Case studies and potential best practices

Road to tobacco endgame – European practices

• Belgium: Interfederal strategy 2022-2028 towards a smokefree generation

  In December 2022, Belgium's "Interfederal Strategy 2022-2028 for a Smoke-Free Generation" was signed. This political agreement was realised by extensive consultations between 24 different cabinets of the governing parties, both at the regional and federal levels.
  Behind this vision of a smoke-free generation is the concrete goal of drastically reducing tobacco use by 2040. This means:

  • reducing the number of daily tobacco users to 5% among the population aged 15 years and older;
  • reducing the number of people who start using tobacco products to 0% or close to 0%.

  By 2028, the target is to reduce daily tobacco consumption to 10% and daily consumption of tobacco products to 6% in the 15-24 year-oldsyears old age group. The strategy acts on different levels: product regulation, taxation, youth and education, prevention, help to quit, healthcare, and scientific research. Therefore, the strategy to be implemented must inevitably be transversal and multidisciplinary.

• Finland: Collaborative action to advance Tobacco- and Nicotine-Free Finland 2030

  In Finland, ending the use of tobacco products that cause addiction and are toxic to health has been the objective of the Tobacco Act since 2010. In 2016, the objective was broadened to cover also nicotine products regulated under the Act. In practice, the objective has been defined as aiming for less than 5% of daily tobacco and non-pharmaceutical nicotine use in the adult (working age) population by the year 2030.

  The transition from only controlling and reducing the harms into aiming to end the tobacco epidemic was driven by the establishment of a network "Smoke-free Finland 2040" between civil society organizations, research institutes, and government agencies in 2008, later updated into "Tobacco-Free Finland 2030" (incl. nicotine).

  Another key driver has been the multisectoral ministerial working groups established regularly by the Ministry of Social Affairs and Health. These monitor the progress with tobacco control policies and propose a set of new regulatory and other measures towards the aim of this objective, with reports in 2008, 2018 and 2023.

• The Netherlands: Towards a smokefree generation in 2040

  In the Netherlands, the National Prevention Agreement “A healthier Netherlands: it’s up to us” launched in 2018 addresses the three largest causes of the burden of the disease in the country: smoking, problematic alcohol consumption and overweight. It was agreed with a broad representation of different stakeholders, including patient organisations, care providers, health insurers, municipalities, sports associations, businesses, funds, educational institutions, civil society organisations and central government.

  The agreement is focusing on the year 2040, with the aim that a healthy lifestyle will by then be the norm. As part of this agreement an ambition for a smoke-free generation in 2040 was set. Specifically, this means that no child will take up smoking in 2040 and only 5% of adults will still smoke, and there will be no more women who smoke during pregnancy. The measures focus on creating a tobacco and smoke-free environment, helping people to quit smoking, and making buying cigarettes or tobacco as unappealing as possible.

  The National Prevention Agreement consists of three sub-agreements. Organisations that sign one or more agreements will be committed to achieving the objectives. The National Institute for Public Health and the Environment (RIVM) monitors progress to see whether the measures taken are enough to achieve our aims for 2040. Where necessary, this will allow to adjust or introduce new measures.

• Slovenia: Towards Tobacco- and Nicotine-Free Slovenia 2040

  In Slovenia, the official endgame goal is included in the Strategy for reducing harmful consequences of tobacco use – For Tobacco-Free Slovenia – 2022 to 2030 with its first action plan for implementation for the period of 2022-2024. Many stakeholders in tobacco control, joined in the tobacco control stakeholder group called Anti-Tobacco Working Group coordinated by National Institute of Public Health. They have been jointly working to achieve the adoption of the endgame goal for more than 5 years.

  In 2022, the government adopted the strategy including endgame objective that states that in 2040, there will be less than 5% users of tobacco, related and other nicotine products (not registered as nicotine replacement therapy) among inhabitants of Slovenia, aged 15 or more. The Strategy for reducing harmful consequences of tobacco use – For Tobacco-Free Slovenia – 2022 to 2030 includes the measures necessary to set the path towards tobacco and nicotine free Slovenia.