Cigarette endgames: Reality-based approaches that are ready to move forward

Although U.S. smoking prevalence is about half of what it was when the first Surgeon General's Report of Smoking and Health was issued a half century ago, new and bold policies are urgently needed to initiate a true endgame for cigarettes, which are still causing nearly a half million preventable deaths each year.

Polling to date has demonstrated significant support for reducing nicotine in cigarette down to non-addictive levels and even for banning cigarettes altogether. This support has come about despite a lack of any formal advocacy for either policy or any other "endgame" approach to cigarette smoking.

There are 2 “endgame” strategies that are legally feasible and achievable in this decade. One involves federal rulemaking through the Food and Drug Administration (“FDA”) and one involves state and local action to permanently discontinue selling cigarettes to anyone born after December 31, 1999. These cigarette “endgame” initiatives are legally and logically consistent and complementary and could be initiated immediately.

By engaging federal authorities through public comments and state and local authorities through policy advocacy, these 2 endgames can be put into action to dramatically change the tobacco control landscape and provide an example to other nations that endgames around cigarettes are not only possible but are achievable and essential components of public health practice.