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			 The researchers used survey data from one point in time, so they 
			can’t say that smoking illegal cigarettes leads to drug use, only 
			that the two often coincide and that’s enough to warrant stronger 
			tobacco control policies. 
 “The concern for us is that contraband tobacco may be a gateway to 
			other drugs, but we cannot infer causality,” said coauthor Mesbah F. 
			Sharaf of the economics department at the University of Alberta in 
			Edmonton.
 
 In Canada, unmarked and untaxed contraband cigarettes are either 
			illegally manufactured domestically or illegally imported across the 
			U.S. border, often from Native American reservations, the authors 
			write in The Journal of Primary Prevention.
 
 They cite a national survey from 2007 that found 18 percent of all 
			cigarettes used by teens who smoked daily were contraband.
 
 “Here in Canada the contraband market is really substantial, almost 
			30 percent of tobacco sales in the whole country,” Sharaf told 
			Reuters Health.
 
			
			 
			  
			For the new study, he and his coauthors used data from Canada’s 
			2010-2011 Youth Smoking Survey, a school-based survey of kids in 
			grades six through 12.
 It included questions about smoking unbranded or Native 
			American-brand cigarettes over the previous twelve months as well as 
			use of amphetamines, cocaine, heroin, ecstasy and ketamine over the 
			same period.
 
 Focusing on the answers from kids who smoked, the researchers found 
			that 31 percent of them had used contraband cigarettes at least once 
			in the previous year. And contraband cigarette smokers were more 
			likely to report using other drugs than kids who only smoked legal 
			cigarettes.
 
 Twenty percent of contraband cigarette users reported trying heroin, 
			compared to three percent of non-contraband smokers. For 
			hallucinogens, 46 percent of contraband smokers reported trying it, 
			compared to 30 percent of non-contraband smokers.
 
 “The issue of illicit tobacco is a prominent problem worldwide,” 
			said Dr. Russ Callaghan, associate professor in the Northern Medical 
			Program at the University of Northern British Columbia in Prince 
			George, who was not part of the new study.
 
 “In general, the way it is defined is any tobacco product that 
			doesn’t have the full set of taxes or levies applied to the purchase 
			price,” Callaghan told Reuters Health.
 
 Illicit tobacco is less of an issue for kids in the U.S., but it is 
			contributing to a lot of youth smoking in Canada, and the tobacco 
			products they get largely come across the border from upstate New 
			York, he noted.
 
 The new study does show an association between contraband tobacco 
			and illegal drugs, but it cannot say anything about causation, which 
			is important, Callaghan noted.
 
			
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			Sharaf cites a Royal Canadian Mounted Police drug bust in which 
			contraband tobacco was found with other illicit drugs as evidence 
			that kids may be getting their illegal cigarettes and other 
			substances from the same source. 
			“So it seems that this contraband market is managed by probably 
			organized crimes and criminal gangs that may be using contraband as 
			an avenue to other illicit drugs,” Sharaf said. “Most likely it is 
			the same source.”
 But in interviews with teen smokers in Canada, Callaghan has not 
			found that to be the case.
 
 “When I’ve asked young people about whether their sources of illicit 
			cigarettes and illicit drugs are the same, they say no,” he said.
 
 Some corner stores sell the cigarettes, which could be where young 
			people purchase them, he noted.
 
 Although the authors suggest the “gateway hypothesis,” wherein 
			illegal tobacco leads to the use of other illegal drugs, “I don’t 
			think they are really warranted in inferring that at all,” Callaghan 
			said.
 
 “I think what’s probably happening here is you have young people who 
			may be marginalized, have low academic achievement, more deviance, 
			and they engage in both of these activities,” he said.
 
 In the past, some have argued that marijuana is a gateway drug to 
			more dangerous substances, and that has been mostly disproved, 
			Callaghan said.
 
 “It’s not that I don’t think that illicit drugs are a problem, but 
			I’d be wary of that particular line of reasoning,” he said. “There’s 
			a relation, but we need to be careful. I hope it’s not alarmist.”
 
 Linking contraband tobacco to further drug use could bring more 
			attention to the problem, but policymakers may argue to lower taxes 
			on legitimate cigarettes to reduce the contraband market, which 
			would in turn lead to cheaper cigarettes and more smokers, Callaghan 
			said.
 
			
			 
			Earlier this year, Canadian criminal codes were amended to make 
			trade, promotion or sales of contraband a criminal offense, which is 
			a step in the right direction, Sharaf said.
 “This needs to be supplemented with creative government measures,” 
			he said.
 
 SOURCE: http://bit.ly/1zu7vlf The Journal of Primary Prevention, 
			online November 1, 2014.
 
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