Belinda Iringe-Koko, Ann McNeill, Robert West and Andy McEwen
Presenter(s)
Belinda Iringe-Koko PhD Researcher, University College London
Abstract
Background:
For many years the use of illicit tobacco, smuggled and counterfeit, has been prevalent in the UK. With high tobacco taxes proven to be the most effective policy to encourage smokers to quit, it has been hypothesised that the existence of the illicit tobacco market undermines this policy by providing cheap tobacco which encourages smokers to continue to smoke. It is important that this is investigated in an English population as if found to be the case, could carry significant consequences for smoking cessation efforts in England.
Aims:
This study aimed to determine whether reported use of illicit tobacco was associated with no motivation to quit smoking or having made a quit attempt in the past year.
Methods:
National household surveys were undertaken in 2007-8, 2010-11 and 2012 on use of illicit tobacco, motivation to stop smoking and making a quit attempt.
Results:
Of the total sample, 4% (n=273; 95% CI 3.5 – 4.5) reported exclusive illicit tobacco purchase, 9% (n=611; 95% CI 8.3 – 9.7) used both duty paid and illicit tobacco sources and 87% (n=5892; 95% CI 86.0 – 87.8) purchased duty paid tobacco only. Compared with smokers who reported exclusive duty paid tobacco or cigarette purchase, smokers who purchased illicit tobacco only were more likely to smoke RYO tobacco, be older, male, with low socio-economic status and have high tobacco dependence.
Smokers who reported exclusive illicit tobacco purchase had a mean motivation score of (3.0; SD = 1.9) compared with exclusive duty paid tobacco purchasers (3.6; SD = 2.1) (F (2, 5765) = 11.4; p<0.001). Among exclusive illicit tobacco smokers, 26.6% (n=73; 95% CI 21.4 – 31.8) made a quit attempt in the past year, compared with those who purchased duty paid tobacco only (31.6%; n = 1858; 95% CI 30.4 – 32.8) (χ2 = 5.49, df = 2; p=0.064). Smokers who purchased illicit tobacco exclusively had lower motivation to quit smoking compared with those who purchased duty paid tobacco only (OR = 0.86; 95% CI 0.81 – 0.93); p<0.001). There was no significant association between illicit tobacco purchase and having made a past quit attempt.
Conclusions:
Smokers who reported illicit tobacco use had reduced motivation to quit smoking compared with duty paid tobacco users. However, illicit tobacco use does not appear to undermine quitting. Illicit tobacco users being less motivated to stop smoking is possibly as a result of their ability to access cheap tobacco which eliminates the financial motivation to quit, thereby jeopardising their quit attempts and encouraging their continued smoking. In order to promote successful smoking cessation in this population, limiting the supply of illicit tobacco as well as more targeted interventions is recommended.
Source of funding: Cancer Research UK Lynn MacFayden Studentship in Tobacco Control
