Over the years, the ratification of the WHO FCTC has led to the implementation of key tobacco control measures, which have resulted in significant reductions in tobacco use at global level. Several European countries are now advancing forward-looking tobacco control policies through official national tobacco endgame goals, which are integrated into governmental strategies or tobacco control legislation.
As of 2024, in the EU, seven Member States have official endgame goals with differing definitions. In European non-EU countries, endgame goals have also been set by two countries. The adopted endgame goals address the general population or specific groups (children or pregnant women), often focusing on <5% prevalence level, have target years between 2025-2040, and cover various products from combustible tobacco only to all tobacco and nicotine products. Of these countries, two (Finland and Norway) have integrated their goal into the national tobacco control legislation.
| Country | Goal and specification(s) | Year launched | Target year |
|---|---|---|---|
| Belgium | Smokefree generation: <5% of population aged ≥15 years use tobacco daily , 0% or almost 0% people start using tobacco products | 2022 | 2040 |
| Finland | Ending the use of tobacco and other nicotine products: <5% of the adult population use tobacco and nicotine products daily (originally 2% of adult population will use tobacco products) | 2016 (first in 2010) | 2030 (first by 2040) |
| France | Tobacco-free generation: Children born since 2014 become the first generation of adult non-smokers (<5% smokers) | 2018 | 2032 |
| Ireland | Tobacco-free Ireland: <5% smoking prevalence rate of the Irish population | 2013 | 2025 |
| The Netherlands | Smokefree generation: Fewer than 5% of the residents of the Netherlands aged 18 years and over and 0% of young people and pregnant women will smoke | 2018 | 2040 |
| Norway | Tobacco-free society: The proportion of daily smokers and snus users should be below 5% in all age and education groups, children born in 2010 and later must not use tobacco products and related products | 2023 (first in 2013) | Not defined |
| Slovenia | Tobacco-free Slovenia: Less than 5% of Slovenia's population aged 15 or over will use tobacco, related products and other nicotine products that are not registered as nicotine replacement therapy | 2022 | 2040 |
| Sweden | Smoke-free Sweden: <5% smoking prevalence | 2016 | 2025 |
| United Kingdom (England) | Smoke-free England: ≤5% smoking rate, a smoke-free generation | 2019 | 2030 |
| United Kingdom (Scotland) | Smoke-free Scotland: ≤5% smoking prevalence of adults, a tobacco-free generation (children born in 2013 by the age of 21 years) | 2013 | 2034 |
Tobacco endgame measures
Countries can adopt different forward-looking tobacco control policies and measures, regardless of the existence of a national tobacco endgame goal. These can be grouped into four broad categories: Product-, Consumer-, Retail- and Market-oriented. Some examples of these measures, based on literature and available examples from European countries, are presented below. Depending on the country's context, these measures can be applied to a different range of tobacco and nicotine products.
Product-oriented
Very low nicotine content (VLNC, denicotinization) regulations aim to make products non-addictive or less addictive. The VLNC policy for cigarettes is among the most studied tobacco endgame policies. Evidence suggests positive effects on reduction in cigarette smoking, smoking prevalence and related harm, potential benefits in vulnerable groups, and public support. In Europe, no countries have yet adopted VLNC policies. In the EU, the Tobacco Products Directive regulates nicotine levels and could potentially move towards VLNC regulation.
Product standards that regulate the pH-level (which influences inhalation and nicotine absorption) and prohibit flavours (which influence inhalation, nicotine absorption, toxicity and increase attractiveness) aim to make products unappealing or to remove the most toxic products from the market. The guidelines for the implementation of Articles 9 and 10 of the WHO FCTC state that from the perspective of public health, there is no justification for using ingredients that increase attractiveness, such as flavouring agents.
There is evidence of public support for the policy for flavor bans (such as banning menthol). In the EU, the Tobacco Products Directive (TPD) and the delegated directive 2022/2100 prohibit characterizing flavours, including menthol, in cigarettes, roll-your-own, and heated tobacco products. At least Belgium, Finland, Germany, Hungary and the Netherlands have also prohibited menthol completely in combustibles as an additive that facilitates inhalation. Some countries have also prohibited most or all other than tobacco flavours in electronic cigarettes.
Consumer-oriented
This measure aims to protect future generations by prohibiting sales by year born, instead of maintaining an age-of-sales regulation. In Europe, the United Kingdom first proposed this in 2023, and it will become an offence to sell tobacco products to anyone born on or after 1 January 2009. In Norway, the national strategy from 2023 includes a goal that children born since 2010 do not use tobacco and nicotine products, but no regulation has yet been adopted.
If combined with policies of denicotinization and substantial retail outlet reduction, this policy could have major impacts on reducing inequities in health. It is rare to initiate the use after 20 years of age, so even a single increase in the age limit may also have a substantial impact in the European context, where most countries have an age limit of 18. Ireland has decided in 2024 to introduce an age limit of 21 for tobacco sales, and Latvia an age limit of 20 for tobacco and related products (including e-cigarettes and tobacco substitutes such as nicotine pouches).
Retail-oriented
Restrictions aim to substantially reduce availability through regulations that limit the number, type, or location of retailers. Several European countries have recently adopted or announced measures in this category. Stepwise reductions in sales are being implemented in the Netherlands and Belgium. In the Netherlands, the online sales of tobacco and related products became prohibited in July 2023, supermarket sales will be banned from July 2024, and a sales ban in petrol stations will be implemented starting in 2030.
This means that only specialist stores will be allowed to sell tobacco and related products from 2032 and e-cigarettes from 2026. Belgium has prohibited temporary points of sale, including festivals from January 2025, tobacco and e-cigarette sales in large supermarkets (>400m2) from July 2025. In France and Hungary, only specialist shops can sell tobacco. In Hungary, this applies to tobacco products, e-cigarettes, e-liquids, nicotine pouches, and herbal products for smoking, and the number of shops is limited to 1 shop/4000 people.
Retail sale licensing is an effective way to control the supply and availability of tobacco and related products. It provides the platform to introduce supervisory fees that gradually reduce the sales points. In Europe, Finland has introduced high annual supervisory costs to tobacco and e-cigarette retail sale license holders, resulting in a substantial decrease in sales points.
Article 17 of the WHO FCTC requires countries to promote, as appropriate, economically viable alternatives for tobacco workers, growers and individual sellers. Incentives to sellers are generally rare. In Europe, France has established a protocol between the confederation of tobacconists (specialist shops that are allowed to sell tobacco) and the Ministry of Finance to support tobacco retailers in transforming to other local shops.
Market-oriented and other measures
From the perspective of consumer protection standards and human rights, there is no justification for allowing the deadliest consumer product, cigarettes, to be on the market. Some of the transnational tobacco companies have claimed that they will stop selling cigarettes in the future in some countries, but industry self-regulation rarely works.
Given the increasing product portfolio of transnational tobacco companies, it is possible to obligate them to gradually end cigarette sales. This is feasible, especially in countries where smoking prevalence is lower and smoking cessation services are available. This approach has sometimes been called 'abolition' instead of prohibition.
This model focuses on the transfer management of tobacco supply to an agency with a mandate to phase out tobacco sales or whose goals are consistent with the overall aims of tobacco control, or state takeover of tobacco companies by non-profit entities with a public health mandate. In Europe, Austria, France, Hungary, Italy and Spain have a state monopoly on tobacco sales.
Performance-based regulation means, for example, that tobacco companies are required to meet smoking prevalence targets or be fined; companies are fined based on the quantity of their products consumed by minors; or manufacturers pay a levy based on sales volume similar to ‘polluter pays’ schemes.
Tobacco taxation is one of the most effective tobacco control measures. In tobacco endgame, the difference with regular tobacco taxation – the WHO recommended level of at least 75% total tax – is to introduce substantial increases that make tobacco products generally unaffordable in the long term, or to introduce taxation that targets industry profits (e.g., tobacco supplier profits surtax).
For example in France, a Social Affairs Committee, part of France's Senate, has proposed a 5% annual increase in cigarette prices until 2040. If implemented, this would result in a single pack costing 25 EUR in 2040.
Set a regularly reducing quota on the volume of tobacco products manufactured or imported into a country (’sinking lid’). Another connected issue, not addressed much even in tobacco endgame, is the free trade of tobacco.