Attitudes And Exposure To Illicit Tobacco In England, 2022

Nathan Davies; Tessa Langley; Leah Jayes; Manpreet Bains; Jamie Brown; Deborah Arnott; Ilze Bogdanovica

doi:10.1093/ntr/ntae118

Attitudes And Exposure To Illicit Tobacco In England, 2022

Nicotine Tob Res. 2024 May 16:ntae118. doi: 10.1093/ntr/ntae118. Online ahead of print.

Authors

Nathan Davies¹, Tessa Langley², Leah Jayes³, Manpreet Bains⁴, Jamie Brown⁵, Deborah Arnott⁶, Ilze Bogdanovica⁷

Affiliations

¹ NIHR Doctoral Fellow and Specialty Registrar in Public Health, School of Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
² Associate Professor of Health Economics, School of Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB and SPECTRUM consortium, Edinburgh, EH8 9AG, UK.
³ Senior Lecturer in Public Health, Institute of Health and Allied Professions, Nottingham Trent University, Clifton Campus, Nottingham NG11 8NS, UK.
⁴ Associate Professor in Qualitative and Mixed Methods Health Research, School of Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
⁵ Professor of Behavioural Science, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
⁶ Chief Executive Action on Smoking and Health, The Foundry, 17 Oval Way, London, SE11 5RR. and School of Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB.
⁷ Associate Professor in Public Health, School of Medicine, University of Nottingham, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB and SPECTRUM consortium, Edinburgh, EH8 9AG, UK.

PMID: 38752805
DOI: 10.1093/ntr/ntae118

Abstract

Introduction: The UK has achieved reductions in illicit tobacco (IT) market size and share. However, there remains a 17.7% tobacco duty gap, contributing to health inequalities. In January 2024, the UK government announced a new strategy to control IT, along with provision of new funding.

Methods: A representative cross-sectional survey of adults in England ran in April 2022 to evaluate attitudes and exposure to IT. Tobacco smokers were asked questions about encounters with IT, while all participants answered questions on knowledge and perspectives on IT.

Results: Of 262 tobacco smokers, 18.3% (95% CI 13.8% - 23.6%) had come across IT in the past year. Men had four times the odds of encountering IT recently than women. Among 1,767 adults responding to questions on IT, two-thirds agreed IT harmed children, and more than half agreed IT was linked to organised crime. Younger adults, smokers and those in lower socio-economic groups were less likely to agree IT was harmful.

Conclusions: Exposure to IT, especially among younger males, remains a concern. While most of the public acknowledge its harm, this is not universal, and some population groups are less likely to do so.

Implications: The study highlights persistent exposure to illicit tobacco in England, especially among younger males, and varying perceptions of illicit tobacco harm across socio-economic groups. Tackling illicit tobacco requires collaboration between health and enforcement agencies, independent of the tobacco industry's influence. Strategies should include components that shift demand for illicit tobacco and denormalise its presence in communities, particularly in lower socio-economic areas with higher smoking prevalence.