The Underminers: Booming Illicit Trade of Roll Your Own and Waterpipe Tobacco in Turkey.

OBJECTIVES: The aim of this study is to specify the reasons and extents of illicit Roll-Your-Own (RYO) and waterpipe tobacco (WPT) markets which broke out in Turkey and to determine the destruction of these markets over the effectiveness of main tobacco control measures, the effect of this destruction on increase in tobacco use and the measures that can be taken.
MATERIALS AND METHODS: Reliable data about illicit trade are quite limited. This study was prepared through using the recommended methods on illicit trade in "Methods for Evaluating Tobacco Control Policies" published by the International Agency For Research On Cancer (IARC) and "Understand, Measure, and Combat Tobacco Smuggling" published by the World Bank.
RESULTS: RYO and WPT markets are almost totally illicit in Turkey. These markets serve to tobacco outbreak by increasing total tobacco use far beyond the official data through its size surpassing 30% of total consumption and they have begun to invalidate all of the principle tobacco control measures by hindering and undermining them.
CONCLUSION: In order to implement tobacco control measures effectively in Turkey, these illicit markets must be included in system by doing necessary regulations promptly. It is strongly needed that illicit RYO and WPT production and trade should be described as newly emerged threat areas in tobacco control literature, since other countries may suffer from similar problems.