UCSF

The successes of tobacco control in some countries and locales have led to discussions of ending the tobacco epidemic, often called the endgame. In this paper, we recommend articulating the endgame goal as phasing out sales of cigarettes, a goal once called unthinkable. We develop a logic and argumentation for ending cigarette sales intended to move the discussion beyond the shadow of prohibition, proposing an approach that appeals to consumer protection standards and suggesting that the effort be led by low-prevalence communities. While phasing out cigarettes will not happen everywhere all at once, and may unfold differently along several lines, we argue that the gradual phase-out approach we propose will reduce the likelihood of the negative consequences often predicted to come with such a policy. To continue permitting widespread sales of the single most deadly consumer product in history is a public health failure that must be addressed.