Household tobacco expenditure and associated characteristics during substantial regular tobacco tax increases: analysis from a nationally representative longitudinal study in Australia from 2006 to 2022.

Objective: We investigated household tobacco expenditure by socioeconomic status and examined the associated factors in Australia from 2006 to 2022, incorporating a period of substantial regular tobacco tax increases (2010-2020).  METHODS: We conducted a repeated cross-sectional analysis of household data from the Household, Income, and Labour Dynamics in Australia survey to examine differences in household tobacco expenditure by Socio-Economic Indexes for Areas (SEIFA). Descriptive analyses were performed for all households and those with any tobacco expenditure, with dollar values adjusted for inflation to 2022. Linear regression with generalised estimating equations (GEE) assessed associations between different individual-level factors and household tobacco expenditure.

Results: Between 2006 and 2022, smoking prevalence decreased by 5.6% points. Overall average annual household tobacco expenditure decreased by $7.8 ($980.5 to $972.7), while households that purchased tobacco increased spending by $1092.2 ($3839.5 to $4931.7). In 2022, households in the most disadvantaged areas allocated more than double the proportion of their disposable income to tobacco (6.3%) compared with households in the most advantaged areas (2.7%). GEE analysis showed a dose-response relationship between SEIFA category and household tobacco expenditure, with the most disadvantaged households spending an additional $245.5 (95% CI: $193.7-$297.2) compared with the most advantaged households. The additional tobacco-related expenditure for people who currently smoked compared with those who never smoked was $1500.5 (95% CI: $1424-$1577).

Conclusion: Disadvantaged households allocated more of their income to tobacco and spent more on tobacco overall than advantaged households, reflecting higher smoking prevalence. Additional non-price-related measures are needed to address these inequities.