The impact of tobacco control policies on illicit tobacco trade: A scoping review

Abstract

ABSTRACTIntroductionThere are concerns that progressively stringent tobacco control policies will result in increased illicit tobacco trade (ITT). We reviewed the international evidence base to identify studies examining the impact of tobacco control polices on ITT.MethodsGuided by JBI scoping review methodology, we searched six databases (PubMed, CINAHL, EMBASE, PsycINFO, Scopus, and Web of Science) in 2022 and 2024 for original research published in English since 2000. One reviewer screened titles and abstracts, and two reviewers screened full-text articles against inclusion criteria. We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews Checklist.ResultsWe identified 60 articles examining the impact of eight tobacco control policies or combination of policies on the ITT, including tobacco tax increases or decreases (n=43); menthol bans (n=5); decreasing allowable cigarette filter ventilation levels (n=1); standardised packaging (n=5); tobacco sales bans (n=1); a substantial reduction in the number of tobacco retailers (n=1); a very low nicotine content mandate (VLNC; n=2); and multicomponent policy interventions (n=4).ConclusionsThe available evidence is predominantly focused on the impact of tobacco tax increases on the ITT, with equal numbers of studies describing an increase in the ITT or no impact on the ITT, countering claims that tobacco tax increases are the primary driver of increased ITT. Evidence on the impact of other tobacco control policies on the ITT is limited. Collaborative efforts to develop accurate and consistent methods to assess the ITT are needed.ImplicationsTo our knowledge, this scoping review is the first to synthesise the available evidence on the association between multiple tobacco control policies and ITT. Findings suggest that evidence for the association between tobacco tax increases and ITT is mixed, with an equal number of studies (n=18) describing an increase or no impact of this policy on ITT. Evidence for the impact of other policies was limited; the only policies with some evidence for increasing the ITT include tobacco sales bans (n=1), a concurrent tobacco sales and smoking ban (n=2), and a hypothetical VLNC standard mandate (n=2).