Does spending on cigarettes crowd out other household expenditures in China? findings from the ITC China survey

Background: Spending on cigarettes may crowd out other household expenditures like food in both developing and developed countries. The goal of this study was to examine the prevalence of and factors associated with this behavior among smokers (age ≥18) in China.

Methods: Data were analyzed from Waves 1-3 of the International Tobacco Control (ITC) China Survey, conducted from 2006-2009 among adult smokers in six cities in China (N=8,556). Crowding out was measured with the survey question “In the last six months, have you spent money on cigarettes that you knew would be better spent on household essentials like food?” We examined whether sociodemographic factors and smoking intensity were associated with crowding out behavior using generalized estimating equations modeling. Sociodemographic factors included age, gender, marital status, education, income, employment status, and city.

Results: 7.5% of smokers reported crowding out household expenditures by purchasing cigarettes. We found that low income smokers (OR=2.32, 95%CI=1.65-3.26) and smokers resident in Yinchuan (OR=2.56, 95%CI=1.62-4.04) were more likely to engage in crowding out than high income smokers and smokers resident in Beijing. We also found that retired smokers were less likely to engage in crowding out than employed smokers (OR=0.60, 95%CI=0.41-0.89). There was no statistically significant relationship between smoking intensity and crowding out.

Conclusions: Our findings indicate that some groups of smokers in China acknowledge spending money on cigarettes that could be better spent on household essentials. Tobacco control policies that reduce smoking prevalence in China may improve household living standards by reducing this crowding out effect.