Table 2

Summary of included evidence syntheses characteristics

Endgame topicSyntheses (n)Types of evidence synthesesPopulationsAddressed equity impactsPolicy actors involved in authoring, funding or publishing evidence syntheses
Product focused
Mandate VLNC for smoked tobacco products to make them non-addictive or minimally addictive.26

  • 18 traditional reviews (narrative)5 28–30 32–35 42–48 50 52 89

  • 4 simulation modelling studies38–41

  • 3 systematic reviews36 49 51

  • 1 consensus/expert opinion study37

  • Adolescents (n=3)28 43 50

  • People experiencing mental illness (n=4)28 45–47

  • Pregnant women (n=1)28

  • Women of childbearing age (n=1)48

  • People who experience socioeconomic disadvantage (n=2)47 48

  • Indigenous populations (n=1)49

  • Modelling study populations: USA (n=4)38–41

  • General population (n=16)5 29 30 32–37 42–44 50–52 89

928 30 37 44–46 48 49 51

  • US National Institute of Drug Abuse (NIDA)32–35 37 38 40 41 44–47 52

  • US Food and Drug Administration’s (FDA) Center for Tobacco Products (CTP)32 34 35 39 44 46 47 52

  • US National Institutes of Health (NIH)40 50

  • US FDA45

  • US NIH’s National Cancer Institute36 40 42

  • US National Institute on Alcohol Abuse and Alcoholism36

  • WHO28 29

  • US NIH’s National Institute of General Medical Sciences45 51

  • American Legacy Foundation37

  • American Medical Association43

  • US National Academies of Sciences30

  • Australia’s National Health and Medical Research Council (NHMRC)49

  • Health Research Council of New Zealand49

  • Cure Kids New Zealand49

  • James Russell Lewis Trust, New Zealand49

  • Cancer Research UK5

  • US Veterans Administration Mental Illness Research, Education and Clinical Center33

  • US California Tobacco-Related Disease Research Program41

Set product standards for nicotine products that make combustible tobacco products unappealing or removed from the market for exceeding toxicity thresholds.1

  • 1 traditional review (narrative)5

  • General population5

0

  • Cancer Research UK5

Move consumers from combustible tobacco products to non-smoked reduced risk nicotine products (when implemented as a tobacco endgame policy).8

  • 5 traditional reviews (narrative)4 34 56 58

  • 3 simulation modelling studies53–55

  • General population (n=3)4 34 56 57

  • Pregnant women and fetuses, children, adolescents (n=1)58

  • Youth57 58

  • People with cancer57

  • Modelling study populations (n=3): USA,53 54 Singapore55

164

  • US Truth Initiative Schroeder Institute53 56

  • Singapore’s Ministry of Health55

  • Singapore’s National Medical Research Council55

  • Singapore’s National Research Foundation55

  • US NIDA34

  • US FDA CTP34 54

  • US NIH’s National Cancer Institute53 54

User focused
Require consumers to obtain a purchaser’s licence or medical prescription to purchase tobacco.0
Restrict tobacco sales by year born (tobacco-free generation).4

  • 3 simulation modelling studies55 59 60

  • 1 traditional review (narrative)61

  • Modelling study populations (n=3): Singapore,55 Solomon Islands,59 New Zealand72

  • Global: people born on/after 1 January 2000 (n=1)61

172

  • Singapore’s Ministry of Health55

  • Singapore’s National Medical Research Council55

  • Singapore’s National Research Foundation55

  • Health Research Council of New Zealand59 60

  • National Cancer Centre, Singapore61

Market/supply focused
End commercial retail sale of combustible tobacco (abolition).2

  • 1 simulation modelling study59

  • 1 traditional review (narrative)5

  • Modelling study population: Solomon Islands (n=1)59

  • General population (n=1)5

0

  • Cancer Research UK5

  • Health Research Council of New Zealand59

Set a regularly reducing quota on the volume of tobacco products manufactured or imported into a country (sinking lid).2

  • 2 simulation modelling studies31 60

  • Modelling study populations (n=2): New Zealand31 60

172

  • Health Research Council of New Zealand31 60

  • Ministry of Health of New Zealand31

Actions that reduce the commercial viability of tobacco companies, such as a ‘corporate death penalty’, or criminal charges (eg, ‘corporate manslaughter’), requiring compensation for full impacts of tobacco use, or limiting profitability.0
Increases in tobacco tax that make tobacco products generally unaffordable.7

  • 7 simulation modelling studies55 59 60 62–65

  • Modelling study populations (n=7): New Zealand,60 62 63 65 Canada,64 Singapore,55 Solomon Islands59

360 62 63

  • Health Research Council of New Zealand59 60 62 63

  • National Health and Medical Research Council62 63

  • Health Canada Substance Use and Addiction Program64

  • Singapore’s Ministry of Health55

  • National Medical Research Council55

  • Singapore’s National Research Foundation55

Restrictions on tobacco retailer density/location/type/licensing that substantially reduce tobacco availability.10

  • 6 simulation modelling studies60 64 70–73

  • 2 traditional reviews (narrative)66 67

  • 2 systematic reviews68 69

  • School-age youth (n=1)68

  • Modelling study populations (n=6): New Zealand,60 70 71 73 Canada,64 Australia72

  • General population (n=3)66 67 69

760 67 69–73

  • Health Canada Substance Use and Addiction Program64

  • US NIH’s National Cancer Institute67 69

  • US NIH66 68

  • US Tobacco-Related Disease Research Program66

  • US California Department of Public Health66

  • US Office on Smoking and Health at the Centers for Disease Control and Prevention67

  • Cancer Society of New Zealand68

  • US NIH’s National, Heart, Lung and Blood Institute68

  • Health Research Council of New Zealand60 70 71 73

  • Sax Institute (Australia)72

  • Queensland Health (Australia)72

Institutional structure focused
Transfer management of tobacco supply to an agency with a mandate to phase out tobacco sales.0
Performance-based regulation whereby tobacco companies are required to meet smoking prevalence targets or be fined; or manufacturers pay a levy based on sales volume similar to ‘polluter pays’ schemes.0

  • VLNC, very low nicotine content.