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Determining the proportion of illicit (contraband) cigarettes in a local public health jurisdiction. Julie Stratton, Manager, Epidemiology Peel Public Health. Background. Self report surveys: Most smokers buy their cigarettes legally
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Determining the proportion of illicit (contraband) cigarettes in a local public health jurisdiction Julie Stratton, Manager, Epidemiology Peel Public Health
Background • Self report surveys: • Most smokers buy their cigarettes legally • 1% of Canadians might have purchased smuggled cigarettes (CTUMS) • 13% of Canadians buy cigarettes from a First Nations reserve (23% of Ontarians)
Background Cigarette Butt Studies • Canadian Convenience Store Association • 26% in Ontario youth (2008) • 38% in Peel youth (2008) • Ontario Convenience Store Association • 21% in Ontario residents (2014) • 22% in Brampton residents (2014) • Post-secondary campuses in Ontario – 14%
Peel Region • West of Toronto • 1.3 million residents (20,000 people added each year) • 15% of Peel residents smoke
Research Questions • What proportion of cigarettes in the Region of Peel are illicit (untaxed?) • Are there differences in the proportion of illicit cigarettes by location of collection?
Methods – Sampling Frame • 4 types of locations within Peel Region • Regional hospitals (3 locations) • Regional buildings serving the public (2 locations) • College campuses (2 locations) and university campus (1 location) • Secondary schools (random selection of 10 locations)
Methods – Pilot Study • Piloted process from one location from each venue • Collection • Identification
Methods – Sample Size • Required 1,209 butts per venue • Parameters • Estimated number of cigarettes smoked per day • Estimated per cent of contraband based on pilot study • Adjustment factor 1/0.7 - 1 • Precision of the estimate = 3% • Statistical power = 80% • Type 1 error rate = 5% • Cigarette butt discard rate based on results of pilot study
Methods – Collection and Storage • Hand collection from the ground or dumped from cigarette disposal bins • Collected butts until quota was met • Collected on non-rainy days • Stored in a fire proof cabinet in plastic bins at an off-site location
Classification - Testing • Brand name or symbol • Existence of a dry patch within the plug wrap • Number of rows and type of ventilation holes • Type of filter (acetate or polypropylene) • Resources: www.cigarettespedia.com
Classification – Brand Name Examples • du Maurier • Player’s • Matinee • Viceroy • Export A
Classification – Plug Wrap and Dry Patch Dry patch (area with no glue) Plug wrap
Laser Electrostatic Mechanical
Classification - Filter • Polypropylene vs acetate • Some illegal cigarettes use polypropylene filters • Do not dissolve in acetone
Classification • Legal branded • International • Legal native • Contraband (illegal) • Discards • Unknown or other
Classification – Legal Native • Putters • DKS • Sago • Ménage • Podium
Classification – Contraband Examples • Canadian • Playfair • Unbranded
Results – Overall Classification Note: Excludes discards
Conclusion • Lower percentage of contraband cigarette butts than reported in other studies (5.3%) • The percentage of contraband cigarette butts varied by venue (highest in secondary schools) • Contraband rates are low - Peel will focus on other aspects of tobacco control
Implications for Public health practice • Collection of cigarette butts to assess percentage of contraband cigarettes can easily be replicated in the field • Peel Health has developed the following protocols which can be shared: • Cigarette Butt Study protocol • Cigarette Butt Collection Protocol • Cigarette Butt Identification Protocol • Cigarette Butt Photo Library
For more information • Julie Stratton, Manager, Epidemiology, Peel Public Health, julie.stratton@peelregion.ca • Dr. Megan Ward, Associate Medical Officer of Health, Peel Public Health, megan.ward@peelregion.ca
Limitations • International and some contraband cigarettes might have been classified as legal • Selection of venues