Just over 14% of the cigarette butts collected from a sample of 25 Ontario college and university campuses were First Nations/Native tobacco. Quantities of First Nations/Native tobacco found on campuses surveyed ranged from 2% to 39%. Based on the assumption that most of this First Nations/Native tobacco is being consumed illicitly [14, 37], these findings suggest a fairly substantial level of contraband tobacco use among young adult, Ontario post-secondary students. While attempts to assess the validity of the current findings by comparing them to previous studies are confounded by the different age cohorts studied (i.e., youth vs. young adults) and differences in methodologies (i.e., self-report vs. collection of butts), there are some similarities. Like this study, studies of cigarette butts discarded on Ontario high school properties have shown highly variable proportions of contraband tobacco across sites (ranging from 13% to 39%) [28–30]. Similar to the overall proportion of contraband observed here (i.e., 14%), self-reports of youth [10, 11, 31] and adults [11, 13] suggest that some 10% to 20% of tobacco consumed is contraband. In this context, the results of the current study can probably be regarded as a credible estimate of the volume of contraband tobacco being consumed by young adult smokers on college and university campuses in Ontario.
Regional variations in contraband use were observed in this study. Specifically, the highest proportion of contraband was found among institutions located in the Northern, primarily rural, region of Ontario (30%). The lowest proportion occurred among institutions in the urban, Toronto region (6%). Given that Aboriginals comprise about 2% of Ontario’s overall population, but as much as 10% of the population in the northern communities where post-secondary institutions are located [40, 41], it may be that some of the First Nations/Native butts collected from campuses in the Northern region represent tobacco legally purchased by Aboriginal students who live and attend school there. While this possibility presumes that schools in northern Ontario, like the communities themselves, have a higher percentage of Native students, census data actually show lower post-secondary educational participation among Native people residing in northern Ontario compared to those residing elsewhere in the province [40]. It seems plausible to conclude, therefore, that the butts collected from northern Ontario schools do actually represent contraband tobacco.c
Results showing more contraband tobacco in the Northern region compared to most other geographic regions mirrors results reported by Luk et al. [13] who noted that adult smokers residing in northern Ontario were significantly more likely than those residing elsewhere in Ontario to report “usual” and “recent” purchasing of tobacco (usually First Nations/Native tobacco) on Native reserves. In Canada and elsewhere, individuals from more socially-deprived economically-depressed, rural/remote areas tend to bear a disproportionate burden of tobacco-related morbidity and mortality [3, 19, 22, 26, 27, 32, 43]. The greater volume of cheap contraband tobacco found for Ontario’s rural, socioecomically-stressed Northern region is consistent with this pattern, and also quite troubling given its appearance on post-secondary campuses. Higher education is generally viewed as health-protective, with lower rates of smoking uptake, less frequent smoking, and earlier cessation of any tobacco use among educated individuals. The widespread use of cheap contraband tobacco on northern Ontario post-secondary campuses suggests that education may not mitigate sociogeographic risk factors that contribute to persistent social inequities in the tobacco-related health burden. Similar findings have been reported for European [26, 43], Australian [23], and American [44] samples.
The proportion of First Nations/Native tobacco was found to be slightly, but not significantly, higher on college campuses (17%) compared to university campuses (12%). Potentially higher volumes of contraband tobacco on college campuses may reflect differences in sociodemographic characteristics and smoking patterns of college and university students. There is evidence, for example, that heavier tobacco consumption is associated with greater use of contraband tobacco among youth and adults [10–13]. Similarly, lower socioeconomic status is generally related to greater likelihood of purchasing cheaper (contraband) cigarettes [13, 19, 27, 45]. Given that family income is typically lower among college than university students [46], and rates of tobacco consumption are typically higher [47], it is not unexpected to find a higher proportion of First Nations/Native tobacco on college than university campuses.
Limitations
While unobtrusive collection of discarded cigarette butts on campus grounds has the advantage of overcoming potential under-estimation of contraband use that may occur when participants are asked to self-report an illegal behaviour, there are some limitations to this approach. First, this approach reveals the proportion of cigarettes that are contraband, but not the proportion of individuals using contraband tobacco. Similarly, identification of contraband tobacco is restricted to what can be determined from visual inspection. Some forms of contraband tobacco (e.g., smuggled brand-name cigarettes and counterfeit cigarettes) cannot be readily identified through the process of examining discarded cigarette butts. First Nations/Native tobacco cigarette butts can be reliably identified, but are contraband only if the manufacture or sale of these cigarettes violates government regulations—contingencies that could be assumed but not verified in this observational study. These limitations must be weighed against evidence that smuggled brand-name and counterfeit cigarettes make up a very small proportion of contraband tobacco in Ontario [14, 37], and the general consensus in the Canadian literature [10, 12, 13, 31] that large proportions of First Nations/Native tobacco are produced or consumed illicitly and can reasonably be assumed to represent contraband tobacco. Finally, the exclusive use of First Nations/Native tobacco to represent contraband tobacco should not be seen as a commentary on First Nations manufacturers of tobacco, the legality of production, packaging and sales of First Nations/Native tobacco, or the actions and attitudes of First Nations people in Ontario.
Implications
Results of the current study showing geographically widespread and relatively high levels of use of First Nations/Native (contraband) tobacco by young adults suggest that public health initiatives to reduce smoking among young adults need to address this group’s use of contraband as well as commercial tobacco. Taxation has been a powerful public health strategy for reducing tobacco use among all age groups, but especially younger smokers who are price-sensitive [3, 4, 7, 8, 12, 13, 35]. In the absence of contraband tobacco, higher taxes on regulated tobacco discourage smoking uptake and encourage cessation of smoking [4, 5, 7, 8]. In the presence of contraband tobacco, however, higher taxes can encourage individuals to seek out cheap contraband tobacco [22, 27, 32, 45, 48].
The likely ineffectiveness of taxation strategies in the current market indicates the need for other anti-contraband strategies. Enforcement of laws related to international movement of dutiable, taxable, controlled goods, and to the manufacture and distribution of First Nations/Native and other tobacco products can be effective strategies to deal with tobacco growers, cigarette manufacturers and distributors, and retailers who shape and sustain the contraband market [13, 14, 49]. In Canada, law enforcement in these critical areas generally falls to the federal government. In the case of First Nations/Native tobacco, however, enforcement strategies to reduce the availability of contraband tobacco necessitates cooperation among federal, provincial and municipal law enforcement officers, as well as First Nations’ own police services. To this end, federal initiatives including Public Safety Canada’s First Nations Organized Crime Initiative[50], and the RCMP-led Combined Forces Special Enforcement Unit, Contraband Tobacco Initiative[51] have begun to disrupt the flow of contraband tobacco through successful inter-governmental, multi-agency collaboration [37]. As the current study and others [13, 29, 30] show, it will be necessary for these nationally-led initiatives to respond to regional variations between and within provinces to effectively reduce availability of cheap contraband tobacco and impact tobacco use among smokers of all ages.
Law enforcement can also target consumers of contraband tobacco, however its impact in this regard may be limited. Penalizing individual smokers for purchasing illicit cigarettes may do little to contain the contraband market [48]. Public education, on the other hand, may be a more viable way to address the consumer side of the contraband market [9, 23, 48]. In this regard, development of coherent, action-oriented public education messages that specifically motivate and support young adult smokers to avoid contraband tobacco will require attention to several challenges. Most notably, the message that First Nations/Native tobacco is being manufactured or sold in a manner that makes it illegal must not support negative stereotypes of First Nations people. In fairness to all residents of Ontario and Canada, this potential consequence is one that should be anticipated and avoided. Public education campaigns describing the illicit nature of non-Aboriginals’ use of First Nations/Native tobacco must also avoid the unintended consequence of raising young adult smokers’ awareness of this cheap tobacco supply to the point of promoting rather than discouraging its use. Similarly, because efforts to inform the public that inexpensive contraband tobacco does not necessarily adhere to government health and safety guidelines can create the impression that commercial cigarettes are healthier or safer, young adults—like all smokers—must be informed that no cigarettes are good for health.
Public education messages presenting the use of contraband tobacco as unlawful based on tax evasion must account for the likelihood that most people, including young adults, seem unconcerned with or unaware of the illegality of not paying taxes on cigarettes [27, 31, 32, 48]. Describing how this personal act of unlawfully purchasing tobacco can undermine global health objectives, reduce tax revenues that support education and social programs, contribute to the proliferation of organized crime, and weaken legitimate local economies will be effective only if the messages resonate with young adults. Thus, reminding the public that decreases in government revenues from tobacco taxes translate into less funding for the health care system and could ultimately affect them personally may be more effective for adults than young adults who are typically unconcerned with personal access to or public expenses of healthcare. Likewise, messages explaining that cheap tobacco increases smoking uptake and escalation among youth may dissuade adults—especially those with children—from purchasing First Nations/Native tobacco, but have limited impact on young adults. Issues such as social equity and responsibility, funding for public education, economic justice, and control of organized crime may be more relevant to young adults. Similarly, because young adults may be unaware that purchasing First Nations/Native tobacco is in fact illegal, campaigns that convey this message, while highlighting the compelling social costs of a contraband market and avoiding the pitfall of re-legitimizing commercial tobacco, may deter young adults from using contraband tobacco. In any case, careful age-tailoring of messages will be required.
