BACKGROUND: Bolivia is a developing country with widespread illicit trade across most consumer goods. Additionally, Bolivia shares borders with Paraguay—a country frequently involved in the illicit trade of cigarettes in Latin America. The objective of this study was to analyse cigarette consumption patterns and estimate, for the first time, the penetration rate of illicit trade in four Bolivian cities through a smoker survey. Consumption patterns included smoking intensity, brand, price, packaging, purchase location, flavoured cigarette use, and electronic cigarette consumption.
METHODS: A stratified smoker survey by sex and city used high-traffic data and household surveys for sampling. Self-reported smoking behaviours, socioeconomic data, and type of purchase were collected. Participants identified whether their last purchase involved loose cigarettes or a full pack. Cigarette pack photographs were also taken when available. The sample included 2,366 smokers (18+ years, all income levels) from La Paz, El Alto, Cochabamba, and Santa Cruz, representing 75% of urban smokers (2021). The margin of error was 5%, with a 95% confidence level. Illicit cigarettes were identified based on brand, health warnings, and price.
RESULTS: Illicit trade accounted for 37% of cigarette consumption in the four cities, with nearly all illicit products originating from Paraguay. Significant variations in the penetration of illicit trade were observed between Santa Cruz (54%) and the other cities, where rates ranged from 10% in La Paz and El Alto to 14% in Cochabamba. Additionally, the survey revealed a high penetration of flavoured cigarettes in the Bolivian market, exceeding 60% of the market share.
CONCLUSIONS: City-specific differences in illicit trade cannot be attributed solely to uniform factors like taxation. Proximity to Paraguay, law enforcement, and cultural patterns likely play a role. The pervasive presence of flavoured cigarettes—among the highest in Latin America—calls for immediate regulatory action to curb their expansion.