A pioneering programme to tackle the use of illicit tobacco in the North of England has had a positive impact and offers a blueprint for similar programmes both nationally and internationally, research by the UK Centre for Tobacco Control Studies has shown.
‘Tackling Illicit Tobacco for Better Health’ is a pilot scheme which was launched in 2009 to improve the health of people in the North West, North East and Yorkshire and Humber by trying to reduce the supply of and demand for illegal cigarettes and tobacco.
Prior to the pilot programme, illegal tobacco was mainly the responsibility of Her Majesty’s Revenue & Customs (HMRC) which focused principally on tackling supply. The new scheme has been the first large-scale attempt to cut public use of black market tobacco using healthcare agencies as well as enforcement, groundbreaking social marketing campaigns and intelligence-generating initiatives.
The UK Centre for Tobacco Control Studies was commissioned to deliver a verdict on the impact of the programme using a multi-disciplinary research team from the Universities of Nottingham, Durham, Stirling, Northumbria and University College London.
Leading the evaluation, Professor Ann McNeill, said: “Our research shows that ‘Tackling Illicit Tobacco for Better Health’ has had a measurable effect on the problem in the North of England. It was the first programme to develop a comprehensive approach to tackling the demand for and the supply of illicit tobacco in communities through the development of partnerships between health and enforcement agencies. We have concluded that the scheme is an exemplar of partnership working and should now be widely disseminated.”
'Elephant in the room'
Dr Andrew Russell, who led the ethnographic elements of the evaluation from Durham University, said: “Illicit tobacco was very much the ‘elephant in the room’ of tobacco control before the programme began. It was a big problem making the economic levers that might otherwise discourage people from smoking much less effective, thus adding to the weight of health inequalities and socio-economic disadvantage that smoking creates. Individual agencies working alone were finding the problem extremely hard to address. ‘Tackling Illicit Tobacco for Better Health’ has informed many more people than before about the true nature of the elephant and the social harm it is causing.”
Blowing the whistle
The study found that the programme was associated with significant increases in intelligence reports and indications of a promising reduction in demand for illicit tobacco. Two websites set up by the campaign attracted a great deal of interest and a social marketing campaign Get Some Answers appears to have widened the impact of the key messages of health promotion, the risks to young people and how the criminality surrounding illicit tobacco affects local communities on a daily basis.
There was also a substantial increase in intelligence reports to Crimestoppers during the campaign period. Calls in the North East and North West more than tripled and calls to the Customs Hotline also increased steadily across the three regions during the period.
Proof of effectiveness
Surveys carried out in 2009 and 2011 showed the proportion of smokers buying illegal tobacco fell by 10% overall (by 2 percentage points from 20% to 18%) and particularly among those aged 16-34 years old. Awareness of illegal tobacco among non-smokers increased by 15% and the proportion of smokers who felt ‘uncomfortable’ with illicit tobacco rose by 4%. The proportion of people reporting that they were likely to report someone selling illicit tobacco increased by three percentage points to 29%.
Judith Kelly, HRMC Head of Tobacco Strategy commented: “The programme has shown that partnership working can be effective in directly targeting those involved in the illicit tobacco trade, and that it can also have a significant impact on public awareness of this crime and in changing attitudes to illicit tobacco. It is clear that there is real public concern about illicit tobacco and HMRC will continue to work with other enforcement agencies and local authorities to punish more individuals involved in this illegal activity.”
Professor McNeill added: “This research also substantiates HMRC data that illicit tobacco use is not increasing. The tobacco industry is countering new tobacco control measures such as the introduction of plain packaging by arguing that it will increase illicit tobacco use. The continuing implementation of HMRC strategies and programmes like this one demonstrate, in contrast, that illicit tobacco use can be controlled.”
Professor Paul Johnstone, Director of Public Health for NHS North of England, said: “All tobacco is harmful and it’s still our biggest public health challenge. But we know that the easy availability of illegal tobacco which is sold at half or a third of the legal retail price encouraged people to keep smoking and smoke more, and makes it easier for children and young people to smoke. That’s why from a health point of view we were keen to work with others to tackle illegal tobacco, and the progress so far has been really encouraging, but we need to maintain the momentum.”
Deborah Arnott, Chief Executive of Action on Smoking and Health (ASH) said, “The North of England anti-smuggling programme has been a notable success, one which must be replicated throughout the UK if we are to build the partnerships needed to marginalise and eradicate the illicit trade in tobacco”.
The researchers stress that the achievements of ‘Tackling Illicit Tobacco for Better Health’ are all the more notable considering it was carried out in a period of recession and cuts to staff and resources in the agencies taking part over the past three years.
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The Executive Summary for the evaluation can be found at: www.ukctcs.org/ukctcs/research/featuredprojects/index.aspx
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About the Programme: Agencies involved in the development of the North of England Tackling Illicit Tobacco for Better Health programme include regional public health organisations (including Tobacco Free Futures (formerly Smokefree North West), Fresh (Smoke Free North East), and Smokefree Yorkshire & the Humber), HMRC, trading standards groups, local authorities, the Association of Chief Police Officers, local police forces, the Serious and Organised Crime Agency and the newly formed UK Border Agency.
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