Any plan to reduce the prevalence and impact of lung cancer will fail if it does not address smoking.
It is unclear if that realization has reached the United States.
In the US, the Department of Health and Human Services’ Healthy People 2030 initiative includes aggressive moves to reduce cancer, including drastic reduction in smoking prevalence. Originally, the target was to cut smoking prevalence to less than 5% by 2030. Unfortunately, the goal was changed to 6.1% in 2022 because the goal was not going to be reached. Perhaps this is because there are no new federal plans in place to accelerate a reduction in smoking with the possible exception of a law reducing nicotine in cigarettes to non-addictive levels. However, it is uncertain when that rule will take effect.
New Zealand’s leadership, in contradistinction, did not move the goal posts when they realized they were not going to reach their smoking reduction goal. Rather, they changed their strategy to reach the goal. Late last year, New Zealand implemented a plan for a smokefree generation. Now, no one in New Zealand born after January 1, 2009, can buy a combustible cigarette. The country will also drastically decrease the number of tobacco retailers and is reducing nicotine content in cigarettes to below addictive levels.
There is more concrete action in Europe, where both the European Union and some individual countries have set ambitious plans to drastically reduce cancer rates by 2040. The EU plan mentions tobacco 67 times and recognizes the enormous contribution of smoking to the incidence of cancer. They have set up a task force to discuss policies to achieve an 80% reduction in tobacco use by 2040. French President Emmanuel Macron has also called for a tobacco-free generation as a prerequisite to reduce the incidence of cancer. The tobacco-free generation concept has been implemented for the first time in Brookline, Massachusetts. The tobacco industry fought it strongly, but the Massachusetts Attorney General was clear—it is legal. This means that no one born after the year 2000 can ever legally purchase a tobacco product in Massachusetts, hopefully leading to future tobacco-free generations.
To support and press EU efforts, a group of European civil society organizations have launched a citizens’ petition to force the European Parliament to consider a true tobacco-free generation law, banning the sale of tobacco products to anyone born after 2009. European citizens have until January 2024 to sign. If a million people from at least seven EU countries sign, Parliament must debate the issue. Please let your EU friends and networks know!
For the rest of the world, we too should be implementing stronger tobacco control laws. Future tobacco-free generations are a good option; these laws gradually wean society from tobacco sales. Banning the sale of tobacco products is another great option. Beverly Hills and Manhattan Beach in California have done this successfully. We do know what to do—if only we would do it—to save millions of lives.