BACKGROUND AND IMPLEMENTATION CHALLENGES: Illicit tobacco undermines effective tobacco control. Tobacco can be cheap and easily available in communities which already have high smoking rates, keeping people addicted and enabling children to afford cigarettes.

There is strong national action on illicit tobacco but action is also needed and delivered at sub-national levels to address the ongoing challenge of availability. This requires partnership working between local and regional regulatory teams and those working in public health.
INTERVENTION OR RESPONSE: Fresh is the North East of England’s regional tobacco control programme funded by local government and regional health partners. Since its launch in 2005, Fresh has worked closely with local and regional regulatory teams and the national revenue department. In 2006, it pioneered strategic partnership working on tackling illicit tobacco. Evaluation showed this was an ‘exemplar of partnership working’ which ‘should be rolled out nationally’.

This approach is encapsulated in a strategic framework of eight key strands for reducing supply and demand within broader tobacco control programmes:

1. Developing partnerships
2. Engaging frontline workers
3. Generating intelligence
4. Delivering enforcement
5. Marketing and communications
6. Working with businesses
7. Protecting policies from the tobacco industry
8. Assessing progress.

RESULTS AND IMPACT: Delivery of the framework has resulted in ongoing sustained action to address illicit tobacco. The North East of England region has developed strong partnerships between health, regulation and the revenue department, resulting in the delivery of insight-led demand reduction campaigns, generating over 14,000 intelligence reports for use by enforcement partners since 2017, biannual tracking of the illicit tobacco market, active enforcement and successful collaboration. It is currently estimated that the illicit market in the region is 14% though enforcement action suggests that it still remains a problem in some areas.

All activity complies with WHO FCTC Article 5.3 guidelines.
CONCLUSIONS: The strategic framework for illicit tobacco supports partnership working and can be applied at all levels.