Progress, challenges and the need to set concrete goals in the global tobacco endgame

Abstract

The tobacco endgame is rapidly moving from aspirational and theoretical toward a concrete and achievable goal and, in some cases, enacted policy. Endgame policies differ from traditional tobacco control measures by explicitly aiming to permanently end, rather than simply minimize, tobacco use. The purpose of this paper is to outline recent progress made in the tobacco endgame, its relationship to existing tobacco control policies, the challenges and how endgame planning can be adapted to different tobacco control contexts. Examples of implemented policies in three cities in the United States and national policies in the Netherlands and New Zealand are outlined, as well as recent endgame planning developments in Europe. Justifications for integrating endgame targets into tobacco control policy and the need to set concrete time frames are discussed, including planning for ending the sale of tobacco products. Tobacco endgame planning must consider the jurisdiction-specific tobacco control context, including the current prevalence of tobacco use, existing policies, implementation of the World Health Organization’s Framework Convention on Tobacco Control, and public support. However, the current tobacco control context should not determine whether endgame planning should happen, but rather how and when different endgame approaches can occur. Potential challenges include legal challenges, the contested role of e-cigarettes and the tobacco industry’s attempt to co-opt the rhetoric of smoke-free policies. While acknowledging the different views regarding e-cigarettes and other products, we argue for a contractionary approach to the tobacco product market. The tobacco control community should capitalize on the growing theoretical and empirical evidence, political will and public support for the tobacco endgame, and set concrete goals for finally ending the tobacco epidemic.

Modeling the future of tobacco control: Using SimSmoke to explore the feasibility of the tobacco endgame in Korea

“…In fact, beginning in 2027 New Zealand plans to prohibit tobacco sales to anyone born on or after 2009 6 . Moreover, several countries, including Denmark, Spain, Ireland, Singapore, and Malaysia, are considering adopting the TFG 6,38 . Our findings indicate that the male smoking prevalence will decrease by 8.8%p in 2050 if non-price policies are implemented in conjunction with the TFG strategy in 2023, compared to implementation of only highintensity non-price policies.…”

Consumo de tabaco en Costa Rica: ¿está el país preparado para el “fin del juego”?

“…En otros países, como España, un grupo de organizaciones han propuesto una declaración del “fin del juego” del tabaco para impulsar la acción política. En muchos países de América Latina, sin embargo, el “fin del juego” no está en la agenda política hoy en día, pero el contexto actual de control del tabaco en algunos países de la Región hace plausible lograr el objetivo ( 3 ). Uno de estos países es Costa Rica, donde el CMCT de la OMS entró en funcionamiento mediante la Ley 9028 en el año 2012.…”

“…Además de la pertinente aplicación del CMCT de la OMS, la prevalencia baja de consumo de tabaco y la marcada tendencia decreciente en el consumo, existen otros factores que facilitan a escala nacional el objetivo de terminar con la epidemia de consumo de tabaco ( 3 ). Por un lado, existen potentes instrumentos de cooperación entre diferentes organizaciones en el control del tabaco; el más importante es la Red Nacional Antitabaco, una red formada por organizaciones estatales, no gubernamentales y del ámbito académico ( 4 ).…”

Progress, setbacks and changing perception of the possible: reflections on Aotearoa/New Zealand’s changed political landscape and tobacco policy plans

“…There are a growing number of bold tobacco endgame initiatives enacted or planned in various countries by local, state and national governments 4 ; however, SERPA was the first comprehensive national approach with an explicit goal to rapidly end smoking. Drawing on years of research on various policy options, public attitudes, policy perspectives and modelling studies, [5][6][7][8][9][10][11][12] its key measures were reducing nicotine in cigarettes to nonaddictive levels, reducing tobacco retailers by more than 90% and introducing a Smoke-Free Generation policy for people born after 2008.…”