Smoking may worsen malnutrition in developing nations

A new study finds that smokers in rural Indonesia finance their habit by dipping into the family food budget—which ultimately results in poorer nutrition for their children. The findings suggest that the costs of smoking in the developing world go well beyond the immediate health risks, according to authors Steven Block and Patrick Webb of Tufts University.

The study is published in the October issue of Economic Development and Cultural Change.

Using surveys of 33,000 mostly poor households in Java, Indonesia, the researchers found that the average family with at least one smoker spends 10 percent of its already tight budget on tobacco. Sixty-eight percent of a smoking family's budget goes to food, and 22 percent for non-food, non-tobacco purchases. The average non-smoking family, on the other hand, spends 75 percent of its income on food and 25 percent for non-food items.

"This suggests that 70 percent of the expenditures on tobacco products are financed by a reduction in food expenditures," the researchers write.

That decreased spending on food appears to have real nutritional consequences for children of smokers. The study found that smokers' children tend to be slightly shorter for their ages than the children of non-smokers. Height is often used by health researchers as a general barometer for nutrition in children.

The decrease in child nutrition associated with a parent who smokes is "an intuitive but rarely documented empirical finding," the researchers write.

The poorer nutrition in smoking families comes not only because they buy less food in total, but also because the food they buy tends to be of lower quality. The surveys show that, compared to non-smoking families, families with a smoker spend a larger budget share on rice and a smaller share on meats, fruits and vegetables, which are nutrient-rich, but more expensive.

Nearly 60 percent of Indonesian men smoke. Rates are similarly high—and increasing—in other developing Asian nations. Block and Webb's research suggests that these increasing rates pose a dual threat to developing nations.

"The combination of direct health threats from smoking coupled with the potential loss of [food] consumption among children linked to tobacco expenditure presents a development challenge of the highest order," the researchers conclude.

###

Steven A. Block and Patrick Webb, "Up in Smoke: Tobacco Use, Expenditure on Food, and Child Malnutrition in Developing Countries." Economic Development and Cultural Change 58:1. (October 2009)

A multidisciplinary journal of development economics, Economic Development and Cultural Change publishes studies using modern theoretical and empirical approaches that examine both determinants and effects of various dimensions of economic development and cultural change.