Background In Uruguay, real tobacco taxes increased significantly during 2005–2010 and 2014–2017 and decreased during 2010–2014. The effects of these tax changes on illegal and legal cigarette usage differed significantly when we compared cities in the middle and south of the country with cities on the border.
Objective This paper analyses whether supply side factors such as geographical location, distribution networks and the effectiveness of tobacco control play a significant role in sales and use of illegal cigarettes when tobacco taxes change, particularly given the price gap between legal and lower-priced illegal cigarettes.
Methods Using the International Tobacco Control Evaluation Project Uruguay Survey data (2008, 2010, 2012 and 2014), choices among illegal, legal and roll-your-own cigarettes are estimated as a function of smokers’ geographical location, an indicator of illegal cigarette supply, and controlling for socioeconomic and demographic variables. Smoking behaviours in Montevideo, Durazno and Maldonado were compared with those in two border cities, Salto and Rivera, where illegal cigarette prevalence may differ.
Findings An increase in taxes on manufactured legal and roll-your-own cigarettes increased the odds that smokers in cities near the borders and women switched down to illegal cigarettes. City geographical location, controls effectiveness and distribution networks may play a significant role in accessibility of illegal cigarettes. To improve the effectiveness of increased taxes and prices in reducing smoking, policy-makers may consider specific policies intended to reduce access to illegal cigarettes, such as ratification and effective implementation of the Protocol to Eliminate Illicit Trade in Tobacco Products of WHO.
- Illegal tobacco products
- roll-your-own (RYO) tobacco
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Contributors DC, CS, FJC and GTF planned the work as described in the article. DC and CS conducted the analysis, wrote the draft and reported the work after discussion with other authors. DC is responsible for the overall content as guarantor.
Funding The ITC Uruguay Project was supported by grants P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center) and P01 CA138389 from the US National Cancer Institute, International Development Research Centre (IDRC), and Canadian Institutes of Health Research (115016, 118096 and FDN 148477). Additional support was provided to Geoffrey T Fong from a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute. Additional support in preparing this paper was provided to University of Waterloo by the Canadian Institutes of Health Research (FDN-148477).
Competing interests None declared.
Patient consent Not required.
Ethics approval Office of Research Ethics, University of Waterloo, Canada and International Research Board, Universidad de la Republica, Uruguay.
Provenance and peer review Not commissioned; externally peer reviewed.
Collaborators Anne Chiew Kin Quah.
Correction notice This article has been corrected since it was published Online First. Additional details of funding have been added.
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