Smoking Poverty in the UK

Unpacking The Causes:

If we look at income and poverty alone, financial stability has a significant impact on the quality of someone’s life. It can be affected by general economic changes as well as individual factors like family, education and where someone lives. Consider the fact that living in a lower decile area, rented accommodation or council funded accommodation can make someone twice as likely to smoke. Then, add to that the financial strain of sustaining a smoking habit to an already tight budget and breaking free of poverty is going to be even more of a challenge. To understand better why smoking is more prevalent in lower decile areas, we need to look at a number of factors:

Where You’re From And Who You’re Around Plays A Big Part

Being born into and growing up in a poorer area sets people up for being more likely to smoke. There’s a significant impact on your environment, who you’re around and what you do that can combine to influence how likely you are to smoke. If you consider the life path of someone born into a lower decile suburb, there are a number of triggers that can result in smoking addiction.

• First of all, growing up in a smoking household makes a child significantly more likely to later take up the habit themselves. It also provides access to cigarettes they may not otherwise have(3).
• Even if a child has non-smoking parents, the added stress of living pay-check to pay-check can affect anyone’s life - even if you’re not the one paying the bills.
• A recent study from Scotland found that children in less affluent areas came into contact with shops selling cigarettes on average 149 times in a single week. For children in better off areas that number was only 23(8).
• Living in poverty has a knock on effect to education. Essentially, those from lower income neighbourhoods or those living in poverty are more likely to struggle in school. With a lower educational qualification level having a direct correlation with higher smoking rates, it’s another factor that’s amplified by living in poverty.
• A lower educational level factors into career prospects. With highly educated professionals having the lowest smoking rate in the UK with around one in 10 smoking, manual labourers and those in routine oriented jobs have a one in four chance of being a regular smoker(4).
• Adults and children living in the lowest 20% income bracket are two to three times more likely to suffer from poor mental health(10). Poor mental health is yet another contributing factor to smoking(4). With a lower average income, increased job and financial stress, things like depression and anxiety are more likely to manifest.
• Following a recent analysis undertaken by Landman Economics on behalf of ASH(26), it was found that 3 out of 5 all households containing smokers living under poverty where living in the Midlands and North of the UK. This recent study elucidates how the impacts of smoking within local communities is heightened on lower income households.

Why Does Stress Lead To Smoking?

From this trend, we can see that stress is one of the main contributing factors to increasing someone's likelihood of being a smoker. Why is that? Stress causes the release of a hormone called cortisol. There are two kinds of stress, both release cortisol but have different triggers. One form is eustress, which is beneficial in day to day life. Small doses of cortisol boost concentration and productivity and your body will stop producing cortisol once you’ve completed the task that’s causing you stress in the first place. This is the function that helps people focus when they have a tight deadline or need to get something done in a certain timeframe.

The second kind of stress is distress. It’s where there’s no “end trigger” to tell your body to stop producing cortisol so it builds in your system over time. The end result is being in a constant state of agitation and “fight or flight” mode(11). So what’s the correlation between stress and smoking?

Smoking triggers the release of dopamine in the brain(12), the happy molecule that makes you feel calm. When there are a number of stressful factors in your life - including financial strain and mental health issues for example - smoking can become a coping mechanism. However, the more you smoke, the higher your tolerance becomes meaning you need more over time to achieve the same effect(13). Essentially, a smokers brain becomes desensitised to nicotine with more use whilst still craving the same effect. Smoking gives a perceived relaxing effect, even though the withdrawal symptoms then add more stress to their body once the nicotine has been synthesised in their brains.

The Rising Cost Of Smoking, Compared To A Slower Increase In Average Income.

If these factors combine, once you start smoking, it’s that much more difficult to break free of the poverty line. Back in 2009, just a decade ago, the average cost of a 20 pack of premium cigarettes was just £5.45, compare that to an average cost in 2023 of £14.57 for the same product. Sustaining a pack a day smoking habit now costs nearly triple what it did just a decade earlier(5).

In comparison the average inflation rate from 2009 to 2023 means the buying power of £1 back then equates to £1.48 now. In real terms, if cigarettes had stayed in line with this price point, a standard 20 pack would cost £10.71. A pack-a-day smoker can stand to spend around £3913.05 a year at the current price whereas standard inflation change would cost £2642.60 - a difference of £1270.45 a year.

Cost Of Smoking Increasing At A Greater Rate Than Inflation

The increase in price largely stems from the government raising the import tax on tobacco products. While this was done to discourage consumption, the tobacco companies respond by passing the increased cost onto consumers. For those already addicted, the options are either to cut down, switch to less premium brands or purchase counterfeit cigarettes from the illicit and illegal tobacco industry. What doesn’t change is the fact that a comparatively higher proportion of household income will still be going to fund tobacco addiction, adding to financial strain and stress in the home.

Let’s consider the average household income. In 2009 the median full-time weekly earnings were £488.50, while in 2018 they’d risen to £569(7) - a 16% increase. Bearing in mind this is the average, a 16% increase in average weekly income is still far outstripped by the 98% increase in the cost of smoking for the same period. A pack a day smoker will spend around £75.81 a week on cigarettes which - based on the average income - would be 13% of their take home pay. For households on a lower than average income, this percentage will be even more significant with sustaining a smoking habit taking a greater relative percentage of their income. According to ASH, there are 5.1 million households in England with at least one smoker. Of these, 1.4 million fall below the poverty line due to the cost of smoking which equates to more than a quarter (27%) of all households. If these smokers quit, an estimated 418,127 households would be elevated back above the poverty line(20).

The Knock On Effect And Greater Cost To Society:

Smoking poverty is harmful not only at an individual level, but also to the wider community as far as the illicit tobacco industry goes as well as the cost to the healthcare system.

Cost Of Smoking To The Economy And Public Health:

With the ill-effects of smoking affecting someone’s health, that can have a knock on effect on their ability to work. It’s estimated the UK collectively loses £8.4bn a year in productivity due to smoking breaks alone. Add to that absences from work due to smoking related illness that affect both employer and employee and the cost is amplified.

It’s not just the smokers who are affected - pregnant mothers, children and passive smokers all have their health affected. Rates of mothers who smoke during pregnancy are still relatively high in the UK with the NHS stating an average 10.8% of women are still smoking at time of delivery. This can cause complications with birth as well as increasing the chances of things like SIDS and asthma. If the expectant mother isn’t a smoker but her partner is, second hand smoke can also have the same effect(18).

Children from families that smoke are more likely to smoke too, resulting in a self-perpetuating cycle of smoking and poverty. This in turn also contributes to more strain on the NHS and public health facilities as well as contributing to demand for the illicit cigarette trade. With smoking related illnesses costing the NHS around £2.5bn a year and an additional £760m a year on local councils for social care services(16), smoking is draining everyone’s pockets as well as their health.

The Illegal Cigarette Trade:

With such high demand for cigarettes and many people struggling to afford to sustain a habit, the illegal tobacco industry is thriving in the UK. Aside from contributing to people’s addiction as well as making cigarettes more accessible to younger people, it also undermines proper taxation. For the 2015-2016 period at a mid-range level, HM Revenue and Customs estimated that 13% of all cigarettes and 32% of hand-rolling tobacco in the UK were illicit. What this translates to financially is a collective loss of £3.5bn in tobacco duties and a further £1.3bn in VAT for that period alone(17).