INTRODUCTION: Spending on tobacco products may exacerbate health-related financial hardship experienced by low-income older adults. This study examined tobacco spending and the relationship between tobacco use and non-tobacco spending among low-income older adults in the U.S.
METHODS: Using pooled 2021–2023 Consumer Expenditure Survey data, 1,983 single-person households (aged >/=65 years, with income <200% of the federal poverty level) were analyzed. Descriptive statistics summarized quarterly expenditures and budget shares for tobacco and nontobacco goods. Generalized linear and fractional logit models compared non-tobacco expenditures and budget shares between people who use (versus do not use) tobacco, controlling for sociodemographic covariates.
RESULTS: Overall, 10.6% of respondents reported tobacco spending. Respondents who used tobacco spent an average of $305.0 (SD=303.4) per quarter on tobacco (7.8% of their total budget). Compared to respondents that did not use tobacco, respondents that used tobacco spent significantly more per quarter on alcohol ($54.8 vs $22.0, p<0.001) and significantly less per quarter on food ($783.9 vs $837.0, p<0.01), housing ($1,754.5 vs $2,189.7, p<0.05), health care ($564.0 vs $720.2, p<0.05), and clothing ($47.8 vs $64.7, p<0.05). Similarly, respondents that used tobacco spent a significantly greater portion of their budget on alcohol (1.3% vs 0.4%, p<0.001) and a significantly lower portion on food (19.6% vs 19.7%, p<0.05), housing (38.8% vs 43.4%, p<0.01), health care (14.7% vs 16.8%, p<0.01), and other expenses (2.0% vs 3.9%, p<0.01).
CONCLUSIONS: Tobacco spending and its complementary alcohol spending may reduce low-income older adults’ expenditures on food, housing and health care.
Tobacco spending among low-income older adults in the United States, 2021-2023
American Journal of Preventive Medicine, 69 (2), 107661. doi: 10.1016/j.amepre.2025.107661.