The legislation in Bhutan lasted until the COVID-19 pandemic, when concerns around the smuggling of tobacco across international borders – and the associated risk of cross-border transmission of the COVID-19 virus – led to sales of tobacco being permitted in some shops. This reversal remains in place. Although the Bhutanese government insists it is a temporary measure and tobacco production and manufacturing remain banned, such a U-turn in one of the first examples of a tobacco-endgame approach has heightened the scepticism surrounding these kinds of policies.
The role of the tobacco industry
Interference from the tobacco industry continues to act as a barrier to endgame progress across the world. The industry uses rhetoric about the failure of alcohol prohibition to undermine government efforts to ban the sale of cigarettes. Accusations of ‘nanny statism’ are often invoked, as are fears of fuelling an expanded illicit tobacco trade.
In Malaysia, an ‘unprecedented level of industry interference’ reportedly resulted in a proposed generational tobacco ban being dropped from a new anti-smoking law. Similarly, public health experts published a brief pointing to potential tobacco industry influence on New Zealand’s coalition government, which in 2024 repealed legislation prohibiting the sale of tobacco to anyone born after January 2019. The new government argued that the ban would boost the illegal tobacco market.
Based on WHO estimates, current progress in curbing tobacco use is not sufficient for countries to reach their endgame goals – especially those with 2025 targets.
The future of tobacco endgame
As patterns of tobacco and nicotine use change, endgame policies must adapt. In Finland, for example, the tobacco endgame includes the country being ‘nicotine-free’ by 2030. Yet the increase in the use of smokeless nicotine pouches, such as snus, will likely hamper efforts to meet this target. Governments must decide whether so-called ‘reduced-risk products’ such as vapes or e‑cigarettes are enablers of or obstacles to their endgame objectives.
Tobacco industry interference is a clear challenge to endgame success. Developing tools to effectively mitigate such interference is, therefore, a necessary condition of achieving tobacco endgame objectives.
There is cause for optimism, nonetheless. Public support for most tobacco endgame policies is high, which is crucial if they are to be accepted and successfully implemented. And tobacco endgame policies are closely aligned with the WHO Framework Convention on Tobacco Control, resulting in more and more countries adopting similar policies with a growing consensus that anti-smoking legislation requires ambition to be effective.
However, while many countries are still without tobacco endgame policies, more must be done to raise awareness of the benefits of these policies among governments, civil society and the wider public. Multi-national initiatives, such as the European Union’s Joint Action on Tobacco Control, can play a crucial role in sharing insights and disseminating endgame best practice. Ultimately, countries must work together to implement and refine measures that are most effective in protecting human health and reducing tobacco risks.
The opinions expressed in this blog are those of the author and do not necessarily represent the views of The Health Policy Partnership.
