Are Retail Prices Higher for Legal or Illicit Cigarettes?
An Analysis in 14 Low- and Middle-Income Countries
Joanna Cohen, PhD, Jennifer Brown, MPH, Rajeev Cherukupalli, PhD, Carmen Washington, MPH, Jacqueline Ferguson, MHS, Katherine Clegg Smith, PhD
Background
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Results
Illicit trade of tobacco products is a global problem that undermines tobacco
control policies.
There is limited information on the purchase price of illicit cigarettes, especially in
low- and middle-income countries (LMICs).
We examined differences in mean purchase price of legal and illicit cigarettes in 14
low- and middle-income countries.
4.51
Mean Purchase Price of Illicit and Legal Cigarettes (USD)
3.72
Illicit
3.37
Legal
3.38
3.08
2.87
Methods
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1.96
Purchase Price:
USD 1.09
Purchase Price:
USD 1.52
1.92
1.72
1.61
$2.04
$2.22
$2.30
$1.33
$1.43
$1.43
$3.35
$3.35
$3.06
1.46 1.50
1.47
1.46
1.41
1.65
Bought in
Viet Nam
1.21
0.94
0.87
0.95
n/a
n/a
Bought in
Bangladesh
$2.57
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$8.08
0.68
0.36
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Example of
illicit pack:
HWL NOT from
Viet Nam
2.90
2.83
2.83
Bought in
Pakistan
2.29
Cigarette (n=3,017) and kretek (n=224) packs systematically purchased in 14
countries in 2013
Three purchase cities selected in each country, based on population size and
diversity
Per city, 12 vendors selected from low-, middle- and high-socioeconomic areas
Per country, bought one of every unique cigarette pack; purchase price recorded
Pack categorized as ‘legal’ or ‘illicit’ based on presence of country’s health warning
label (HWL)
High correlations between correct tax stamp and having HWL from that country
(R=0.97-1.00, n=8)
Prices of cigarettes scaled to 20 sticks; prices converted to USD for comparison
Mean purchase price of legal and illicit packs calculated; t-tests assessed
differences in mean purchase price by legal status
Example of legal
pack: HWL from
Viet Nam
Examples of Illicit Packs from Countries Where the Mean
Purchase Price of Legal Packs in our Sample was <1 USD
(Purchase Price (USD))
Overall, 24 percent of the 3,241 cigarette and kretek packs purchased were deemed to be illicit,
ranging from none in Brazil and Indonesia to 81 percent in Pakistan.
Mean sticks per pack was 18-20, except for India and Indonesia (mean=15)
Mean purchase price of legal cigarettes was higher than for illicit cigarettes in: Mexico, Turkey
and Ukraine (p<0.05)
Mean purchase price of illicit cigarettes was higher than for legal cigarettes in: Bangladesh,
Egypt, India, Pakistan, Philippines, Thailand and Viet Nam (p<0.05); in these countries, the
difference in mean retail price, controlling for sticks per pack, ranged from US$0.80 (Viet Nam) to
US$2.01 (Bangladesh)
Three of the four countries that had the largest proportion of illicit packs in our sample had very
low prices of legal cigarettes – under 1 USD.
Acknowledgements: This work was supported by a grant from the Bloomberg Initiative to Reduce Tobacco Use to the Johns Hopkins Bloomberg School of Public Health; Conflicts of Interest : None
www.globaltobaccocontrol.org/tpackss
$3.35
Discussion
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Mean retail price was higher for illicit than for legal cigarettes in
the six countries where illicit packs comprised ≥25 percent of
packs purchased, and in Egypt (5 percent illicit packs).
Presence of a domestic health warning label appears to be a
good proxy of legal, tax-paid cigarettes.
This is the first study to systemically assess the relationship
between price and pack legal status in 14 LMICs; further
research should confirm these findings using other methods of
pack collection.