{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:05:03Z","timestamp":1790877903980,"version":"4.1.0"},"reference-count":39,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015283","name":"Bloomberg Philanthropies","doi-asserted-by":"publisher","award":["2022-110829"],"award-info":[{"award-number":["2022-110829"]}],"id":[{"id":"10.13039\/100015283","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2026,9,17]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional survey of 2366 adults who smoke in Bolivia\u2019s 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2026-060345","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T17:25:14Z","timestamp":1790875514000},"page":"tc-2026-060345","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Measuring illicit cigarette purchases in Bolivia: evidence from an intercept survey"],"prefix":"10.1136","author":[{"given":"Joaqu\u00edn","family":"Morales","sequence":"first","affiliation":[{"name":"Universidad Privada Boliviana - Campus La Paz, La Paz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier Ignacio","family":"Finot","sequence":"additional","affiliation":[{"name":"Universidad Adolfo Ibanez, Penalolen, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Arteaga","sequence":"additional","affiliation":[{"name":"Universidad Privada Boliviana - Campus La Paz, La Paz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauricio","family":"Chumacero","sequence":"additional","affiliation":[{"name":"Universidad Privada Boliviana - Campus La Paz, La Paz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mateo","family":"Vargas","sequence":"additional","affiliation":[{"name":"Universidad Privada Boliviana - Campus La Paz, La Paz, Bolivia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Pruzzo","sequence":"additional","affiliation":[{"name":"Universidad Adolfo Ibanez, Penalolen, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7863-907X","authenticated-orcid":false,"given":"Guillermo","family":"Paraje","sequence":"additional","affiliation":[{"name":"Business School, Universidad Adolfo Ibanez, Penalolen, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"2026100110200982000_tc-2026-060345v1.1","unstructured":"Institute for Health Metrics and Evaluation (IHME) . 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