The successes of tobacco control in some countries and locales have led to discussions of ending the tobacco epidemic, often called the ‘endgame’. In this paper, we recommend articulating the endgame goal as phasing out sales of cigarettes, a goal once called ‘unthinkable’. We develop a logic and argumentation for ending cigarette sales intended to move the discussion beyond the shadow of ‘prohibition’, proposing an approach that appeals to consumer protection standards and suggesting that the effort be led by low-prevalence communities. While phasing out cigarettes will not happen everywhere all at once, and may unfold differently along several lines, we argue that the gradual phase-out approach we propose will reduce the likelihood of the negative consequences often predicted to come with such a policy. To continue permitting widespread sales of the single most deadly consumer product in history is a public health failure that must be addressed.
- End game
- Human rights
- Public policy
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Contributors EAS wrote a first draft of the paper. REM and EAS both contributed to subsequent drafts.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests REM owns one share each of Philip Morris International, Reynolds American and Altria stock for research and advocacy purposes and has participated in tobacco control advocacy. See full statement on funding here: https://tobaccocontrol.bmj.com/pages/wp-content/uploads/sites/49/2016/12/RuthMaloneCompetinginterestsstatement.pdf
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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