Tobacco & Poverty

Download book chapter
Call To Action

Governments should strengthen tobacco control programs to prevent tobacco consumption from impoverishing citizens and impeding economic development.

Percentage of median household income needed to buy 10 of the cheapest brand of cigarettes per day, 2012

There is an inextricable and pernicious relationship between tobacco and poverty. In many ways, tobacco and poverty are part of the same vicious cycle. Across the globe, smoking is generally common among the poorest segments of the population. These groups, already under financial stress, have little disposable income to spend on cigarettes. Consumption of tobacco adds directly to financial stress. For example, in a city such as New York, a pack-per-day smoker living at the poverty level spends as much as 20% of his household income in supporting his smoking habit. In lower-income countries, the World Health Organization estimates that as much as 10% of household income can be spent on tobacco products, leaving less money for food, education, housing, and clothing.

There are costs to smokers that go far beyond the money that they pay to buy cigarettes. Smokers develop many more illnesses than non-smokers, which places enormous cost stresses on any country’s health care expenditures, and makes it more difficult to afford health coverage. As a result, in places where individuals purchase health insurance, those costs are proportionately much higher than they are for non-smokers. Smoking-related illness takes workers out of the work force, adding to the indirect costs of tobacco and creating further downward pressure on the economy, especially in LMICs.

Furthermore, working in the tobacco industry can trap people in poverty. In LMICs, many small tobacco farmers are often forced to sell their crop at a low, fixed price and have few choices but to over-pay the tobacco companies for fertilizer, seeds, technical advice, and other items (see Growing Tobacco). Trapped in a type of indentured servitude, they are added to the lists of those victimized directly or indirectly by the tobacco economy.

Financial strain

Percentage of smokers who spent money on cigarettes instead of household essentials

Smokers spend money on cigarettes instead of on household essentials such as food and education. This could exacerbate the poor’s disadvantaged circumstances and standard of living.

Child Labor

Working in tobacco fields affects school attendance and retention rates

Suza in Kasungu district and Katalima in Dowa district of Malawi: 2008

63% of children of tobacco-growing families were involved in child labor.

10–14% of children from tobacco-growing families are out of school because of working in tobacco fields.

16% of parents said their children were out of school because of an inability to pay educational fees and buy uniforms and shoes.

Lack of education drives individuals further into poverty.

“…when child and maternal mortality are falling universally around the world, the threat of a rise in tobacco is heading in the wrong direction…The developing world is about to enter a phase of rapid growth in tobacco at a time when it can least afford it” –Keith Hansen, The World Bank Group, 2012



Hansen K. Remarks by Mr. Keith Hansen, Director of Human Development for Latin America and Caribbean – The World Bank Group: The Tobacco Atlas DC Launch. D.C., USA: The National Press Club; 2012.

“In 2004-2005, tobacco consumption [impoverished] roughly 15 million people in India.”

—Rijo M John et al, Tobacco Control, 2011

“The yawning poverty gap in smoking exacerbates existing, and unconscionable, health disparities. Endgame strategies, therefore, must pay particular attention to the least advantaged, focusing on the equitable distribution of benefits. What justice requires is that the poor do not feel the blowback of the last blasts in the war against Big Tobacco” –Keith Hansen, The World Bank Group, 2012

Vicious cycle

Disadvantage increases smoking likelihood, and smoking increases likelihood of disadvantaged circumstances

Tobacco impoverishes countries

Productivity loss and healthcare cost burdens undermine economic development in many countries.


Tanzania earns $50 million per year from tobacco but spends $40 million for tobacco- related cancers alone.


US smokers cost their employers an excess of $6000 a year per smoker due to lower on-the-job productivity, higher absences, and excess healthcare costs.


The cost to Brazil due to tobacco is approximately 100 million reals per thousand smokers in lost productivity.

In Burkina Faso in 1998, a Rothman’s representative said, “the average life expectancy here is 40 years, infant mortality is high, the health problems which some say are caused by cigarettes just won’t be a problem here.”

“We reserve …[the] right [to smoke] for the poor, the young, the black and the stupid.” –R.J. Reynolds Tobacco Company executive, 1993

Download book chapter