“They're doing people a service”—qualitative study of smoking, smuggling, and social deprivation

Abstract Objectives: To examine the behaviour and attitudes related to smoking and contraband tobacco products among smokers in two socially deprived areas. Design: Cross sectional study with qualitative semistructured interviews, augmented by smokers' day grid. Setting: Two areas of socioeconomic deprivation in Edinburgh. Participants: 50 male and 50 female smokers aged 25-40 years randomly selected from general practitioners' lists from two health centres, each located in an area of deprivation. Results: Most smokers wanted to quit but felt unable to because of the importance of smoking in their daily routine and their addiction to nicotine. Strategies for maintaining consumption levels in the face of increasing cigarette prices and low income included purchasing contraband cigarettes and tobacco. Vendors were contacted through social networks, family, and friends as well as common knowledge of people and places, particularly pubs where contraband was available. Most users of contraband considered that smugglers were providing a valuable service. Purchasing contraband tobacco was viewed as rational in the face of material hardship. Many smokers criticised the government for its high tobacco taxation and the lack of local services to help them to stop smoking. Conclusions: Smokers in deprived areas perceive a lack of support to help them to stop smoking. Cigarette and tobacco smuggling is therefore viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes. Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to deal with the material and personal factors that make it difficult for them to quit. What is already known on this topic Areas of deprivation have the highest rates of smoking and lowest levels of cessation Around 25-30% of cigarettes consumed in the United Kingdom are contraband We know little about the attitudes of smokers in these areas to smuggled cigarettes or whether and how they access them What this study adds In such areas the easy availability of cheap tobacco products through contraband networks works against many smokers' desire to quit Given the perceived lack of support to help them to stop smoking, this smuggling network is viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to address the material and personal factors that make it difficult for them to quit