Abstract:
Background: Consumption of illicit cigarettes poses a serious threat to public health as well as being a source of huge losses in government revenues. It brings tobacco onto the market cheaply, making cigarettes more affordable and thus stimulating consumption, especially among the youth group, consequently increasing the burden of ill-health. Illicit cigarette sabotages national tobacco taxation and tobacco control strategies and has become a major concern for governments and international organizations. Therefore, it is important to understand this problem thoroughly in order to reduce it. The high magnitude of illicit cigarette trade in southern Thailand offers an opportunity to examine the situation of illicit cigarette consumption. Objectives: To investigate behaviours and factors associated with illicit cigarette consumption in southern Thailand. Methodology: A survey and qualitative study were conducted in a border province in southern Thailand next to Malaysia. A modified snowballing technique was used to recruit 300 illicit and 150 non-illicit cigarette smokers. A structured questionnaire was used to interview subjects. Smoking behaviours and associated factors with illicit cigarette consumption were analysed by complex survey regression adjusted for a cluster of samples identified by each recruiter. Qualitative results by content analysis are presented to reveal the situation of illicit cigarette consumption in southern Thailand. Results: Smoking of illicit cigarettes has spread from border areas and the trade centres to rural areas in southern Thailand. It has become accepted in the communities, and the availability and accessibility of illicit cigarettes in supermarkets has made them easy to purchase. Friends and other illicit smokers were the key component for access and source of information. The main factors associated with smoking illicit cigarettes, compared to smoking non-illicit cigarettes, were younger age, higher education, higher average monthly expenditure on cigarettes, and number of other illicit cigarette smokers known. The low price of illicit cigarettes was the main reason for illicit cigarette use. Selling strategies included low price, sale in individual sticks, sale in shops, and direct sale through social networking. Conclusions: Illicit cigarette consumption is still a hidden public health risk problem, especially among youth and young adults. The challenge will be to find ways to control it.
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