Financial stress in Australia is a growing issue (ACOSS, 2023). Community service providers have reported an increase in the number of people accessing their services due to rising levels of financial stress, likely compounded by the impacts of COVID-19 and increases to the cost of living (WACOSS, 2022). This is placing added pressure on the already limited resources of community service providers such as emergency relief, food relief,financial counselling, mental health and domestic violence services.

How does tobacco use impact people experiencing financial stress?
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Tobacco use is an expensive substance dependence. In Australia, a typical packet of cigarettes currently costs $43.60 for a 25 pack or $64.50 for 25 grams of loose tobacco (roll-your-own). For example, a person who smokes 20 tailor-made cigarettes a day could spend $1110 in a month and $13322 in a year. Spending on things like lighters and papers/filters (if using loose tobacco) further adds to this cost. The cost of managing smoking-related illnesses can also impact household budgets, including buying medication, more medical appointments and having more time off work. The more a person smokes, the more they experience financial pressures in their day-to-day life which leads to financial stress (Siahpush et al, 2003).  

In Australia, people experiencing financial stress are more likely to smoke and less likely to quit (Guillaumier et al, 2017). Australian families, where one or more parent uses tobacco, experience more long-term financial insecurity and a greater likelihood of experiencing poverty (Greenhalgh et al, 2022). The financial impact of smoking is particularly acute in people already experiencing financial hardship (Guillaumier et al,2017). An Australian study with participants experiencing financial hardship found in order to continue purchasing tobacco those who smoked were more likely to:

·        Sell something;

·        Go without meals;

·        Seek assistance from emergency relief organisations; and

·        Rely on the support of family and friends (Guillaumier et al, 2017).  

Tobacco use perpetuates the cycles of financial insecurity and poverty experienced by Australians. Quitting smoking reduces financial stress.
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An Australian study found that people who quit smoking had a 25% reduction in their financial stress and higher levels of material wellbeing (Siahpush et al, 2003). Quitting smoking increases money available for essentials such as food, housing, education, healthcare and bills, but also leisure activities and hobbies to support people’s mental health.

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Community service providers can play an important role in highlighting the benefits of quitting smoking for clients with a dependence on tobacco. ‍

How does mental health impact tobacco use?

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In addition to the financial burden of tobacco use, the link between mental ill health and smoking is widely acknowledged. When the underlying causes of mental health experiences are not appropriately addressed, a person may engage in substance use such as smoking tobacco (Greenhalgh et al, 2022). Conversely, when a person is experiencing financial hardship, they may engage in tobacco use as smoking has been perceived as a mechanism to relieve the anxiety and stress experienced in day-to-day life. In fact, tobacco use worsens symptoms of mental ill health and raises the likelihood that a person will have to increase their dosage if using medication to treat a mental health condition (Just et al, 2021). Quitting smoking lessons symptoms of depression, anxiety, stress and improves quality of life, for people with and without a diagnosed mental health condition (Taylor et al, 2014).

Community service providers can help reduce the impact of tobacco use  

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Many people who are experiencing financial hardship and use tobacco would like to stop, with concerns about money and health being the main drivers (AIHW, 2020). However, we understand there are many circumstances facing people experiencing financial hardship that make it more difficult for them to stop. These include barriers to accessing supports and services to make a quit attempt and continue their quitting journey. In addition to ongoing support from funding bodies to increase access and availability of cessation programs and wrap around supports, community service providers can play an important role in connecting clients to specialist supports to both address the underlying factors that lead to tobacco use. and support them in their quitting journey.

What can community service providers do?

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It is important that community service providers are equipped with knowledge of the supports available to help community members reduce and quit their use of tobacco. Referral to Quitline for behavioural support alongside facilitating access to stop smoking medications such as combination nicotine replacement therapy (NRT) is an evidence-based approach. (Johnson et al, 2020). Below are some strategies that community service providers can use in the assessment and referral process to support clients to reduce and quit their use of tobacco. These strategies can be used once the service provider has established rapport with the person or if they have requested this type of assistance. Offering clients support as early as possible empowers people to make informed decisions about their health and their financial security.

Brief Advice: Ask, Advise, Help (AAH)

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The nationally recognised AAH brief advice model, used by Cancer Council WA, is an effective tool to help connect people who use tobacco to evidence-based support to help people in their quitting journey.

This model follows three steps which include:

1.   Ask all clients about their tobacco use status when appropriate and document this answer in their case file to help you when supporting the client throughout their engagement with your service.

2.   Advise all clients who use tobacco to quit, in a non-confrontational and personalised way that focuses on the benefits of quitting and the support available.

3.   Help clients by facilitating access to stop smoking medications such as combination NRT. Offer to make a referral to Quitline (13 78 48) so clients can receive free calls as part of Quitline’s call back service. Aboriginal and Torres Strait Islander counsellors can be accessed through Quitline by requesting to speak to an Aboriginal Quitline counsellor.  

The Quit Planner resource can help clients plan out their quitting journey and the My QuitBuddy app provides the opportunity for clients to track their quitting progress including dollars saved.

See this page for more information on evidence-based quit supports.
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Where can community service providers access training in smoking cessation?
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Staff working at a community service provider can complete free smoking cessation brief advice training. Please click here for more details on smoking cessation brief advice training available for community service workers and volunteers.

For more information about ways you can further support community members experiencing financial stress who use tobacco visit MakeSmokingHistory.org.au or contact the team at Cancer Council WA on makesmokinghistory@cancerwa.asn.au    

Where to access additional specialist supports
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The following resources provide information on specialist services for community members who request support to address concerns related to mental health or other substance use.

Alcohol and Drug Support Line
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The Alcohol and Drug Support Line is a confidential, non-judgemental telephone counselling, information and referral service for anyone in Western Australia seeking help for their own or another person’s alcohol or drug use. Contact with the Alcohol and Drug Support Line is one-to-one with a professional counsellor. Community members can contact the helpline, 24 hours, 7 days a week by dialling (08) 9442 5000.

Head to Health Assessment and Referral Phone Service
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The Head to Health Assessment and Referral Phone Service provides state-wide access to telephone-based assessment and referral to match people to services that meet their mental health needs. Community members can contact the helpline, free of charge, Monday to Friday: 8:30 am to 5:00 pm by dialling 1800 595 212.

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To access the references used in this blog piece, please contact makesmokinghistory@cancerwa.asn.au

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This blog was developed in partnership with the Community Relief and Resilience program, which is delivered by WA Council of Social Service and funded by Lotterywest.

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Last updated 19 October 2023