“They're doing people a service”—qualitative study of smoking, smuggling, and social deprivation

OBJECTIVES: To examine the behaviour and attitudes related to smoking and contraband tobacco products among smokers in two socially deprived areas. DESIGN: Cross sectional study with qualitative semistructured interviews, augmented by smokers' day grid. SETTING: Two areas of socioeconomic deprivation in Edinburgh. PARTICIPANTS: 50 male and 50 female smokers aged 25-40 years randomly selected from general practitioners' lists from two health centres, each located in an area of deprivation. RESULTS: Most smokers wanted to quit but felt unable to because of the importance of smoking in their daily routine and their addiction to nicotine. Strategies for maintaining consumption levels in the face of increasing cigarette prices and low income included purchasing contraband cigarettes and tobacco. Vendors were contacted through social networks, family, and friends as well as common knowledge of people and places, particularly pubs where contraband was available. Most users of contraband considered that smugglers were providing a valuable service. Purchasing contraband tobacco was viewed as rational in the face of material hardship. Many smokers criticised the government for its high tobacco taxation and the lack of local services to help them to stop smoking. CONCLUSIONS: Smokers in deprived areas perceive a lack of support to help them to stop smoking. Cigarette and tobacco smuggling is therefore viewed positively by low income smokers as a way of dealing with the increasing cost of cigarettes. Smokers in areas of deprivation may thus show little support for tackling smuggling until more action is taken to deal with the material and personal factors that make it difficult for them to quit.

研究目的：探讨两个社会经济贫困区域内吸烟者针对吸烟及违禁烟草制品的行为与态度。
研究设计：本研究为横断面研究，结合半结构化定性访谈方法，并辅以吸烟者每日行程日志记录。
研究场景：选取爱丁堡市两个存在社会经济贫困问题的区域。
研究对象：从两所位于贫困区域的全科医疗中心的注册患者名单中，随机抽取50名男性及50名年龄介于25至40岁的吸烟者作为研究对象。
研究结果：多数吸烟者有戒烟意愿，但因吸烟在其日常生活中的重要性以及尼古丁成瘾而难以付诸行动。面对卷烟价格上涨与收入偏低的困境，维持烟草消费量的策略包括购买违禁卷烟及烟草。可通过社交网络、家人与朋友联系到违禁烟草供应商，或是凭借大众熟知的交易人群与地点线索获取相关信息，其中酒吧是常见的违禁烟草交易场所。多数违禁烟草使用者认为走私者提供了颇具价值的服务；在面临物质拮据的情况下，购买违禁烟草被视为理性之举。诸多吸烟者批评政府征收高额烟草税，且缺乏本地戒烟帮扶服务。
研究结论：贫困区域的吸烟者普遍认为自身缺乏戒烟帮扶支持。因此，对于低收入吸烟者而言，烟草走私被视作应对卷烟价格持续上涨的积极解决方案。故而在采取更多措施解决导致吸烟者难以戒烟的物质与个人层面阻碍因素之前，贫困区域的吸烟者对打击烟草走私的支持度或较为有限。