Expenditure on smoking and alternative nicotine delivery products: a population survey in England

Background and Aims The expense associated with using non-combustible nicotine products as an alternative to smoking may deter smoking reduction or cessation. This study aimed to estimate (i) how much adults in England spend each week on smoking and alternative nicotine products and (ii) the potential cost saving that could be achieved by switching from smoking to using an alternative nicotine delivery product. Design and Setting Data came from September to November 2018 waves of the Smoking Toolkit Study, a series of national household surveys of the adult population in England. Participants A total of 859 adults (aged >= 16 years) who reported current smoking or current use of an alternative nicotine product. Measurements Participants reported their average weekly expenditure on smoking and alternative nicotine products [nicotine replacement therapy (NRT) or e-cigarettes]. Findings Current smokers who did not use any alternative nicotine delivery products (n = 602) reported spending on average 23.09 pound [95% confidence interval (CI) = 21.64-24.54] pound on smoking each week. Ex-smokers who used alternative nicotine products (n = 91) reported spending on average 8.59 pound (95% CI = 6.80-10.39) pound on these products each week; 8.03 pound (95% CI = 6.03-10.03) pound on e-cigarettes and 10.05 pound (95% CI = 5.62-14.47) pound on NRT. People who both smoked and used alternative nicotine products (dual users, n = 166) spent on average 24.54 pound (95% CI = 21.78-27.29) pound on smoking and 7.49 pound (95% CI = 6.00-8.99) pound on alternative nicotine products each week. Expenditure on smoking was higher among heavier, more addicted smokers and lower among those with routine/manual occupations, non-daily smokers and roll-your-own tobacco users. Expenditure on e-cigarettes was higher among men, users from central and southern versus northern England and smokers who had tried to quit in the past year, and lower among current smokers. Expenditure on NRT was lower among roll-your-own tobacco users. Conclusions In England, expenditure among e-cigarette and nicotine replacement therapy users is approximately one-third of the expenditure of smokers. The average smoker may save an estimated 15.06 pound per week by switching completely to e-cigarettes or 13.04 pound per week by switching to nicotine replacement therapy, although this is likely to differ according to individual usage patterns.