Center for Regulatory Effectiveness

< “The illicit tobacco trade is regularly described as a critical public health issue because lower prices enable greater consumption and more damage to health and simultaneously decrease the money available for state-funded health care (Arnott et al., 2008; Lee & Collin, 2006 ). The public health significance of increased consumption of a substance with known health hazards is unarguable, but almost nothing is known about the relative health risks of smoking tobacco obtained illicitly. Illicit tobacco can be adulterated by producers and sellers to increase weight and therefore profits (Bittoun, 2002 , 2004 ), grown using techniques that elevate concentrations of heavy metals and other toxic substances (Pappas, Polzin, Watson, & Ashley, 2007; Stephens, Calder, & Newton, 2005), or simply mishandled in ways that increase the potential for damage to consumers’ health (Bittoun, 2004 ). p. 997 [Emphasis added].