Policy options for endgame planning in tobacco control: A simulation modelling study

Adam Skinner, Pippy Walker, Jo An Atkinson, Rebecca Whitehead, Tim Roselli, Mark West, Margaret Bright, Mark Heffernan, Geoff McDonnell, Lennert Veerman, Ante Prodan, David P. Thomas, Suzan Burton

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)


Objective: To investigate the potential impacts of several tobacco control interventions on adult daily smoking prevalence in the Australian state of Queensland, using a system dynamics model codeveloped with local and national stakeholders. 

Methods: Eight intervention scenarios were simulated and compared with a reference scenario (business as usual), in which all tobacco control measures currently in place are maintained unchanged until the end of the simulation period (31 December 2037). 

Findings: Under the business as usual scenario, adult daily smoking prevalence is projected to decline from 11.8% in 2017 to 5.58% in 2037. A sustained 50% increase in antismoking advertising exposure from 2018 reduces projected prevalence in 2037 by 0.80 percentage points. Similar reductions are projected with the introduction of tobacco wholesaler and retailer licensing schemes that either permit or prohibit tobacco sales by alcohol-licensed venues (0.65 and 1.73 percentage points, respectively). Increasing the minimum age of legal supply of tobacco products substantially reduces adolescent initiation, but has minimal impact on smoking prevalence in the adult population over the simulation period. Sustained reductions in antismoking advertising exposure of 50% and 100% from 2018 increase projected adult daily smoking prevalence in 2037 by 0.88 and 1.98 percentage points, respectively. 

Conclusions: These results suggest that any prudent approach to endgame planning should seek to build on rather than replace existing tobacco control measures that have proved effective to date. Additional interventions that can promote cessation are expected to be more successful in reducing smoking prevalence than interventions focussing exclusively on preventing initiation.

Original languageEnglish
Pages (from-to)77-83
Number of pages7
JournalTobacco Control
Issue number1
Early online date19 Dec 2019
Publication statusPublished - Jan 2021


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