ATTUD Journal Club Postings

Planning the “End Game” When We Are Not Winning

Recently, tobacco control advocates have begun discussion “end game” strategies. A recent review lists the many interesting and novel strategies being considered (Tobacco Control 25:594). The problem is that the recent MMWR report (Nov 15, vol 68, Number 45) suggests this is wishful thinking.

Click here for a figure from that article illustrating the change over time in recent cessation and in lifelong cessation. Although these are increasing, the change does not suggesting we are winning the war on smoking. For example, the increase in recent cessation is 1%/yr; thus, if things continue as is, we will eliminate smoking in15 yrs from now (along with several million deaths in the interim). And it will surely be even longer to eliminate in vulnerable populations.

I think the many interesting ideas to implement in the TC article should be seriously considered; however, not from a “closing out” rationale but from a “we have to get braver” or we will end up mimicking the climate change “end game” scenario.