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Closing the gaps in tobacco endgame evidence: a scoping review
  1. Cheneal Puljević1,2,3,
  2. Kylie Morphett1,2,
  3. Marita Hefler1,4,
  4. Richard Edwards1,5,
  5. Natalie Walker1,6,7,
  6. David P Thomas1,4,
  7. Md Arifuzzaman Khan1,2,
  8. Andrew Perusco1,8,
  9. Michael Le Grande1,9,
  10. Katherine Cullerton1,2,
  11. Driss Ait Ouakrim1,10,
  12. Georgia Carstensen1,2,
  13. David Sellars1,2,11,
  14. Janet Hoek1,5,
  15. Ron Borland1,9,10,
  16. Billie Bonevski1,12,
  17. Tony Blakely1,10,
  18. Claire Brolan1,2,
  19. Coral E Gartner1,2
  1. 1NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
  2. 2School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
  3. 3Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia
  4. 4Menzies School of Health Research, Charles Darwin University, Casuarina, Northern Territory, Australia
  5. 5Department of Public Health, University of Otago, Wellington, New Zealand
  6. 6Centre for Addiction Research, Faculty of Medicine and Health Sciences, The University of Auckland, Auckland, New Zealand
  7. 7National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
  8. 8Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
  9. 9School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
  10. 10Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
  11. 11College of Public Health, Medical and Veterinary Sciences, James Cook University, Cairns, Queensland, Australia
  12. 12College for Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
  1. Correspondence to Associate Professor Coral E Gartner, NHMRC Centre of Research Excellence on Achieving the Tobacco Endgame, School of Public Health, The University of Queensland, Brisbane, QLD, Australia 4006; c.gartner{at}


Objective Tobacco endgame policies aim to rapidly and permanently reduce smoking to minimal levels. We reviewed evidence syntheses for: (1) endgame policies, (2) evidence gaps, and (3) future research priorities.

Data sources Guided by JBI scoping review methodology, we searched five databases (PubMed, CINAHL, Scopus, Embase and Web of Science) for evidence syntheses published in English since 1990 on 12 policies, and Google for publications from key national and international organisations. Reference lists of included publications were hand searched.

Study selection Two reviewers independently screened titles and abstracts. Inclusion criteria were broad to capture policy impacts (including unintended), feasibility, public and stakeholder acceptability and other aspects of policy implementation.

Data extraction We report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.

Data synthesis Eight policies have progressed to evidence synthesis stage (49 publications): mandatory very low nicotine content (VLNC) standard (n=26); product standards to substantially reduce consumer appeal or remove the most toxic products from the market (n=1); moving consumers to reduced risk products (n=8); tobacco-free generation (n=4); ending sales (n=2); sinking lid (n=2); tax increases (n=7); and restrictions on tobacco retailers (n=10). Based on published evidence syntheses, the evidence base was most developed for a VLNC standard, with a wide range of evidence synthesised.

Conclusions VLNC cigarettes have attracted the most attention, in terms of synthesised evidence. Additional focus on policies that reduce the availability of tobacco is warranted given these measures are being implemented in some jurisdictions.

  • endgame
  • electronic nicotine delivery devices
  • nicotine
  • public policy

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  • Twitter @ChenealPuljevic, @kyliemorphett, @m_hef, @CoralGartner

  • Contributors Conceptualisation: CEG. Refinement of study design and protocol: all authors. Title, abstract and full-text screening and data extraction: CP, KM, CEG, MLG, AP, DAO, DS, MAK, NW, GC, DPT, MH, KC, RE. First draft of manuscript: CP. Revision of manuscript: CEG, CP, KM, RB, BB, TB, RE, MH, JH, DS, AP, NW, MAK, CB, KC.

  • Funding This study is funded by an NHMRC grant (GNT1198301). AP receives an Australian Research Development Training Program stipend.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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