Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey

Abstract Background Tobacco use deepens poverty. Egypt, a lower-middle income country, is one of the few countries worldwide where tobacco use is rising. However, no published study examined the adverse impacts of tobacco on the Egyptian household welfare, specifically after the first Egyptian Pound...

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Main Authors: Aya Mostafa, Rasha Saad Hussein
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21676-w
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author Aya Mostafa
Rasha Saad Hussein
author_facet Aya Mostafa
Rasha Saad Hussein
author_sort Aya Mostafa
collection DOAJ
description Abstract Background Tobacco use deepens poverty. Egypt, a lower-middle income country, is one of the few countries worldwide where tobacco use is rising. However, no published study examined the adverse impacts of tobacco on the Egyptian household welfare, specifically after the first Egyptian Pound (EGP) devaluation by 80% in 2016. To address this gap and inform tobacco taxation policymaking, we aimed to provide evidence characterizing national household tobacco expenditure in Egypt. Methods We conducted a secondary analysis of the 2017/2018 Household Income, Expenditure and Consumption Survey, focusing on the most used tobacco products in Egypt: cigarette and waterpipe tobacco. We identified the proportion and background characteristics of cigarette and waterpipe tobacco smoker households. We calculated household tobacco expenditure share as a proportion of total household expenditure. We compared mean household expenditure shares of 12 expenditure groups among smoker and nonsmoker households and examined the differences by income quintiles. We determined the factors associated with household tobacco expenditure. Descriptive, bivariable, and multivariable analyses were performed. Results Cigarette and waterpipe tobacco smokers were present in 41.1% and 7.0% of 12,845 households, respectively. Annual household expenditure on cigarettes (10.7%) was triple that of waterpipe tobacco (3.4%) (p < 0.001). Smoker households spent less than nonsmoker households on virtually all expenditure groups (p < 0.001). The poorest income quintile spent 11.1% of its total expenditure on tobacco (1.26 times higher than the richest, p = 0.006). More waterpipe tobacco than cigarette smoker households lived below the poverty line (40.6% versus 24.4%, p < 0.001). Cigarette smoker households spent less on food and housing but more on tobacco than waterpipe tobacco smoker households. The poorest cigarette and waterpipe tobacco smoker households spent 7.0-9.7 times as much on tobacco as on education. Common independent factors associated with higher household expenditure on cigarettes and waterpipe tobacco were urban residence (p = 0.011 and p = 0.015, respectively), and lower income (p < 0.001). Conclusion In 2017/2018, one-tenth of Egyptian smoker household’s expenditure was allocated to tobacco, disproportionately concentrated among the poorest. Our results preliminarily indicate that tobacco expenditure is associated with potential compromises of varying extent in almost all other expenditures in smoker households. This baseline profiling of household tobacco expenditure can potentially inform an evidence-based tobacco taxation policy, supporting the reduction of tobacco-associated socioeconomic inequalities.
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spelling doaj-art-d31740f06efd43ffab9d3600a8a692ce2025-08-20T02:13:20ZengBMCBMC Public Health1471-24582025-02-0125111810.1186/s12889-025-21676-wTobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption SurveyAya Mostafa0Rasha Saad Hussein1Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams UniversityDepartment of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams UniversityAbstract Background Tobacco use deepens poverty. Egypt, a lower-middle income country, is one of the few countries worldwide where tobacco use is rising. However, no published study examined the adverse impacts of tobacco on the Egyptian household welfare, specifically after the first Egyptian Pound (EGP) devaluation by 80% in 2016. To address this gap and inform tobacco taxation policymaking, we aimed to provide evidence characterizing national household tobacco expenditure in Egypt. Methods We conducted a secondary analysis of the 2017/2018 Household Income, Expenditure and Consumption Survey, focusing on the most used tobacco products in Egypt: cigarette and waterpipe tobacco. We identified the proportion and background characteristics of cigarette and waterpipe tobacco smoker households. We calculated household tobacco expenditure share as a proportion of total household expenditure. We compared mean household expenditure shares of 12 expenditure groups among smoker and nonsmoker households and examined the differences by income quintiles. We determined the factors associated with household tobacco expenditure. Descriptive, bivariable, and multivariable analyses were performed. Results Cigarette and waterpipe tobacco smokers were present in 41.1% and 7.0% of 12,845 households, respectively. Annual household expenditure on cigarettes (10.7%) was triple that of waterpipe tobacco (3.4%) (p < 0.001). Smoker households spent less than nonsmoker households on virtually all expenditure groups (p < 0.001). The poorest income quintile spent 11.1% of its total expenditure on tobacco (1.26 times higher than the richest, p = 0.006). More waterpipe tobacco than cigarette smoker households lived below the poverty line (40.6% versus 24.4%, p < 0.001). Cigarette smoker households spent less on food and housing but more on tobacco than waterpipe tobacco smoker households. The poorest cigarette and waterpipe tobacco smoker households spent 7.0-9.7 times as much on tobacco as on education. Common independent factors associated with higher household expenditure on cigarettes and waterpipe tobacco were urban residence (p = 0.011 and p = 0.015, respectively), and lower income (p < 0.001). Conclusion In 2017/2018, one-tenth of Egyptian smoker household’s expenditure was allocated to tobacco, disproportionately concentrated among the poorest. Our results preliminarily indicate that tobacco expenditure is associated with potential compromises of varying extent in almost all other expenditures in smoker households. This baseline profiling of household tobacco expenditure can potentially inform an evidence-based tobacco taxation policy, supporting the reduction of tobacco-associated socioeconomic inequalities.https://doi.org/10.1186/s12889-025-21676-wTobacco expenditureIncome quintilesPovertyInequalityHouseholdHealth policy
spellingShingle Aya Mostafa
Rasha Saad Hussein
Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
BMC Public Health
Tobacco expenditure
Income quintiles
Poverty
Inequality
Household
Health policy
title Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
title_full Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
title_fullStr Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
title_full_unstemmed Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
title_short Tobacco and household expenditure in Egypt: insights into socioeconomic inequalities and spending profiles from the Household Income, Expenditure and Consumption Survey
title_sort tobacco and household expenditure in egypt insights into socioeconomic inequalities and spending profiles from the household income expenditure and consumption survey
topic Tobacco expenditure
Income quintiles
Poverty
Inequality
Household
Health policy
url https://doi.org/10.1186/s12889-025-21676-w
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