BACKGROUND: Colombia has some of the lowest cigarette prices in the Americas, and tobacco use is a significant public health concern among Colombians, contributing to nearly 4% of annual deaths and ranking as the second leading modifiable risk factor for mortality. Taxation represents one of the most cost-effective strategies for reducing tobacco consumption, yet the tobacco industry opposes such policies, contending that higher taxes will exacerbate illicit tobacco trade (ICT). The country implemented a tobacco tax reform in 2016, and a new tax increase is currently under consideration. Consequently, this study aims to monitor the prevalence of ICT in Colombia to inform the performance of the controlling tobacco policies
METHODS: A cross-sectional survey was conducted from June to July 2024 across five Colombian cities, which collectively account for 56.1% of the country's smokers. Participants were selected using stratified sampling, divided by sex and age into ten distinct strata, ensuring enhanced geographical representation. Cigarettes were classified as licit or illicit based on current Colombian legislation.
RESULTS: The study found that the prevalence of ICT was 10% based on smokers and 21% based on cigarette packs, ranging from 77% in Cúcuta to 12% in Bogotá. Among the illicit packs, 53.1% lacked identifiable origin, while 42% were marked as originating from the USA, primarily linked to the leading illicit brand, Rumba. ICT was associated with older age, lower education, and heavy smoking. Flavor was the primary factor influencing cigarette purchases, while 13% of consumers considered price a key factor.
CONCLUSIONS: ICT increased compared to prior research, even in the absence of recent tax increases. Implementing heightened tobacco taxes alongside complementary strategies to regulate ICT could enforcement the control tobacco policies and contribute to reducing tobacco use.