title: Countering the demand for, and supply of, illicit tobacco: an assessment of the 'North of England Tackling Illicit Tobacco for Better Health' Programme.
abstract: BACKGROUND
  Illicit tobacco (IT) undermines the effectiveness of tobacco control strategies. We assessed the implementation and impact of a new programme designed to reduce demand for, as well as supply of, IT, in the north of England, where IT was prevalent.
  
  
  METHODS
  'Mixed methods' research was undertaken. Qualitative methods included stakeholder interviews (at outset and 1 year later) and ethnographic research. Indicators reflecting those supply and demand issues for which data were available were identified and monitored, including relevant items on two cross-sectional surveys carried out in 2009 and 2011 with over 4000 individuals from which a social marketing campaign was also developed. IT reports to two existing hotlines, promoted through the programme, were assessed.
  
  
  RESULTS
  Initially, concerns abounded about the different philosophies and ways of working of local and national enforcement and health agencies, but these were much reduced at follow-up. A protocol was developed which greatly facilitated the flow of intelligence about IT supply. A social marketing campaign was developed highlighting two messages: IT makes it easier for children to start smoking and brings crime into the community, thereby avoiding misleading messages about relative harms of illicit and licit tobacco. Public and stakeholder awareness of IT increased as did calls to both hotlines.
  
  
  CONCLUSIONS
  A partnership of agencies, with competing values, was established to tackle IT, a complex public health issue and, inter alia, implemented a social marketing campaign using novel messages. This improved the flow of intelligence about the supply of IT and increased awareness of IT.
authors: Addictions Department, Institute of Psychiatry, UK Centre for Tobacco Control Studies, King's College London, London, UK.
authors: Ann
authors: A
authors: McNeill
authors: Department of Epidemiology and Public Health, University College London, London, UK.
authors: Belinda
authors: B
authors: Iringe-Koko
authors: Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
authors: Manpreet
authors: M
authors: Bains
authors: Socio-Management, University of Stirling, UK Centre for Tobacco Control Studies, Stirling, UK.
authors: Linda
authors: L
authors: Bauld
authors: NEMS Market Research Ltd, Billingham, UK.
authors: Geoffrey
authors: G
authors: Siggens
authors: Department of Anthropology, Durham University, Durham, UK.
authors: Andrew
authors: A
authors: Russell
mesh_terms: D000293:Adolescent; D003132:Commerce / Q000331:legislation & jurisprudence*; D003415:Crime / Q000517:prevention & control / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D006293:Health Promotion; D015277:Hotlines; D006801:Humans; D008297:Male; D011634:Public Health; D012907:Smoking / Q000191:economics / Q000453:epidemiology; D000074606:Smoking Prevention; D040241:Social Marketing; D062789:Tobacco Products / Q000600:supply & distribution*; D055815:Young Adult
keywords: Illegal tobacco products; Public policy; Social marketing
references: Lancet. 2000 Feb 12;355(9203):557
references: 10683016
references: BMJ. 2008 Oct 09;337:a1933
references: 18845593
references: Tob Control. 2012 Mar;21(2):230-4
references: 22345257
references: Tob Control. 2014 May;23(e1):e17-23
references: 23233420