The Illicit Trade Debate: Why the Tobacco Industry Distorts What Truly Protects Public HealthEconomic and Health Policy Research, American Cancer Society
A strange argument has consistently arisen when people discuss the illicit trade in tobacco products: the tobacco industry, private research firms, some public health advocates, many law enforcement officials and certain regulatory agencies have all claimed that illicitly-traded cigarettes are more unhealthy than legally sold cigarettes, and therefore pose a greater threat to the public health. But this claim is hollow. It lacks scientific grounding and it serves as yet one more decoy argument in the tobacco control policy debate. Using this argument has troubling implications for public health messaging.
The “illicit cigarettes pose a threat to the public health because they are more unhealthy” argument implies that if people simply substituted smoking legal cigarettes for illicit cigarettes, then that would benefit their personal health, and subsequently the public health. Such an assumption is wrong because it ignores the fact that almost all illicit cigarettes were made by the same tobacco companies arguing that illicit cigarettes are more unhealthy than legal cigarettes. It also implies that the contents of legal cigarette products are regulated in the interest of protecting the public health, while illicit cigarettes are not.
This argument is a distraction from the best anti-illicit trade strategy available: strong tobacco control policy measures and enforcement.
We will address this claim and conclude, as always, with our signature call to action.
Almost all illicit cigarettes were made by the same tobacco companies that argue that illicit cigarettes are more unhealthy than legal cigarettes.
The large majority of the world’s illicit cigarettes were legal somewhere else before they became illicit. Government seizures indicate, academic studies confirm, and the tobacco industry even admits this fact in their own communications to investors.
Most illicit cigarettes are not counterfeits manufactured by shadowy criminal outfits. The vast majority of illicit cigarettes are legally manufactured by the same tobacco companies that claim to be harmed by the illicit trade in cigarettes.
In reality, the major international tobacco companies have been repeatedly implicated as facilitators, or at least knowing co-facilitators, of the illicit trade in cigarettes. Yet, tobacco companies continue to warn that illicit cigarettes do not meet health standards when they lobby against effective tobacco control measures. In Poland in 2011, JTI claimed:
“The further increase in trading of smuggled and counterfeit cigarettes, which do not meet any of the Polish health requirements, obviously do not help to meet the country’s goals (both health and fiscal), but it contributes to development of new organized-crime groups that produce or distribute illegal products.”
If the tobacco industry wants to seriously exclaim that illicitly-traded cigarettes pose a risk to public health because they do not meet health regulations in a certain country, then they have the ability to globally change their products’ contents to match the strictest national regulations. They make the illicit cigarettes after all. But this quandary begs us to ask, what could a government regulation make a tobacco company change in their cigarette to make it healthier?
This brings us to a closely related industry claim.
In another fundamentally misleading claim about the relative dangers of legal vs. illicit cigarettes, the industry claims that legal cigarette manufacturing is currently heavily regulated, while illicit cigarettes are manufactured by criminal outfits that will produce a cigarette that is more unhealthy than a legal, regulated product. This claim also fails to stand up even to cursory scrutiny.
While a few valid scientific studies have found that there are higher levels of various harmful constituents in seized counterfeit cigarettes than in legal cigarettes (e.g. Ribisl, 2012 cites three such studies), after performing an exhaustive literature search, we could not find a single longitudinal study that attempted to look at the difference in health outcomes between being exposed to illicit versus to legal cigarettes. There simply isn’t any substantiated evidence to show that legal cigarettes are less unhealthy to smoke than illegal cigarettes, but health warnings about unregulated illicit cigarettes persist. Health agencies have warned that illicit cigarettes contain dangerous substances including sawdust, rat feces, and asbestos. Commercial market research firms, such as Euromonitor International, repeat these messages:
“Illicit products, particularly counterfeit, are often produced in secret, or underground purpose-built factories to very low manufacturing standards and have been shown to contain potentially dangerous materials beyond those found in legally manufactured cigarettes. As such, prevalence of illicit trade is a threat to public health (beyond that posed by legal cigarette consumption) through the potential of poisoning or inhalation of toxins.”
These claims miss a central truth about why tobacco use harms human health: TOBACCO. To call the current tobacco product manufacturing “heavily regulated” is ridiculous. The fact that every single legally sold cigarette on the planet is permitted to contain more than 60 substances that are definitively proven to cause cancer, and that smoking even the lightest of so-called “light cigarettes” raises a smoker’s chance of being stricken with lung cancer by 2000%, debases any meaning of “heavily regulated.”
The tobacco industry’s internal communications have acknowledged that their exclamations to the public that counterfeit or illicit cigarettes contain arsenic and radioactive chemicals are disingenuous because their own legal cigarettes also contain those very same poisonous substances. In reality, in the vast preponderance of countries, the product contents of legally manufactured cigarettes are not currently regulated in a manner that is meaningful to the health of their consumers. Doing so would likely require extracting the tobacco leaf itself, from the cigarette. We do not expect any current regulation of cigarette product contents that would limit machine-measured tar content, remove flavorings, or even prevent the use of unclean tobacco, to improve the health outcomes of people using such regulated products compared to those who use unregulated products. Some of these regulatory changes – such as bans on flavorings – will likely help to decrease youth initiation of smoking and perhaps even improve smokers’ success rates in quitting, but none will change the disease course of a lifelong smoker. A small number of countries, including Canada and Brazil, are trying to regulate the product in this way, and while their efforts are commendable, the practice is still in its infancy as a regulatory strategy.
Tobacco products have, by way of intensive industry effort, carved out a unique place in the consumer product regulatory structure. Cigarettes are the only legal consumer product that, if used as suggested by the manufacturer, will kill more than half of its users. Finding a solution to fix this problem is fundamental to the burgeoning field of tobacco regulatory science, but consuming legal cigarettes instead of illicit cigarettes will not ensure that a consumer’s health is better protected by government regulation of their cigarette’s product contents.
Call to Action
We could critically analyze each scientific study that is trotted out to make the case that illicit cigarettes are more unhealthy for smokers than legal cigarettes, but doing so plays exactly into the tobacco industry strategy of creating a diversion from the proven tobacco control strategies to which we should be allocating time and resources to promoting.
We must emphasize that the illicit trade in tobacco products undermines all tobacco control policies. We ask policymakers to take the problem of illicit trade seriously, but to be wary of the “illicit cigarettes are more unhealthy” argument because it is fundamentally misleading. Instead, we must redouble our existing efforts on cornerstone tobacco control policies including raising tobacco excise taxes; banning tobacco advertising, promotion and sponsorship; implementing graphic warning labels on tobacco packaging; and making sure all public areas and workplaces are smoke-free as well as those that children frequent.