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Original research
Strategies and barriers to achieving the goal of Finland’s tobacco endgame
  1. David S Timberlake1,2,
  2. Ulla Laitinen2,
  3. Jaana M Kinnunen2,
  4. Arja H Rimpela2,3,4
  1. 1 Program in Public Health, University of California, Irvine, Irvine, California, USA
  2. 2 Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, Finland
  3. 3 PERLA - Tampere Centre for Childhood, Youth and Family Research, Tampere University, Tampere, Finland
  4. 4 Department of Adolescent Psychiatry, Pitkäniemi Hospital, Tampere University Hospital, Nokia, Finland
  1. Correspondence to Dr David S Timberlake, Program in Public Health, University of California, Irvine, Irvine, CA 92617, USA; dtimberl{at}uci.edu

Abstract

Objectives Finland boldly legislated the end of tobacco use in its 2010 Tobacco Act, and subsequently expanded the goal in 2016 to eradicate other nicotine-containing products. This study explored stakeholders’ perceptions about the strengths, barriers, solutions and rationale for Finland’s comprehensive but conventional strategy to achieve its nicotine-free goal.

Design Study participants were selected based on expertise in policy or practice of tobacco control (n=32). Semi-structured interviews, conducted in 2017 and 2018, covered topics ranging from consensus among stakeholders to Finland’s ranking on the 2016 Tobacco Control Scale. The framework method was chosen for analysing interview transcripts.

Results A perceived strength of Tobacco-Free Finland 2030 was the consensus and cooperation among members of the tobacco control community. The objective of becoming a nicotine- versus smoke-free society had almost unanimous support, challenged by a small minority who argued for greater discussion of harm reduction approaches. The need for maintaining legitimacy and historical successes in tobacco control were reasons for using a conventional strategy. Barriers to achieving the endgame goal included insufficient funding and over-reliance on non-governmental organisations, political/legal constraints, impact of institutional practices on tobacco disparities, ambivalence about the role of mass media and lack of prioritising smoking cessation.

Conclusions Stakeholders’ broad confidence in reaching the goal of Finland’s tobacco endgame suggests that future policy initiatives will reflect the current, conventional strategy. If the Finnish government chooses to continue this approach, then it should designate separate funds for Tobacco-Free Finland 2030 and implement structural changes that will facilitate tobacco control initiatives.

  • media
  • end game
  • disparities
  • cessation
  • global health

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tobaccocontrol-2018-054779

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    Footnotes

    • Contributors DT and AR developed the research questions and study methodology. AR provided contacts for the initial interviews. DT conducted the interviews and UL edited the transcripts for coding. DT, UL and JMK reviewed the interviews, developed the codebook and coded the transcripts. DT formulated themes from the transcripts and wrote most of the manuscript. UL, JMK and AR assisted with the editing of the manuscript.

    • Funding Research reported in this publication was supported by the Fulbright Finland Foundation and Tampere University.

    • Disclaimer The content is solely the responsibility of the authors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Data are available upon reasonable request.