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The prevalence of illicit cigarette consumption and related factors in Turkey
  1. Bekir Kaplan1,
  2. Ana Navas-Acien2,
  3. Joanna E Cohen1
  1. 1 Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
  2. 2 Department of Environmental Health Science, Columbia University Mailman School of Public Health, New York City, New York, USA
  1. Correspondence to Dr Bekir Kaplan, Institute for Global Tobacco Control, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St 4th Fl, Baltimore, Maryland 21205-2103, USA; bkaplan9{at}, drbekir_ankara{at}


Background The tobacco industry claims that high cigarette taxes drive illicit trade and that governments should therefore not increase tobacco tax because it will increase the level of illicit trade. This study examines illicit cigarette consumption in Turkey after a tobacco tax increase and its related factors.

Method This national cross-sectional survey was conducted in March-June 2013 and 9717 people aged ≥18 years participated in the interviewer-administered survey. Smokers were asked to show their last used cigarette pack to the interviewers and price paid for their cigarettes. Factors associated with smoking cigarettes with a tobacco tax stamp and paying ≥5 TL (Turkish lira) for a pack of cigarettes were analysed with logistic regression.

Results Among the observed cigarette packs, 12.1% did not have the Turkish tax stamp. More illicit cigarettes were observed in the East region than in other regions (p<0.001). The reported average amount paid for a pack of cigarettes was €2.12 (€2.15 for men and €1.97 for women, p<0.001). The amount paid for cigarettes with a tax stamp (€2.15) was higher than the amount paid for cigarettes without tax stamp (€1.08) (per cigarette pack) (p<0.001).

Conclusion Just over 1 in 10 smokers (12%) had an illicit cigarette pack about 5 months after the final tax increase; this was most common in the East region of Turkey. Estimates are comparable to those in previous studies and do not indicate that an increase occurred in the prevalence of illicit cigarette use compared with before the tobacco tax increase.

  • Illicit Cigarette
  • Prevalence
  • Turkey

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  • Contributors BK contributed to study design, data collection, data analysis, result interpretation and drafting of the manuscript. ANA and JEC contributed to the data analysis, interpretation and drafting of the manuscript.

  • Funding This study was supported by the Ministry of Health of Turkey, General Directorate of Health Research.

  • Competing interests None declared.

  • Ethics approval Zekai Tahir Burak Women’s Health Education and Research Hospital Ethics Committee, with the approval number 82/2012.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Correction notice This paper has been amended since it was published Online First. Owing to a scripting error, some of the publisher names in the references were replaced with ’BMJ Publishing Group'. This only affected the full text version, not the PDF. We have since corrected these errors and the correct publishers have been inserted into the references.