The general public is already much further along in thinking about gradually introduced tobacco bans than most policymakers. This became apparent during the first Global Tobacco Endgame Summit at the end of June in Dublin. The time is ripe to ban the sale of tobacco products. 

By the web editor

There is already significant public support for a tobacco endgame, and the challenge now is for academia, civil society and funders to concentrate time and resources to increase political will and accelerate progress. This was one of the key conclusions from the very first Global Tobacco Endgame Summit organised by Action on Smoking and Health (ASH) USA by the end of June in Dublin, on the eve of the World Conference on Tobacco Control. A tobacco endgame is an approach designed to gradually phase out the sale of tobacco (and/or nicotine) products. This can be done using a combination of different policies and strategies, all part of the ‘tobacco endgame’ toolkit. For example, by introducing an age-related ban on the sale of tobacco products, as is currently being prepared in the United Kingdom where the Tobacco & Vapes Bill introduces a tobacco sales ban to anyone born from 2009 onwards.

Tobacco control struggles to stop industry

For too long, various speakers said, the focus has been on tobacco control – on measures that should reduce the use of cigarettes and other nicotine products. But time and again it has become clear how the tobacco industry manages to work around this with new products and new marketing strategies. “We haven’t been clear enough in our shared vision. We haven’t sufficiently predicted where the industry is heading”, Anna Gilmore from the University of Bath stated during one of the panels. According to her, the tobacco market behaves like a balloon: “When we put pressure on profits in one place, the industry simply shifts to another product.”

Public wants more than policymakers think

A striking conclusion from the summit was that the public is often much further ahead than policymakers realise. Approximately seven out of ten young people would support a generation-based sales ban, according to earlier research as referenced in a recent report by the European Respiratory Society.

In countries from the Global South, people regularly ask why all tobacco products, given their toxicity, aren’t simply banned, speakers reported. The problem is that the tobacco industry often remains far too invisible, and people cannot make the connection between product and how producers profit from the addictiveness.

This public support offers opportunities, but the tobacco control movement regularly misses important moments to maximise on it. It is critical that the public health community and policy makers catch up with the public and integrate tobacco endgame in their campaign plans.

Experts pointed to missed opportunities at international treaties and conferences on obesity, climate and environment, where addressing the impact of tobacco products on these topics would also have been relevant. Tom Novotny from San Diego State University emphasised the power of environmental partners like Surfriders, who advocate for healthy oceans: “They may be more effective, but above all, they are partners.” Disposable vapes, for example, pose a growing environmental problem – garbage trucks regularly get damaged due to exploding lithium batteries in discarded vapes.

COP11 as crucial moment

An important focus point for the coming months is the Conference of the Parties (COP11) of the WHO Framework Convention on Tobacco Control (FCTC) in November. A report will be presented there by the expert group ‘Forward Looking Measures’, in alignment with Article 2.1 of the FCTC which clarifies that the FCTC should be seen as a minimum and not a maximum for tobacco policy. The report must be broadly supported, and trailblazers – countries and civil society alike – are needed to ensure that member states actually take measures that are proportionate to the harm tobacco products cause, in order to protect the health of citizens against the tobacco industry.

Strategic dilemmas around nicotine

A recurring discussion centred on whether the focus should be on traditional cigarettes or on the entire nicotine market. Speakers warned that if the movement focuses too much on cigarettes, the industry could completely shift to vapes and other nicotine products. At the same time, others emphasized that the deadliest products must take priority. It was argued that individual approaches and ‘education’ should not be the primary route: “The most powerful way to quit is when the products are not available.”

Endgame requires good narrative

Megan Manning from ASH USA and Eline Goethals from The School for Moral Ambition gave a joint presentation during the summit about narratives surrounding the tobacco endgame. Goethals will publish a report on these communication strategies in early July.

The summit’s findings come at a time when the Netherlands is researching a generation-based tobacco ban following the citizens’ initiative Nicotinee. The ERS report presented by its author Steven Baylis during the summit shows that EU member states legally have the scope to implement such measures nationally without the EU being able to prevent it.

Challenges in cessation support

The final panel focused on the governmental ethical obligation to provide cessation support, especially when endgame laws gradually limit the availability of tobacco products. Experts emphasized that quit attempts must be encouraged by changing social norms and creating more smoke-free areas.

A striking point about inconsistency in government support: people with other addictions receive long-term, subsidized treatment, while smokers often only get twelve weeks of nicotine patches. This inequality can strengthen feelings of marginalization among heavy smokers.

The summit ended with a call for better coordination between various stakeholders – from youth workers to doctors – to make the tobacco endgame a reality. The message was clear: the time for incremental changes is over; profound reforms are needed to definitively end the tobacco epidemic. The public is ready; it is time for civil society and funders to put the necessary resources to achieve a tobacco free future where no one has to die because of tobacco.