Commercial Tobacco Endgame Goals: Early Experiences From Six Countries

Author:

Nip Janine1ORCID,Thornley Louise1,Schwartz Robert2ORCID,Cunningham Rob3,Hara Mervi4,Clancy Luke5ORCID,Evans David6,Howell Fenton7,Duffy Sheila8,Gilljam Hans9,Edwards Richard1ORCID

Affiliation:

1. University of Otago, Department of Public Health , Newtown , New Zealand

2. University of Toronto , Toronto, Ontario , Canada

3. Canadian Cancer Society , Ottawa, Ontario , Canada

4. ASH Finland , Helsinki , Finland

5. Tobacco Free Research Institute Ireland , Dublin , Ireland

6. Health Service Executive, National Social Inclusion Office , Dublin , Ireland

7. Department of Health , Dublin , Ireland

8. ASH Scotland , Edinburgh , Scotland

9. Department of Global Public Health, Karolinska Institute , Stockholm , Sweden

Abstract

Abstract Introduction Tobacco use is a major threat to health globally. A number of countries have adopted “endgame goals” to minimize smoking prevalence. The INSPIRED project aims to describe and compare the experiences of the first six countries to adopt an endgame goal. Aims and Methods Data were collected on the initial experiences of endgame goals in Canada, Finland, Ireland, New Zealand (Aotearoa), Scotland, and Sweden up to 2018. Information was collated on the nature of the endgame goals, associated interventions and strategies, potential enablers and barriers, and perceived advantages and disadvantages. Results The INSPIRED countries had relatively low smoking prevalences and moderate-to-strong smoke-free policies. Their endgame goals aimed for smoking prevalences of 5% or less. Target dates ranged from 2025 to 2035. Except for New Zealand (Aotearoa), all countries had an action plan to support their goal by 2018. However, none of the plans incorporated specific endgame measures. Lack of progress in reducing inequities was a key concern, despite the consideration of equity in all of the country’s goals and/or action plans. Experience with endgame goals was generally positive; however, participants thought additional interventions would be required to equitably meet their endgame goal. Conclusions There was variation in the nature and approach to endgame goals. This suggests that countries should consider adopting endgame goals and strategies to suit their social, cultural, and political contexts. The experiences of the INSPIRED countries suggest that further and more significant interventions will be required for the timely and equitable achievement of endgame goals. Implications By 2018, six countries (Canada, Finland, Ireland, New Zealand (Aotearoa), Scotland, and Sweden) had introduced government-endorsed “endgame goals,” to rapidly reduce smoking prevalence to very low levels by a specified date. The nature and implementation of endgame goals were variable. Early experiences with the goals were generally positive, but progress in reducing smoking prevalence was insufficient, particularly for priority groups. This finding suggests more significant interventions (“endgame interventions”) and measures to reduce inequities need to be implemented to achieve endgame goals. Variation in the nature and experience of endgame goals demonstrates the importance of designing endgame strategies that suit distinct social, cultural, and political contexts.

Funder

New Zealand Health Research Council

Royal Society and Health Research Council of New Zealand

Cancer Society of New Zealand

Publisher

Oxford University Press (OUP)

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1. The Tobacco Endgame: A Never-Ending Story?;Nicotine and Tobacco Research;2024-05-03

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