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Socioeconomic and country variations in cross-border cigarette purchasing as tobacco tax avoidance strategy. Findings from the ITC Europe Surveys
  1. Gera E Nagelhout1,2,
  2. Bas van den Putte3,
  3. Shane Allwright4,
  4. Ute Mons5,
  5. Ann McNeill6,
  6. Romain Guignard7,
  7. François Beck7,8,
  8. Mohammad Siahpush9,
  9. Luk Joossens10,
  10. Geoffrey T Fong11,12,
  11. Hein de Vries1,
  12. Marc C Willemsen1,2
  1. 1Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
  2. 2STIVORO Dutch Expert Centre on Tobacco Control, The Hague, The Netherlands
  3. 3Department of Communication, University of Amsterdam (ASCoR), Amsterdam, The Netherlands
  4. 4Department of Public Health and Primary Care, Trinity College Dublin, Tallaght, Ireland
  5. 5Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
  6. 6UK Centre for Tobacco Control Studies, King's College London, London, UK
  7. 7French Institute for Health Promotion and Health Education (INPES), Saint-Denis, France
  8. 8Cermes3—Cesames team (Research Centre Medicine, Sciences, Health, Mental Health, Health Policy), CNRS UMR 8211, Inserm U988, University of Paris Descartes, Sorbonne Paris Cité, EHESS, Paris, France
  9. 9Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
  10. 10Foundation Against Cancer, Association of European Cancer Leagues, Brussels, Belgium
  11. 11Department of Psychology, School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  12. 12Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  1. Correspondence to Gera Nagelhout, STIVORO Dutch Expert Centre on Tobacco Control, PO Box 16070, The Hague 2500 BB, The Netherlands; gnagelhout{at}


Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing.

Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries.

Methods Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often.

Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2–7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country.

Conclusions Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing.

  • Economics
  • Socioeconomic status
  • Taxation

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