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
Publication Source


Journal article
Europe, The Americas, Western Pacific
Economy status
High-income economies

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 4,984 smokers who participated in Waves 4 and 5 (2005-2007) of the International Tobacco Control (ITC) Four Country Survey, a prospective study of a cohort of smokers in the US, Canada, UK, and Australia.

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 sociodemographic and smoking-related covariates were also examined.

Smokers with financial stress were more likely than others to have an interest in quitting at baseline (OR: 1.63; 95% 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).

Cessation treatment efforts should consider routinely assessing 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.