Consumers of illicit tobacco in West Yorkshire (UK): A repeated cross-sectional analysis of novel epidemiological data

Objectives The trading and subsequent consumption of illicit tobacco poses a significant challenge to both individual and public health, whilst constituting a notable annual expenditure towards combatant strategies. This study aimed to explore how the characteristics of illicit tobacco consumption have changed over time with the purpose of producing epidemiological evidence to inform health policy and strategic intervention. Study design Secondary analysis of a repeated cross-sectional survey. Methods We used anonymised quantitative data collected between 2014 and 2021 in West Yorkshire to investigate: (1) temporal trends and regional variation in the prevalence of illicit tobacco use; (2) sociodemographic risk factors for consuming illicit tobacco; and (3) attitudes and patterns of use amongst those consuming illicit tobacco. We analysed the data using graphical methods, bivariate statistics, and multivariate regression methods. Results We observed a paradoxical trend such that whilst the prevalence of illicit tobacco consumption fell between 2014 and 2021, those who self-identified as illicit smokers consumed illicit tobacco at higher rates. Conclusion If the consumption of illicit tobacco is to be successfully targeted by public health intervention, a sound understanding of its epidemiological profile is key. Our findings suggest a clear patterning of illicit tobacco consumption along various sociodemographic dimensions and relay important information on the motivations for, and attitudes towards, illicit tobacco use. As such, our findings have important implications for the development of targeted interventional strategies.