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 thenumber of daily tobacco users to 5% among the population aged 15 years and older;andreducing 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-olds 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.

  Read more: JATC-2 WP9 case study on Belgium (pdf)

• 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 humanshas been theobjective of the Tobacco Act since 2010. In 2016, the objective was broadened to cover nicotineproducts regulated under the Act. In practice, the objective has been defined as aiming for less than 5% ofdaily tobacco and non-pharmaceutical nicotine use in the adult (working age) population  by  the  year  2030.  Theshiftfrom merelycontrolling  and  reducing  tobacco-relatedharms to actively pursuing the eradication ofthe tobacco epidemic was drivenby the formationof the "Smoke-free Finland 2040" coalitionin 2008. This coalition, comprisingofcivil society organizations,  researchinstitutes,  and  government  agencies,  later evolvedinto the "Tobacco-Free  Finland  2030"network,  expanding  its  scope  to  includenicotine.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 measures to meettheobjective of the Tobacco Act.

  Read more: JATC-2 WP9 case study on Finland (pdf)

• The Netherlands: Towards a smokefree generation in 2040

  The National Prevention Agreement “A healthier Netherlands” 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. 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 Institute for Public Health and the Environment (RIVM) monitors progress to see whether the measures taken are sufficient, whichwill allow to adjust or introduce new measures.

  Read more: JATC-2 WP9 case study on The Netherlands (pdf)

• 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, 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. The important player in proposing new measures is also the Coordination group of the Ministry of Health, including a broad group of stakeholders.

  Read more: JATC-2 WP9 case study on Slovenia (pdf)

• Norway: Collaborative action to advance a Tobacco Free Norway

  The Norwegian Tobacco Control Act has since 2013 had a "tobacco-free society" as its long-term objective. In 2018, the Norwegian Parliament requested the Government to pursue and facilitate a tobacco-free youth generation and, in 2023, a goal of achieving a tobacco and nicotine free generation was stipulated in the Government’s national tobacco control strategy. According to this goal, children born 2010 and later should not use any tobacco or nicotine products.

  Concurrently, the general tobacco-free objective for the population as a whole was broadened to be understood as aiming for less than 5% of daily use of tobacco and non-pharmaceutical nicotine products in all socio-demographic (age and educational) groups. The shift from controlling and reducing tobacco-related harms, to more actively pursuing the eradication of the tobacco epidemic, was initiated by the "Tobacco-free" coalition, comprising of civil society organizations, research institutes, and government agencies. The Norwegian Cancer Society was a particularly important driver, with another key actor being the multisectoral working groups at the Authorities level, led by the Ministry of Health and Care services.