Smokers with financial stress are more likely to want to quit but less likely to try or succeed: findings from the International Tobacco Control (ITC) Four Country Survey

Addiction. 2009 Aug;104(8):1382-90. doi: 10.1111/j.1360-0443.2009.02599.x. Epub 2009 May 12.


Objective: To examine the association of financial stress with interest in quitting smoking, making a quit attempt and quit success.

Design and participants: The analysis used data from 4984 smokers who participated in waves 4 and 5 (2005-07) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom and Australia.

Measurement: The outcomes were interest in quitting at wave 4, making a quit attempt and quit success at wave 5. The main predictor was financial stress at wave 4: '. . . because of a shortage of money, were you unable to pay any important bills on time, such as electricity, telephone or rent bills?'. Additional socio-demographic and smoking-related covariates were also examined.

Findings: Smokers with financial stress were more likely than others to have an interest in quitting at baseline [odds ratio (OR): 1.63; 95% confidence interval (CI): 1.22-2.19], but were less likely to have made a quit attempt at follow-up (OR: 0.74; 95% CI: 0.57-0.96). Among those who made a quit attempt, financial stress was associated with a lower probability of abstinence at follow-up (OR: 0.53; 95% CI: 0.33-0.87).

Conclusions: Cessation treatment efforts should consider assessing routinely the financial stress of their clients and providing additional counseling and resources for smokers who experience financial stress. Social policies that provide a safety net for people who might otherwise face severe financial problems, such as not being able to pay for rent or food, may have a favorable impact on cessation rates.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Australia
  • Canada
  • Cross-Cultural Comparison
  • Female
  • Humans
  • Male
  • Middle Aged
  • Motivation
  • Smoking / economics
  • Smoking / psychology*
  • Smoking Cessation / economics
  • Smoking Cessation / psychology*
  • Smoking Cessation / statistics & numerical data
  • Smoking Prevention
  • Socioeconomic Factors
  • Stress, Psychological / economics*
  • United Kingdom
  • United States
  • Young Adult