ArticleBJPsych open2026
The combined association of individuals' psychological distress, mental health and smoking status with household expenditure.
Article in BJPsych open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundAdults with mental illness have higher smoking prevalence and face greater financial burdens from smoking compared with the general population.
aimsThis study explores how individuals' psychological distress and smoking status are jointly associated with household expenditure patterns in Australia.
methodDaily smokers and ex-smokers were compared using the Household, Income and Labour Dynamics in Australia Survey over three waves. Psychological distress was assessed with the Kessler Psychological Distress Scale (K10) and the mental health domain of Medical Outcomes Study Short-Form General Health Survey (SF-36 MHD). Household expenditure categories included alcohol, clothing, education, fuel, general insurance, medicines, health practitioners, groceries, meals eaten out, internet, utilities, public transport and rent. Regression models using the generalised estimating equation technique compared expenditure data, controlling for age, gender, household composition, socioeconomic position, education level and wave of data collection.
resultsSmokers and ex-smokers showed significant differences in expenditure across K10 psychological distress levels. At low and moderate distress levels, smokers spent more on alcohol and rent and less on insurance, health practitioners, meals out and medicines. At high distress levels, only education expenditure was significantly lower for smokers. Across SF-36 MHD tertiles, smokers spent less on education, insurance and medicine, but more on alcohol, especially at lower and moderate distress levels.
conclusionsSmoking cessation for those with moderate psychological distress may be associated with a reallocation of spending, benefiting both households and their local communities. Targeted interventions addressing smoking cessation and mental health are crucial for reducing financial and health inequities.
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