Abstract
Tobacco and alcohol use are major risk factors for premature mortality and morbidity. Tobacco and alcohol expenditure may also exacerbate poverty. This study aimed to estimate the financial impact of tobacco and alcohol consumption in low income households in the United Kingdom. We undertook a cross-sectional study using a secondary dataset. A sample of 5031 households participated in the 2016-17 Living Costs and Food Survey. Measurements We measured the weekly household income and expenditure on tobacco and alcohol, and the proportion of households with expenditure on tobacco and alcohol overall, by income decile and in households in relative poverty (below 60% of the median household income). Estimates were extrapolated using population data to estimate the number of UK households, adults and children that would be classified as living in relative poverty on the basis of net income after subtracting tobacco or alcohol expenditure ('tobacco and alcohol expenditure-adjusted poverty'). Spending on alcohol was more common in high income groups; 83% of households in the highest and 47% in the lowest income decile purchased alcohol. The reverse was true for tobacco, which was purchased by 8% and 24% of households in the highest and lowest income deciles respectively. Twenty-three percent of households in relative poverty purchased tobacco and 49% alcohol, with a median expenditure of £12.50 and £9.55 per week, respectively. A total of 320 000 households comprising 590 000 adults and 175 000 children were in alcohol expenditure-adjusted poverty, and 230 000 households, comprising 400 000 adults and 180 000 children in tobacco-expenditure adjusted poverty. Tobacco and alcohol expenditure appear to exacerbate poverty in low income households in the United Kingdom. Hundreds of thousands of additional households would be defined as living in relative poverty based on their income after subtracting their tobacco and alcohol expenditure.
Highlights
Tobacco and alcohol use are the first and fourth most important causes of worldwide loss of Disability Adjusted Life Years (DALYs) respectively [1]
Hundreds of thousands of additional households would be defined as living in relative poverty based on their income after subtracting their tobacco and alcohol expenditure
Passive exposure of children to tobacco smoke increases the risk of sudden infant death and of respiratory disease, and children whose parents smoke are twice as likely to become smokers themselves.[4, 5] Children whose parents consume alcohol are more likely to drink heavily in adolescence.[6,7,8] alcohol consumption is a significant contributor to crime and public disorder.[9]. Tobacco and alcohol use in England cost the NHS 2.5 [10, 11] and 3.5 billion pounds each year [12]
Summary
Tobacco and alcohol use are the first and fourth most important causes of worldwide loss of Disability Adjusted Life Years (DALYs) respectively [1]. Passive exposure of children to tobacco smoke increases the risk of sudden infant death and of respiratory disease, and children whose parents smoke are twice as likely to become smokers themselves.[4, 5] Children whose parents consume alcohol are more likely to drink heavily in adolescence.[6,7,8] alcohol consumption is a significant contributor to crime and public disorder.[9] Tobacco and alcohol use in England cost the NHS 2.5 [10, 11] and 3.5 billion pounds each year [12] In addition to these well-recognised health and economic effects, tobacco and alcohol use place a burden on household budgets.
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