The tobacco endgame: where are we, and what are the challenges ahead?

The first panel of the second day of the Calisia World Conference on Family Health, held in Kalisz, Poland on 9-10 June 2019, was devoted to one of the defining public health problems of the last century – cigarette smoking. The panel gathered a range of experts, representing fields ranging from economics, through history, to health advocacy, who attempted to summarise the current state of affairs in tobacco control and outline the key challenges ahead.
The panel opened with two presentations putting tobacco control efforts into a wider historical context. First, the audience watched Allan Brandt’s video address, in which he gave a broad introduction to the panel, looking at the history of tobacco control, and in particular of tobacco industry misconduct, in the last century. See the transcription of Allan Brandt’s presentation below, and the key points summarised in Box 1. Second, Mateusz Zatoński spoke about the three stages of the tobacco epidemic in Poland – see slides in Webappendix. Mateusz carried out an in-depth exploration of the history of tobacco control in 20th century Poland in his PhD thesis [1].
Allan Brandt’s video address:
It is wonderful to be here in Calisia with you today, even from this great distance, in this digital format. Many thanks to Mateusz Zatoński for his introduction and especially for including me in this important panel. And I especially want to acknowledge the visionary work of Dr. Witold Zatoński, one of the truly great, historic leaders of public health in the 20th and 21st centuries, whose work has saved lives and preserved the health of millions of people here in Poland, in Europe, and across the globe. All of us who are dedicated to reducing suffering and to preserving good health are in his debt, and this conference clearly indicates the impact that he has had.
My brief remarks this morning are based significantly on my collaboration with Mateusz Zatoński, and I thought this might be a useful occasion to briefly reflect historically as we consider the foundation for critical next steps in tobacco control. My orientation to this stems from the organisation and implementation in the middle of the 20th century of what has widely come to be called the tobacco industry playbook. This strategy emphasised aggressive work on the part of the companies to undermine the science that had demonstrated the harms of tobacco. It did this through industry-funded research by claiming that “the jury is still...


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