Background:
High tobacco prices reduce smoking prevalence. Illicit tobacco undermines price policies, particularly among youth, and keeps smokers addicted. Furthermore, tobacco companies have a history of smuggling. A UK anti-tobacco smuggling strategy was launched in 2000. A sub-national plan led by Fresh was launched in 2009.

Objectives:
To reduce supply and demand, Fresh developed a strategic framework within broader tobacco control across North-East England, which included: developing partnerships; engaging frontline staff; gathering/developing intelligence; delivering enforcement; delivering communications; engaging retailers; protecting policies from tobacco companies; and assessing progress.

Methods:
Methods include health and enforcement partnerships, developing insight-led, demand-reduction campaigns; developing key message documents; producing enforcement guidance on Article 5.3; tracking public opinion and market share. See www.keep-it-out.co.uk and www.illicit- tobacco.co.uk.

Results:
North-East England illicit market decreased from 15% (2009) to 10% (2019). Nationally, the market has halved since 2000.

Conclusions:
Reducing demand and supply needs to take a strategic approach and be framed within broader tobacco control.