Introduction:
In the last five years, there has been a dramatic shift in the types of nicotine products being purchased. This study aimed to estimate how much users spend on types of cigarettes and alternative nicotine products (e-cigarettes, nicotine replacement therapy (NRT), heated tobacco, nicotine pouches) and describe changes between 2018 and 2022. /
Methods:
Monthly representative cross-sectional survey in England. 10,323 adults who smoked cigarettes or used alternative nicotine reported their average weekly expenditure on these products, adjusted for inflation. /
Results:
Smokers spent £20.49 [95%CI=20.09-20.91] on cigarettes each week (£27.66[26.84-28.50]/£15.96[15.49-16.28] among those who mainly smoked manufactured/hand-rolled cigarettes), e-cigarette users spent £6.30 [5.99-6.55] (£8.41[7.17-9.78]/£6.42[5.58-7.39]/£5.93[5.64-6.30] among those who mainly used disposable/pod/refillable devices), NRT users £6.11 [5.53-6.69], and heated tobacco users £13.87 [9.58-20.09]. Expenditure on cigarettes grew by 10% September-2018 to July-2020, then fell by 10% July-2020 to June-2022. These changes coincided with a 13% reduction in cigarette consumption and a 14% increase in the proportion mainly smoking hand-rolled cigarettes. Expenditure on e-cigarettes was stable between 2018 and late-2020, then rose by 31% up to mid-2022. Expenditure on NRT increased slowly 2018-2020 (+4%) and more quickly thereafter (+20%). /
Conclusions:
Inflation-adjusted expenditure on cigarettes has fallen since 2020, such that the average smoker in England currently spends the same on cigarettes each week as in 2018. This has been achieved by smoking fewer cigarettes and switching to cheaper hand-rolled cigarettes. Expenditure on alternative nicotine has increased above inflation; users spent around a third more on these products in 2022 than between 2018–2020. /
Implications:
People in England continue to spend substantially more on smoking cigarettes than using alternative nicotine products. The average smoker in England spends around £13 a week (~£670 a year) more than people using only e-cigarettes or nicotine replacement therapy. The average expenditure on manufactured cigarettes is double that of hand-rolled cigarettes
