Trends and correlates of current use of illicitly traded tobacco in Australia: Evidence from a decade of national surveys

Background and aims Tobacco taxes reduce smoking, particularly among low socioeconomic groups; however, some individuals seek cheaper alternatives instead of quitting. This study estimated use of illicitly traded tobacco among Australian adults who smoke and examined associations with sociodemographic, smoking‐related (including quit intentions and attempts) and other illicit substance use factors. Design Repeated cross‐sectional study using nationally representative data. Setting Australia, using data from four waves (2013, 2016, 2019 and 2022–2023) of a triennial national survey. Participants A total of 12 596 individuals aged 18 years and over who reported smoking at least monthly. Measurements The primary outcome was self‐reported current use of illicitly traded tobacco, defined as current use of unbranded tobacco at any frequency or the purchase of one or more non‐plain packaged packs in the past three months. Based on these indicators, participants were categorised into four mutually exclusive groups: no use, unbranded use only, non‐plain packaged tobacco use only and use of both types. Predictor variables included survey year, age, sex, education, household income, area‐level disadvantage, employment status, general health, psychological distress, cigarettes smoked per day, tobacco product type, alcohol use, past‐year cannabis use and past‐year non‐cannabis illicit drug use. Findings Current use and/or recent purchase of illicitly traded tobacco in Australia rose from 8.6% in 2016 to 16.5% in 2022–2023. Regular use remained relatively low in 2022–2023: 5.2% of study participants used unbranded and 4.1% non‐plain packaged tobacco daily. Compared with no use of illicitly traded tobacco, unbranded tobacco use only was statistically significantly associated with being outside the labour force [adjusted odds ratio (aOR) = 1.87, 95% confidence interval (CI) = 1.36–2.59], experiencing high psychological distress (aOR very high = 1.95, 95% CI = 1.28–2.97; aOR high = 1.94, 95% CI = 1.34–2.81, vs. low), smoking heavily (aOR 11‐20CPD = 2.27, 95% CI = 1.4–3.69; aOR over 20 CPD = 2.66, 95% CI = 1.62–4.35, vs. non‐daily) and past‐year cannabis use (aOR = 2.05, 95% CI = 1.52–2.77, vs. no use). Using non‐plain packaged tobacco only was statistically significantly associated with past‐year non‐cannabis illicit substance use (aOR = 1.46, 95% CI = 1.15–1.86, vs. no use) and already giving up smoking (aOR = 0.39, 95% CI = 0.24–0.65, vs. no intention to quit smoking). Concurrent use of both types of illicitly traded tobacco was statistically significantly associated with living in the most disadvantaged area (aOR = 3.56, 95% CI = 1.68–7.55), using any non‐cannabis illicit substance use in the past year (aOR = 2.25, 95% CI = 1.45–3.49) and higher cigarette consumption (aOR 11‐20CPD = 6.57, 95% CI = 1.99–21.67; aOR over 20 CPD = 9.12, 95% CI = 2.76–30.15, vs. non‐daily). Conclusions While awareness and use of illicitly traded tobacco in Australia has increased in recent years, regular use remains relatively low.