Tobacco endgame can be achieved in two complementary ways:
- National Strategies: Measurable goals integrated into national tobacco control or health plans, with clear definitions of targeted products.
- Forward-Looking Measures: Individual policies implemented even without a broader national goal.
As the first step, identifying feasible policy options should start by considering the WHO FCTC implementation level. Tobacco endgame should emphasize the importance of continuing to focus on these pre-existing WHO FCTC measures and building upon them to develop forward-looking measures, in line with Article 2.1 of the Convention. Examples of the goals and measures are available on the page Tobacco endgame goals and measures.
Achieving tobacco endgame goals will require a combination of near-, medium-, and long-term strategies. Some policies can be implemented more quickly, while others will take time both in terms of public readiness and availability of smoking cessation services. All policies should have precise and measurable aims, preferably integrated into the implementation action plans with allocated resources. Below we provide three examples of how to facilitate the identification of feasible policy options that advance tobacco endgame.
Most countries should begin by fully implementing the core measures of the WHO FCTC (measures required by the treaty), also reflected in its "best buys" (MPOWER). The EU Cancer Plan goal – less than 5% of tobacco use by 2040 – can be utilized to call for strengthened implementation of the WHO FCTC at the national level. If advocating for a national tobacco endgame goal is already feasible in the local tobacco control context, considering also the current national smoking prevalence and the use of other tobacco and nicotine products, a simple approach would be to align the national goal with the EU goal definition and timeline.
Besides the core measures, the WHO FCTC and its implementation guidelines present multiple recommendations that are considered advanced measures (e.g., plain packaging, prohibiting online sales). In countries that have adopted some or most of these, advocating for forward-looking measures or a national tobacco endgame goal is already more feasible. A simple approach would be to align the national goal with the EU Cancer Plan goal – less than 5% of tobacco use by 2040.
Another option is to compare other countries that have already adopted tobacco endgame goals, identify countries with similar tobacco control contexts, and use the goals of these countries to develop a goal that is realistic in the near future. If a relevant national tobacco endgame proposal from government bodies, research organizations, or civil society organizations not affiliated with the tobacco industry or related entities exists, consider acknowledging it by the government to make it official.
In countries with an official tobacco endgame goal from the government, it is important to ensure that the WHO FCTC is implemented at the highest level and advocate for forward-looking measures that are feasible in the local tobacco control context. Monitor and evaluate progress regularly and use the findings to develop new proposals for actions and policy measures. Assess whether the national goal and measures sufficiently address the increasing product portfolio of the tobacco industry. Share information about your goals and measures so other countries can identify your country as a relevant comparison.
All countries should:
- Encourage multisectoral collaboration and civil society advocacy, and collaborate with other countries to network, exchange information, and provide or receive technical assistance.
- Prevent nicotine addiction (WHO FCTC Article 5.2b) and integrate effective cessation support to tobacco endgame goals and forward-looking measures
- Strictly adhere to Article 5.3 of the WHO FCTC.
- Scrutinize industry-driven harm reduction initiatives and exercise caution around this concept, especially in areas with weaker regulations.
In the EU, regular and forward-looking revision of the directives on tobacco products, taxation, advertising, and updating the smoke-free environment recommendations are critical.
Policy brief: Forward-looking tobacco control measures and tobacco endgame (Julkari)
Regulatory Impact Assessment as a tool for feasibility assessment
Tobacco endgame goals and forward-looking policies, by their very nature, require careful option appraisal, design, delivery, monitoring, and evaluation to ensure they are feasible in the current tobacco control context and have the desired impact. One possible approach to this is Regulatory Impact Analysis (RIA), which is an overarching general approach used widely across different countries/sectors and types of legislation/regulation, and to a limited extent in tobacco control. RIA is a tool used for the structured exploration of different options to address particular policy issues. It is used where one or more of these options is new regulation or a regulatory change and facilitates the active consideration of alternatives to regulation or lighter forms of regulation.
A few examples of the use of RIA by countries and federal states in the realm of tobacco control are available online in English, with varying scope and content. These include:
- United Kingdom:
Impact Assessment on the Prohibition of Display of Tobacco Products at the Point of Sale in England (gov.uk) - New Zealand:
New Zealand Regulatory Impact Statement: Smokefree Aotearoa. Analysis produced for the purposes of Informing Cabinet decisions (Ministry of Health) - Ireland:
Regulatory and Poverty Impact Assessments (Houses of the Oireachtas) - New South Wales:
Regulatory impact assessments (NSW Government) - Canada:
Regulatory Impact Statement, Number 24 Regulations amending the Tobacco Products Regulations (Plain and Standardised) (Government of Canada)
Both those authoring or responding to RIAs should be fully conversant with the provisions of the Article 5.3 of the WHO Framework Convention on Tobacco Control and its related guidelines.
Guidelines for implementation of Article 5.3 (FCTC)