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Illicit Tobacco Trade in Georgia: Prevalence and Perceptions Megan Little,1 Hana Ross,1 George Bakhturidze ‍ ,2,3 Iago Kachkachishvili4

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Illicit Tobacco Trade in Georgia: Prevalence and Perceptions Megan Little,1 Hana Ross,1 George Bakhturidze ‍ ,2,3 Iago Kachkachishvili4 Original research Tob Control: first published as 10.1136/tobaccocontrol-2018-054839 on 18 January 2019. Downloaded from Illicit tobacco trade in Georgia: prevalence and perceptions Megan Little,1 Hana Ross,1 George Bakhturidze ,2,3 Iago Kachkachishvili4 ► Additional material is ABSTRact The new government coming to power in 2004 published online only. To view Background In lower- income and middle- income decided to double and triple taxes for imported please visit the journal online filtered and domestic filtered cigarettes, respec- (http:// dx. doi. org/ 10. 1136/ countries, limited research exists on illicit tobacco tobaccocontrol- 2018- 054839). trade and its responsiveness to taxation. Tobacco taxes tively. In preparation for this increase, tobacco are critical in reducing tobacco consumption, thereby companies prepurchased tax stamps (introduced in 1 Economics, Southern Africa improving public health. However, the tobacco industry 1999) with the lower 2004 value, to use in their Labour and Development 2005 sales. This resulted in an artificial tax revenue Research Unit, University of claims that tax increases will increase illicit tobacco Cape Town, Cape Town, South trade. Therefore, research evidence on the size of the increase in 2004 followed by a sharp fall in early Africa illicit cigarette market is needed in Georgia and other 2005, when the new tax came into effect. Tobacco 2 Tobacco Control Research, low- income and middle- income countries to inform companies then asserted that the tax revenue fall FCTC Implementation and tobacco tax policies. was driven by a sharp increase in illicit trade from Monitoring Center in Georgia, 10% in 2003 to 65% in post-2005.3 This persuaded Tbilisi, Georgia Methods In 2017, a household survey using stratified 3Health Promotion Research, multistage sampling was conducted in Georgia with the government to lower taxes by 30%–40% in Georgian Health Promotion and 2997 smokers, to assess illicit tobacco consumption. 2006, despite the fact that tobacco excise revenue Education Foundation, Tbilisi, Smokers were asked to show available cigarette packs was 47% higher in real terms in 2004/2005 Georgia compared with 2002/2003.3 The cigarette excise 4Sociology and Social Work to the surveyors. These were examined for tax stamps Department, Ivane Javakhishvili taxes began rising thereafter, but only reached their and health warnings which allowed for an assessment of 3 Tbilisi State University, Tbilisi, illegal cigarette consumption in Georgia. 2005 nominal values in 2010. The industry’s illicit Georgia Findings The packs shown to surveyors suggest illicit trade argument, based on their own assessment of cigarette trade is low (1.5%), although with regional the illicit trade market, resulted in a real setback to Correspondence to differences, as illicit cigarette packs were present in 6% tobacco tax policy in Georgia. Megan Little, Economics, Until now, no nationally representative estimates Southern Africa Labour and of the households in Zugdidi. Most illicit cigarettes were copyright. Development Research Unit, purchased at kiosks or informal outlets. This estimate of the size of the illicit cigarette market in Georgia have been published in peer-reviewed literature. University of Cape Town, Cape might be conservative, as 28% of respondents did not Town, 7700, South Africa; Some surveys conducted in the early 2000s indi- show any packs to the surveyors. firdaleconsulting@ gmail. com cated a substantial penetration of illicit cigarettes Conclusions Despite recent tobacco tax increases, illicit in Georgia—between one- third and two- thirds Received 12 November 2018 cigarette trade in Georgia seems to be negligible. The of the market.3 5 6 Subsequent reports suggested Revised 9 December 2018 market is more vulnerable to illicit cigarette trade close to Accepted 12 December 2018 that government reforms in 2004 substantially the border with Abkhazia (near Zugdidi). Tighter control 7 Published Online First reduced the size of the illicit cigarette market and http://tobaccocontrol.bmj.com/ or ban of tobacco sales at kiosks and informal outlets 18 January 2019 in 2017, the Head of the Healthcare Committee may reduce illicit cigarette trade. Further investigation of the Georgian Parliament reported that the illicit is planned to better understand why a large proportion cigarette market share was less than 3% of total of survey participants said they had no pack available at consumption.8 home. This study seeks to understand the consumption of illicit tobacco products and general perceptions of illicit tobacco trade in five geographically spread regions of Georgia, with the intention of informing INTRODUCTION tobacco control policy debates in Georgia, and Georgia has had a persistently high male smoking other lower-income and middle-income countries. prevalence which even increased from 53.3% in on September 27, 2021 by guest. Protected 2001 to 57% in 2016. Women smoke less, but their METHODS smoking prevalence is also on the rise—6.3% in In November 2017, interviews were conducted with 1 2 2001 and 12.2% in 2016. households in the cities of Tbilisi and Kutaisi, and The Republic of Georgia used to be an important the municipalities of Zugdidi, Gori and Akhaltsikhe source of tobacco leaves and manufactured ciga- (see the online supplementary map of Georgia). 3 rettes for the whole the Soviet Union. However, These regions were chosen to represent geograph- the Soviet Union’s fall in the early 1990s led to the ical diversity and varying proximity to border areas © Author(s) (or their collapse of the Georgian tobacco industry and soon employer(s)) 2020. No and Russian occupied territories. commercial re-use . See rights the domestic market was flooded with international Using the sampling frame of the 2016 parlia- 4 and permissions. Published brands. Initially (1991–1997), no taxes were levied mentary voter dataset, a total of 4345 individuals by BMJ. on cigarettes. When they were introduced in late (one per household) were sampled across the five To cite: Little M, Ross H, 1997, the locally manufactured cigarettes enjoyed regions using multistage sampling. First, the areas 3 Bakhturidze G, et al. substantially lower tax rates. The specific excise were preliminarily stratified into rural and urban Tob Control rates remained constant until 2004 allowing their strata. Next, the primary sampling units (PSUs) 2020;29:s227–s233. real value to erode by inflation.4 were selected using probability proportional Little M, et al. Tob Control 2020;29:s227–s233. doi:10.1136/tobaccocontrol-2018-054839 s227 Original research Tob Control: first published as 10.1136/tobaccocontrol-2018-054839 on 18 January 2019. Downloaded from to population size. Thereafter, households (the secondary (SE 0.5) cigarettes per day, respectively. These observations are sampling unit) were selected using a random walking method comparable with the national averages of 21.6 and 14.4 ciga- in each PSU. This method was used because many homes rettes per day, respectively.1 The smoking frequency was higher do not have an address, and therefore it was not possible for those with less than secondary school education (23 ciga- to provide location descriptions to the surveyors if a house- rettes per day, SE 0.5) and for the unemployed (22 cigarettes per hold was randomly selected. The random walk method is day, SE 0.6). frequently used in Georgia. Within each selected household, The legal age to buy tobacco in Georgia is 18 years, but the first adult responder was informed about the purpose of 35% (SE 0.9%) of smokers reported starting smoking before the study and if consent was obtained, was asked to list all they reached that age. The initiation age varied significantly current adult smokers in the household. If no adult smokers by gender, with 36% (SE 0.9%) of male and 19% (SE 2.2%) resided, only a brief general household questionnaire was of female smokers reporting smoking before the age of 18, administered. Otherwise, an adult smoker (the final sampling respectively. Education was negatively correlated with initiation unit) was randomly selected from the list of resident smokers age—45% (SE 3.5%) of those with less than secondary school to complete the individual questionnaire. education began using tobacco before 18, relative to 28% (SE If the selected respondent was not at home at the time of 1.3%) of those with college education. the interview, the interviewer returned up to three times to The majority of smokers (77%, SE 0.8%) bought their last conduct the interview. If the respondent could not be located tobacco products at supermarkets, while 23% (SE 0.7%) bought during the third visit, the interviewer randomly selected them at kiosks or other informal settings such as street- stands. another smoking respondent (where available) from that Purchases in informal settings were more common in rural areas. household. Similarly, if the respondent refused to participate, International brands represented 80% (SE 0.8%) of cigarette the interviewer would select another participant (where avail- last purchased which is in line with national consumption trends able) in the same household. If all eligible smokers refused to (in 2017 84% of the cigarette market consisted of imported participate, it was recorded as ‘refuse to participate’, and the brands while domestic brands made up the rest).11 Women interviewer went on to another household using the random displayed a stronger preference for imported tobacco products step method. The interviews took approximately 15–20 min. as 93% of the women (SE 1.4%) bought international brands A randomly selected 10% of completed interviews (283 inter- during their last purchase, compared with 78% of men (SE views) were cross-c hecked by an independent controller, and 0.8%). International brands were also more common in urban no major errors were found. areas (84%, SE 0.8%), among those with college education Of the 4345 households reached, 22% reported not having (89%, SE 0.9%) and those in employment (91%, SE 1%).
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