Measuring illicit cigarette purchases in Bolivia: evidence from an intercept survey.

Abstract

Background: Bolivia has one of the lowest tobacco tax rates in the Americas and shares a long border with Paraguay, a documented regional source of illicit cigarettes. The most recent estimate of illicit trade in Bolivia dates to 2002 and relied on industry-reported sales data. We provide the first independent, direct estimate of illicit cigarette penetration in the country.

Methods: We conducted a cross-sectional survey of 2366 adults who smoke in Bolivia's three largest metropolitan areas (La Paz/El Alto, Cochabamba and Santa Cruz) between July and August 2024. Cigarette packs were photographed and classified as illicit based on the absence of a Bolivian tax registration number, non-compliant health warnings or missing customs stamps for imported brands. Loose-cigarette purchases were classified using brand authorisation status and price-outlier rules. A probit model examined correlates of illicit purchase.

Results: An estimated 38.1% of cigarette consumption in these cities is illicit, dominated by a single industrial-scale Paraguayan brand accounting for 85% of illicit sales. Penetration varies sharply by metropolitan area: 54.4% in Santa Cruz, 10.4% in La Paz/El Alto and 14.6% in Cochabamba. Because tax and tobacco-control policies are set nationally, these disparities cannot be explained by tax differentials and are more consistent with proximity to the Paraguayan border and local enforcement gaps.

Conclusions: The industry argument that higher tobacco taxes would drive illicit trade in Bolivia is not supported. Policy efforts should focus on the industrial-scale supply of illicit cigarettes through non-price policies related to enforcement (track and trace, licensing, etc) and regional enforcement cooperation, rather than on delaying domestic tax reform.