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(2007) find that counterfeit cigarettes can have as much as seven times the lead of authentic brands, and close to three times as much thallium, a toxic heavy metal.[13] Other sources report finding insect eggs, dead flies, mold, and human feces in counterfeit cigarettes.[14] During prohibition of alcohol in the United States during the 1920s, increased enforcement did not manage to significantly decrease the prevalence of bootlegging because the profit margins were so large, and the distribution networks sophisticated

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Our results raise several additional research questions that could be investigated to further our understanding of tobacco use in low and middle income countries

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