Tobacco ‘endgame’ discourse has emerged in
recognition of the nature of the global public health
emergency created by tobacco use and tobacco
promotion. This discourse is a promising development,
but translating it into action requires developing some
consensus, at least by countries or regions. It also
requires negotiating some of the recurring tensions
within the tobacco control movement, contributing to
risks for the movement as visionaries clash with
pragmatists. This paper outlines one combination of
approaches that might hold promise for the US situation.
Every significant achievement in tobacco control was
preceded by many influential people saying it couldn’t
be done, wouldn’t work, or would create new problems.
The risks of not envisioning an endpoint for the tobacco
epidemic are far greater than the risks of attempting any
endgame solutions and failing.