From illicit to accepted: a qualitative study of illicit tobacco use in Aotearoa New Zealand

Background Illicit tobacco weakens incentives to quit smoking, facilitates uptake among young people and undermines public health initiatives. We probed how people in Aotearoa New Zealand (NZ), a country where illicit tobacco use is rising, rationalise illicit tobacco purchases and negotiate the moral tensions created by participating in illegal markets. Methods We undertook in-depth interviews with 20 adults recruited using social media and community advertising and then snowball sampling, who reported using illicit tobacco in the previous 6 months. We explored their smoking histories, access to illicit tobacco, purchasing experiences, motivations and views on regulation. We analysed the transcripts inductively using Braun and Clarke’s reflexive thematic analysis approach. Results We identified four themes. First, an amorphous illicit tobacco market comprising extended social networks. Second, trade-offs between price and quality that presented illicit tobacco as a rational response to financial hardship. Third, illicit purchases as active resistance to government policies perceived as unfair. Finally, construction of moral boundaries that differentiated illicit tobacco from ‘real’ crime and ‘convenient unknowing’ that avoided information likely to challenge these boundaries. Conclusions While stimulated by price differentials, illicit tobacco use in NZ also depends on social networks and moral narratives that legitimise use. Policy responses require coordinated strategies to disrupt supply chains but also need to address social and economic conditions that legitimise demand. Accessible and culturally appropriate cessation support, alongside social marketing campaigns that question legitimacy narratives, could complement comprehensive regulatory measures.