income Smokers (FISCALS) randomised clinical trial completed a structured telephone questionnaire.ResultsThe median number of cigarettes typically smoked by the 1047 participants was 23 per day. The median spent on tobacco per week was AU$80. Three quarters (73.0%) reported some financial stress and 43.2% reported smoking-induced deprivation. Financial stress was significantly associated with deprivation (IRR: 1.23, 95% CI 1.21, 1.26, p < 0.001). There were no significant associations either between adjusted financial stress or deprivation and motivation to quit or certainty of quit success.ConclusionsFinancial stress and smoking induced deprivation were prevalent among low-income daily smokers, but they were not associated with motivation to quit. Smoking cessation interventions need to be responsive to the role financial stress plays in reducing quit attempts and increasing relapse.Trial registrationAustralian and New Zealand Clinical trials Registry ACTRN12612000725864 6/07/2012
Highlights
Financial stress is a barrier to successful smoking cessation and a key predictor of relapse
Methods used for smoking cessation NRT and other pharmacotherapy use We asked participants: “Prior to entering the study, had you ever used Nicotine Replacement Therapy (NRT)?” and “Have you ever used prescription medications to help you quit smoking”
Tobacco use The median number of cigarettes participants typically smoked was 23 per day (IQR 15–30), and they first started smoking at 15 years (IQR 14–18)
Summary
Financial stress is a barrier to successful smoking cessation and a key predictor of relapse. There is a pernicious cycle where tobacco use increases financial pressures (e.g., difficulty paying for bills, food, rent etc.) [12], which in turn maintains smoking [13], by the use of price-minimization strategies (e.g., by switching to roll-your-own), rather than cessation [14]. This may mean that price-based interventions will deliver diminishing returns over time with socially disadvantaged smokers because rises in taxation increase financial stress and smoking, and decrease quit success [15]
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