Prevalence of smuggled and foreign cigarette use in Tehran, 2009

BACKGROUND Iran is one of two main target markets for tobacco smuggling in the WHO's Eastern Mediterranean Region. The Iranian government has a local tobacco monopoly but there is high demand for international brands. Informal reports show about 20% of cigarette consumption is smuggled brands. This pack survey study is the first in Iran to gather validated information on use of smuggled cigarettes. METHODS A randomized cross-sectional household survey in Tehran in 2008-2009 of 1540 smokers aged 16-90 (83% men) was performed, including interviewer checking of cigarette packs. RESULTS In all, 20.9% of cigarettes and 6.7% of domestic branded cigarettes were smuggled. A total of 60.1% of smokers preferred foreign cigarettes. There was no significant difference between consumption of illegal cigarettes by sex. (Fisher exact test p=0.61) Use of smuggled cigarettes was higher among younger smokers (p=0.01). CONCLUSIONS Use of illegal cigarettes is high. Tobacco control laws outlawing their sale are not being enforced.