Tob Control 21:293-295 doi:10.1136/tc.2010.040881
  • Endgame visions

What are the elements of the tobacco endgame?

  1. Tony Blakely
  1. Department of Public Health, University of Otago, Wellington, New Zealand
  1. Correspondence to George Thomson, University of Otago, Box 7343, Wellington South, Wellington 6002, New Zealand; george.thomson{at}
  1. Contributors All authors wrote the text.

  • Received 27 February 2011
  • Accepted 2 August 2011


The available literature on tobacco endgames tends to be limited to discussing means, targets and difficulties. This article offers additional ideas on the key elements of endgame strategies and the circumstances in which these are likely to be adopted and implemented. We suggest such strategies will include explicit plans, will define the nature of `the end of tobacco use/sale' and have target dates within 20 years. The likely circumstances for endgame strategy development include low (probably under 15% adult smoking) prevalence and/or rapid prevalence reductions, wide support and strong political leadership. Even with some or all these circumstances, opposition from business, internal government forces and international factors may influence results.


  • Funding GT was supported by a Health Research Council of New Zealand (HRC) grant (the Smokefree Kids Project and the ITC Project), RE and NW by the University of Otago and TB by a HRC grant (Health Inequalities Research Programme).

  • Competing interests The authors have previously undertaken tobacco control work for various non-profit health sector organisations and for government and international health agencies.

  • Provenance and peer review Commissioned; externally peer reviewed.

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