{"id":1819,"date":"2026-02-23T06:50:25","date_gmt":"2026-02-23T06:50:25","guid":{"rendered":"https:\/\/blogs.bmj.com\/tc\/?p=1819"},"modified":"2026-02-23T06:50:25","modified_gmt":"2026-02-23T06:50:25","slug":"making-tobacco-endgame-inevitable-how-the-narratives-we-use-influence-the-normalization-of-tobacco-elimination","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/tc\/2026\/02\/23\/making-tobacco-endgame-inevitable-how-the-narratives-we-use-influence-the-normalization-of-tobacco-elimination\/","title":{"rendered":"Making Tobacco Endgame Inevitable: how the narratives we use influence the normalization of tobacco elimination\u00a0"},"content":{"rendered":"

Eline Goethals, Chris Bostic & <\/span><\/i>Megan Manning<\/span><\/i><\/p>\n

The evidence for the tobacco endgame is there. The policies exist, and the public is ready. On average, <\/span>72% of people across countries<\/span><\/a> support phasing out commercial cigarette sales. In the Netherlands, <\/span>63% of young people<\/span><\/a> agree the tobacco and vape industry should not exist. Jurisdictions in the USA are already successfully implementing nicotine sales bans. \u00a0Countries such as Ireland and Finland have set concrete nicotine and tobacco elimination targets. These steps forward, fall under what advocates call the ‘tobacco endgame\u2019. Yet, despite the evidence, the policies and public support, the \u2018tobacco endgame\u2019 is often not high on political agendas worldwide. Why isn’t it gaining the traction it deserves?<\/span>\u00a0<\/span><\/p>\n

A new report by Action on Smoking and Health<\/span><\/a> (ASH) in collaboration with The School for Moral Ambition and the Johns Hopkins Bloomberg School of Public Health argues that part of the answer lies not in a lack of evidence or political opportunity, but in something more fundamental: how we talk about endgame itself. Advocating for the tobacco endgame can be strengthened by addressing three critical weaknesses: inconsistent definitions, a lack of cohesive narrative, and limited awareness beyond tobacco control circles. <\/span>\u00a0<\/span><\/p>\n

When a concept remains unknown or unclear, it is not discussed, preventing its normalization. And when stakeholders believe comprehensive change cannot happen, they settle for incremental progress that preserves tobacco industry power. This report offers 14 communication recommendations to break this cycle. We highlight a few here.<\/span>\u00a0<\/span><\/p>\n

Starting with the term itself, what does “tobacco endgame” actually mean? Definitions vary widely, even among experts. Some define it as achieving below 5% smoking prevalence. Others mean a complete phase-out of commercial tobacco sales. Some include all nicotine products; others focus on cigarettes alone. There is no consensus on when a policy qualifies as “endgame” versus conventional tobacco control. This confusion weakens the concept’s communicative power and limits broader understanding.<\/span>\u00a0<\/span><\/p>\n

The report proposes a simple framework to facilitate understanding the concept of tobacco endgame, drawn from the word itself. “Endgame” has two components: an <\/span>end<\/span><\/i> \u2014 a concrete, measurable end to the operations of the tobacco industry by a specific date and a <\/span>game<\/span><\/i> \u2014 strategic pathways adapted to local context. Together, the tobacco endgame becomes: <\/span>a concrete plan to end all activities of the tobacco industry, with a specific timeline and strategy tailored to each region’s needs.<\/span><\/i> Importantly, this framing places responsibility on the tobacco industry rather than on individuals who smoke, something that is more difficult when the definition centers on prevalence. Reframing it in this way demands a deadline and creates urgency and accountability. And it acknowledges that different jurisdictions need different approaches: endgame is a flexible toolkit, not a single policy.<\/span>\u00a0<\/span><\/p>\n

However, \u00a0a clearer definition alone will not be enough. The report also argues that we need to rethink how we make the case for endgame, starting with where we direct attention. As long as we allow \u00a0smoking be framed as personal choice, the case for structural market change becomes more easily ignored. Endgame messaging should center on the tobacco industry’s deliberate engineering of addiction, rather than \u00a0the behavior of those trapped by it. This shift is not just ethically important, it is also strategically advantageous. In this way, \u00a0policymakers can \u00a0position themselves as champions protecting citizens from corporate exploitation, rather than as regulators restricting personal freedom.<\/span>\u00a0<\/span><\/p>\n

This tobacco industry-centered framing also means we should stop treating tobacco products as if they exist in isolation. The industry’s pivot to e-cigarettes, heated tobacco, and nicotine pouches is not a strategy to reduce the harm of cigarettes. Internal documents show it is a conscious plan to maintain profitability and regain social acceptance. Focusing endgame efforts only on tobacco products plays directly into a strategy the industry has been pursuing for years. The report argues that endgame must ultimately target the addiction-based business model itself, regardless of which product delivers the nicotine.<\/span>\u00a0<\/span><\/p>\n

How \u00a0individual policies are framed matters just as much. Advocates often lead with policy mechanics. The report recommends a different approach: open with a concrete example of tobacco industry manipulation, explain how the proposed policy strips away that specific power, and only then describe how the policy works. The policy itself is not the message, but rather what it achieves.<\/span>\u00a0<\/span><\/p>\n

We should resist framing endgame thinking as radical.<\/span> Endgame thinking has precedent. Harmful products such as asbestos, leaded petrol, and CFCs were eliminated despite powerful industry opposition. There are already examples of tobacco endgame policies in action. In 2021, Brookline, Massachusetts passed <\/span>a first-of-its-kind generational sales ban<\/span><\/a>, over 20 towns have since followed. The Netherlands is <\/span>phasing out tobacco retail points<\/span><\/a> entirely by 2032. These are not just aspirations, but policy reality. <\/span>\u00a0<\/span><\/p>\n

Policymakers who hesitate because they fear public backlash should be inspired by the data: <\/span>73% of Australians<\/span><\/a> support phasing out cigarette sales, <\/span>76% of Americans (including 63% of people who smoke<\/span><\/a>) support mandating very low nicotine content, and <\/span>75% of Irish adults<\/span><\/a> support Ireland’s Tobacco-Free Ireland endgame goal. On this issue, citizens are ahead of their leaders.<\/span>\u00a0<\/span><\/p>\n

The tobacco industry generates <\/span>$880 billion in annual revenue<\/span><\/a>, more than Google, Meta, and Apple combined, while its products kill <\/span>more than 7 million people every year<\/span><\/a>. It is adapting faster than regulations can evolve, pivoting to new nicotine products while keeping its addiction-based business model intact. Traditional tobacco control was never designed to end the tobacco industry itself. While tobacco control advocates manage symptoms, the industry will continue to find new ways to sustain addiction.<\/span>\u00a0<\/span><\/p>\n

Even the best policies need the right narrative. Normalizing endgame thinking is a prerequisite to generate the political will needed to end the tobacco industry. \u00a0We can achieve this with disciplined, coordinated messaging that makes tobacco industry elimination feel not radical, but inevitable.<\/span>\u00a0<\/span><\/p>\n

The full report is available <\/span>here<\/span><\/a>. It is designed not just for researchers, but for advocates, communicators, and policymakers; anyone who communicates about tobacco control. We encourage everyone to read it, use it, and start talking about endgame as a concrete plan, with a deadline, to end the industry that profits from addiction. The century of profiting from addiction is over. It is time.<\/span>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

Authors<\/span><\/b><\/p>\n

Eline Goethals, The School for Moral Ambition, placed at the Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health<\/span><\/i><\/p>\n

Chris Bostic, Policy Director at Action on Smoking and Health (ASH USA).<\/span><\/i>\u00a0<\/span><\/p>\n

Megan Manning, <\/span><\/i>Associate Director of Communications at Action on Smoking and Health (ASH USA).<\/span><\/i>\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Eline Goethals, Chris Bostic & Megan Manning The evidence for the tobacco endgame is there. The policies exist, and the public is ready. On average, 72% of people across countries support phasing out commercial cigarette sales. In the Netherlands, 63% of young people agree the tobacco and vape industry should not exist. Jurisdictions in the […]<\/p>\n

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