Potential smoke-free dividend across local areas in England: A cross-sectional analysis

Morris, Damon; Gillespie, Duncan; Dockrell, Martin; Cook, Mark; Horton, Marie; Brown, Jamie; Langley, Tessa

Abstract

Background
The value that might be added to local economies each year through the money that people who smoke tobacco would save if everyone quit smoking is called the “smoke-free dividend”. This study aimed to estimate the value of the smoke-free dividend across local areas in England, and how it relates to the average income in those areas.

Methods
The study was a cross-sectional descriptive analysis of tobacco expenditure from the Smoking Toolkit Study (STS) matched to income and smoking prevalence data for English local authorities. The STS sample was from 2014–2020 and comprised 18,721 adults who smoke cigarettes. Self-reported expenditure estimates from the STS were adjusted for under-reporting. This adjustment aimed to align the total expenditure estimate with figures derived from government tax receipts and national estimates of illicit tobacco use. The smoke-free dividend is calculated as 93% of spending on legal tobacco, which is the percentage estimated to leave the local economy, plus 100% of spending on illicit tobacco.

Results
The total dividend in England is estimated to be £10.9 billion each year, which equates to£1,776 per person who smokes or £246 per adult regardless of smoking status. The estimated dividend is greater in areas with lower average income, with a correlation coefficient of -0.521(95% Confidence Interval: -0.629, -0.392) between the average income of local areas and the dividend per adult.

Conclusions
This study has estimated that local economies could gain a substantial dividend if everybody stopped smoking, which is larger in lower-income areas, meaning that geographic economic inequalities could be reduced.

Citation

Morris, D., Gillespie, D., Dockrell, M., Cook, M., Horton, M., Brown, J., & Langley, T. (2024). Potential smoke-free dividend across local areas in England: A cross-sectional analysis. Tobacco Control, https://doi.org/10.1136/tc-2023-058264

• Journal Article Type: Article
• Acceptance Date: Jan 9, 2024
• Online Publication Date: Mar 20, 2024
• Publication Date: Mar 20, 2024
• Deposit Date: Feb 14, 2024
• Publicly Available Date: Feb 14, 2024
• Print ISSN: 0964-4563
• Electronic ISSN: 1468-3318
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1136/tc-2023-058264
• Keywords: smoking; economic inequalities; health inequalities; deprivation; tobacco expenditure; illicit tobacco
• Public URL: https://nottingham-repository.worktribe.com/output/31443906
• Publisher URL: https://tobaccocontrol.bmj.com/content/early/2024/02/05/tc-2023-058264