Background:
Youth as young as five years old pick tobacco and are denied an education and basic food requirements in Malawi's tobacco growing sector. Children and adults are trafficked to tobacco farms both within Malawi and in neighboring countries of Zambia, Tanzania and Mozambique. Tobacco workers and their families remain impoverished through tobacco company practices such as collusion over leaf prices and unfair contract arrangements with tobacco companies. The study of trafficked persons requires a critical approach to sensationalized "modern day slavery" narratives that circulate in tobacco control and human rights discourses.

Methods:
A structured questionnaire was administered to 40 farmers and farm workers for health, social and economic information. We conducted content analysis of national and regional newspapers and interpretive narrative analysis of in-depth ethnographic interviews with five tobacco farmers and farm workers.

Results:
A representative case of trafficking involves a man, his wife and two children who receive from an illegal labor recruiter a promise of paid work. Labourers are transported over 800 kilometers. Ultimately, parents send their children to the fields instead of schools and the family remains indebted to the farm owners due to insufficient or non-payment of earnings. Farm owners sell their tobacco to global leaf buyers who, in turn, sell to companies such as Philip Morris. Most study participants indicated they have no finances to exit tobacco farming or return to home. Some individuals acknowledge their workplace dissatisfaction while others are determined to stay on with plans to be independent tobacco farmers.

Conclusions:
Trafficked persons and forced labourers respond in diverse ways to their conditions. An informed approach to labor trafficking seeks to improve health outcomes for workers and challenge tobacco industry behavior that perpetuates exploitation. Global tobacco control needs counter-narratives of tobacco farm workers as resilient and courageous, instead of as victims and targets of policymaking.