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.