Aust Fam Physician. 2012 Nov;41(11):862-5.
Towards an endgame for tobacco.
Abstract
In the early 1950s when (Sir) Richard Doll and Bradford Hill proved that smoking was associated with lung cancer, the smoking rate in male British doctors aged over 35 years was more than 87%. Rates of smoking in Australian doctors had fallen to 3% 15 years ago and it is likely to be even lower now. The Australian Government has specified a national smoking target of 10% by 2018, which would be a sharp fall from current rates. If near elimination of smoking is possible in medical professionals, it is surely reasonable to have the same aim for the whole community. This is the tobacco endgame - the development and implementation of single or multiple strategies that will see smoking rates fall to near zero in a relatively rapid time. New Zealand has adopted a target date of 2025 and Finland a more conservative 2040. In New Zealand there are high levels of support for radical aims and actions and, importantly, the support is strongest in groups who are relatively disadvantaged.
BACKGROUND:
The reduction in smoking in Australia in the past 30 years has established the conditions in which elimination of smoking should now be considered. This is sometimes referred to as the 'tobacco endgame'. A range of approaches can be considered and any that are implemented would build on current actions such as plain packaging.
OBJECTIVE:
This article outlines possible public health and policy approaches with the goal of leading to the elimination of smoking, and discusses a potential target date for the elimination of smoking in Australia.
DISCUSSION:
The most effective strategy for eliminating smoking in Australia is likely to be one that reverses the tolerable, addictive nature of modern tobacco by the elimination of all additives and by specifying a very low level of true nicotine delivery. Use of an unsatisfying, costly and toxic product would naturally, and rapidly, decline.
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