Illicitly Traded Tobacco Use Among Samples of People Who Regularly Use Illegal Drugs in Australia, 2024–2025

INTRODUCTION: Australia's illicit tobacco trade poses major challenges, with evidence of increasing use. We examined: (i) use of illicitly traded tobacco (ITT) and reasons for use among two populations of people who use drugs in Australia; and (ii) factors associated with ITT use, versus exclusive licit tobacco use, in 2024 and 2025. METHODS: Cross-sectional samples of people who regularly (i.e., ≥monthly) used illicit stimulants (Ecstasy and Related Drugs Reporting System (EDRS); n = 1430) or injected drugs (Illicit Drug Reporting System (IDRS); n = 1749) were recruited April-July in 2024 and 2025. Multivariable logistic regression identified factors associated with past 6-month ITT use. RESULTS: In both samples of people who use drugs, the proportion using ITT among those who had recently used tobacco increased between 2024 and 2025: from 38% to 65% (p < 0.001) among EDRS participants and from 54% to 73% (p < 0.001) among IDRS participants. In both years and populations, ITT was most commonly obtained from tobacconists, with price the primary reason for use. Among EDRS participants, males had higher odds of ITT use in both years; older age and recent e-cigarette and nicotine-pouch use were associated with ITT use in 2024 only. Among IDRS participants, age was associated with ITT use in both years, while psychological distress was associated with ITT use in 2024 only. Capital city of residence was associated with ITT use across both populations and years; in 2025, lower odds were observed in Perth, Adelaide, Hobart and Canberra versus Sydney. DISCUSSION AND CONCLUSIONS: Increases in ITT use among these two populations of people who use illicit drugs are concerning. Efforts to restrict availability should prioritise supply-side controls, alongside treatment and demand-reduction strategies.