A billion deaths from tobacco are expected by 2100. Many policy interventions such as increased taxation, restrictions on advertisement, smoking bans, as well as behavioral interventions, such as pharmacological and psychological treatments for smoking cessation, decrease tobacco use, but they reach their limits. Endgame scenarios focusing on tobacco supply rather than demand are increasingly discussed, but meet with resistance by the industry and even by many tobacco control experts. A main stumbling block that requires more attention is what to do with the tobacco industry in endgame scenarios. This industry has employed notoriously talented experts in law, business, organization, marketing, advertising, strategy, policy, and statistics and has tremendous lobbying power. Performance-based regulatory approaches can pose a legal obligation on manufacturers to decrease - and eventually - eliminate tobacco products according to specified schedules. Penalties and rewards can make such plans both beneficial for public health and attractive to the companies that do the job well. We discuss caveats and reality checks of engaging the tobacco industry to eliminate its current market and change focus. Brainstorming is warranted to entice the industry to abandon tobacco for other profit goals. To get the dialogue started, we propose the wild possibility of hiring former tobacco companies to reduce the costs of healthcare, thereby addressing concurrently two major challenges to public health.

译文

:到2100年,预计将有10亿人死于烟草。许多政策干预措施,例如增加税收,限制广告,禁止吸烟,以及行为干预措施,例如戒烟的药物和心理治疗,都减少了烟草使用,但这些措施可以达到目的。限制。越来越多地讨论了以烟草供应而不是需求为重点的残局情景,但最终结果受到了业界甚至许多烟草控制专家的抵制。需要更多关注的主要绊脚石是在终端游戏场景中如何处理烟草业。这个行业雇用了法律,商业,组织,市场营销,广告,战略,政策和统计方面的著名专家,并具有巨大的游说能力。基于绩效的监管方法可能对制造商构成法律义务,要求其按照指定的时间表减少并最终淘汰烟草产品。罚款和奖励可以使这样的计划既有益于公共卫生又可以吸引做得好的公司。我们讨论了吸引烟草业以消除其当前市场并改变重点的注意事项和现实检查。头脑风暴是诱使该行业放弃烟草以实现其他利润目标的诱因。为了开始对话,我们建议雇用前烟草公司以降低医疗保健成本的巨大可能性,从而同时解决公共卫生方面的两个主要挑战。

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