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<p>Tobacco use, a major preventable risk factor for premature death and morbidity, profoundly shapes individual and household decision-making. Tobacco spending in lower-income economies exacerbates economic strain of the households. To accommodate tobacco costs, many households are forced to reduce essential expenditures on health and education—a phenomenon known as the crowding out effect. This study uses data from Albania’s national Household Budget Survey and applies a three-stage least squares method with instrumental variables to estimate Engel curves to shed light on how tobacco use influences household financial decisions. The findings reveal that tobacco spending significantly reduces expenditures on essential needs such as health, education, housing, and clothing. Additionally, tobacco use shows a positive correlation with alcohol spending, revealing another negative influence of an addictive behavior on household resource allocation. The results emphasize the urgent need for stronger tobacco control measures promote better economic decision-making within households. Such measures would enhance public health, improve economic stability, and encourage more equitable resource distribution.</p>

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The dual impact of tobacco spending: crowding out essentials and crowding in addictive behaviors

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年7月9日

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  • Elvina Merkaj,
  • Drini Imami,
  • Jeffrey Drope

摘要

Tobacco use, a major preventable risk factor for premature death and morbidity, profoundly shapes individual and household decision-making. Tobacco spending in lower-income economies exacerbates economic strain of the households. To accommodate tobacco costs, many households are forced to reduce essential expenditures on health and education—a phenomenon known as the crowding out effect. This study uses data from Albania’s national Household Budget Survey and applies a three-stage least squares method with instrumental variables to estimate Engel curves to shed light on how tobacco use influences household financial decisions. The findings reveal that tobacco spending significantly reduces expenditures on essential needs such as health, education, housing, and clothing. Additionally, tobacco use shows a positive correlation with alcohol spending, revealing another negative influence of an addictive behavior on household resource allocation. The results emphasize the urgent need for stronger tobacco control measures promote better economic decision-making within households. Such measures would enhance public health, improve economic stability, and encourage more equitable resource distribution.