Smoke signals: monitoring illicit cigarettes and smoking behaviour in Colombia to support tobacco taxes

Background A street cross-sectional survey in 2016 with a representative sample of 1697 smokers in five Colombian cities was used to estimate the penetration of illicit cigarettes (PIC). The first wave was collected 3 months before a 100% increase in tobacco excise tax, and a second wave collected data 9 months after tax reform was effective. Objective Analyse changes after a cigarette tax increase in PIC, prices and smoking behaviour patterns for five Colombian cities (63% of the market). Smoking behaviour includes consumption intensity, presentation (stick/pack) and place of purchase. Methods Repeated street cross-sectional survey with smokers' self-report on smoking behaviour, last purchase information and direct observation of smokers' packs. Sampling frame: smokers, men and women, aged 12 years or older, all income levels, resident in the five cities with the highest number of smokers representing 63% of cigarette market share (Bogota, Medellin, Cali, Cartagena and Cucuta) with 1 733 316 smokers in 2013. Sample size was 1697 per wave, with confidence level 95%, margin of error 3.5% for Bogota and Medellin and 5% for the other three cities. Smokers in second wave match first wave's location, sex and age group. Illicit cigarettes were identified based on brand, health warnings and price. Results After the tax hike, the average real price of a 20-stick pack increased by 28.2% and by 23.1% for loose cigarettes. Illicit cigarettes represented 3.4% of total cigarette consumption in 2016 and increased to 6.4% in 2017, lower than the current industry estimate of 18%. Consumption intensity decreased: the proportion of heavy smokers (more than 10 cigarettes per day) wentdown from 37% in 2016 to 26% in 2017. Conclusion After the tax increase, Colombia's PIC remained at low levels, and there is enough space for new tobacco tax hikes.