Association of Financial Distress and Monthly Income with Smoking During the COVID-19 Pandemic Recession in Thailand: A Nationwide Cross-Sectional Study

(1) Background: Psychological distress causes increased smoking frequency. Thus, financial distress (FD), a type of psychological distress, during the COVID-19 pandemic recession is possibly associated with increased smoking frequency. We studied the association between disrupted employment or earnings-associated FD and the number of cigarettes smoked daily, as well as the effects of pre-pandemic regular monthly incomes on the association. (2) Methods: We retrieved the collected data from a former nationwide and community-based study regarding the psycho-socio-economic characteristics of Thai people during the third wave of the COVID-19 pandemic in Thailand in 2021. The participants for this study were current smokers aged ≥ 18 years. General demographics, perceived FD, and pre-pandemic regular monthly incomes were analyzed. Descriptive statistics and multivariate logistic regression with sampling weight adjustments were the analyses used (<i>p</i> < 0.05). (3) Results: 849 current smokers were suitable for statistical analyses. We found that 664 (12.9%) of participants experienced FD, but it did not significantly affect smoking frequency. However, those who had FD and regularly earning ≥ THB 10,000 ($271.11 US) per month was significantly associated with increased daily cigarette use, after adjusting for age and sex (adjusted OR = 2.74; 95% CI = 1.18, 6.37, <i>p</i> = 0.020). (4) Conclusion: FD alone did not affect daily smoking frequency. Understanding the psycho-socio-economic factors is necessary for smoking control during the COVID-19 economic recession.