It was rewarding and exciting to attend the 2025 World Conference on Tobacco Control (WCTC) held in Dublin, Ireland. Having been postponed (as the 18th World Conference on Tobacco or Health) in 2021 due to the COVDI-19 pandemic, it was great for tobacco control researchers, advocates, funders; young and old, to reconvene as people with a common cause. We were even more determined than ever to discuss and re-commit ourselves to ending the tobacco epidemic and tackle new challenges posed by the tobacco (and e-cigarette) industry. In this article, I mostly summarize my two core presentations at the conference.
Attending the WCTC 2025 offered a thought-provoking encounter with the future of global tobacco control. As a researcher and advocate, I asked some pungent questions in my first presentation at the State of the Art (SOTA 5) titled “Ending the Commercial Sale of Cigarettes.” I shared the stage with other eminent researchers/advocates from different parts of the world (Chris Bostic of ASH, USA; Kylie Lindorff of New South Wales Cancer Council, Australia; Richard Edwards of Flinders University, Australia and chaired by Joanna Cohen of Johns Hopkins University, USA).
In my discussion of whether or not to include e-cigarettes and other newer tobacco/nicotine products in tobacco endgame strategies, two of the key questions I asked were: Do we (as researchers or advocates) want to recycle the tobacco epidemic or end it? Do we want to be here (conferencing) again in 20–50 years fighting another epidemic driven by same nicotine?
The tobacco industry’s evolution—from cigarettes to products like e-cigarettes and oral nicotine pouches raises critical concerns. These so-called ‘alternatives’ to cigarettes are strategically marketed by the industry as ‘safer’ choices, ‘harm reduction’ tools or ‘cessation aids’, or whichever narrative is more convenient for the ‘business’ at any time. This is all with the aim of maintaining its core business – nicotine addiction.
Drawing from an internal tobacco industry document, I presented how the tobacco industry, discovering the emergence of nicotine replacement therapy, saw it as a threat to their business because it would make it easier for those who smoke to quit, and viewed it as a bigger threat than their competitors (see figure).
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Also, the calculated attempt to downplay the harmfulness of nicotine by supporters of e-cigarettes leaves many questions unanswered. Nicotine is categorized as a toxic substance in many jurisdictions for a reason. The evidence out there showing the harmfulness of nicotine is a deliberate attempt to downplay the harmfulness of nicotine. Its implications for cardiovascular and respiratory health, DNA mutation as well as its role in predisposing individuals to further substance abuse and dependence, are well documented.
I also shared that nicotine is the industry’s core product, while keeping people addicted is their “value proposition.” The industry positioning itself as a solution to a problem they are not interested in ending, should raise a red flag for anyone truly interested in ending the tobacco epidemic.
Any strategy to put an end to the tobacco epidemic cannot but include the recent additions to the market which are maintaining nicotine addiction and which are now more than ever before targeted at recruiting children and youth into a lifetime of nicotine addiction. I maintained that “switching” is not the same as “quitting.” Therefore real solutions to end the epidemic must center around quitting nicotine addiction altogether not repacking it since nicotine is the real driver of the tobacco epidemic.
My second presentation was at the Symposium titled “What are the considerations for a truly ‘global’ tobacco endgame?” where I shared the stage with another set of renowned tobacco control researchers and advocates: Christ Bostic of ASH USA; Brita Matthes of University of Bath and STOP (a global tobacco industry watchdog); Arick Antonio Ochoa of Salud Justa Mx, Mexico and Monika Aurora from the Public Health Foundation, India. This session was chaired by Chris Bostic and Yvette van der Eijk (National University of Singapore).
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I reflected on tobacco endgame for the African region; its prospects, challenges, needs and what African tobacco control stakeholders and policymakers could do to ensure we are not left behind. Drawing from some findings from our study “Tobacco Endgame in Africa,” I discussed the fact that though most African countries have “endgame ready” tobacco use prevalence statistics, and stakeholders in the region are supportive of the endgame movement, countries are not ready in principle largely due to the lack of political will, industry interference and allowing the introduction of new products that fall outside countries’ regulatory frameworks without an immediate attempt to expand such laws to cover these new products.
To build momentum for tobacco endgame in Africa, I proposed that policymakers and tobacco control advocates (and researchers) begin by strengthening tobacco control and capitalize on “low-hanging fruits”—policy changes that are achievable within existing legal frameworks. With strong tobacco control laws, there would be easier transition from tobacco control to tobacco endgame while bearing in mind that both are NOT mutually exclusive.
Another important component that I believe must accompany endgame strategies in Africa is the scaling up of tobacco cessation services which must be seen by those being served as supportive strategies. Too often, our strategies leave behind those already struggling with nicotine addiction creating a void that is now being exploited by the tobacco and e-cigarette industry under the guise of “tobacco harm reduction.”
Having bold and clear targets, goals and purpose are essential ingredients for any endgame strategy to work. Africa, with the youngest population, particularly needs to protect its next generation, that are being targeted by the tobacco and e-cigarettes industry.
Away from my presentations at the WCTC, I also had the opportunity to network with old and new colleagues in the tobacco research and advocacy space. It was particularly heartwarming for me to see our next generation of tobacco control researchers and advocates in action. I had a quick chat with Winnie Olwal, the WCTC 2025 Youth Committee Chair and Regional Programme Lead-Youth in Action at AMREF Health Africa) and was satisfied that the future of tobacco control/tobacco endgame is in safe hands. Winnie reminded us during the closing session that the youth are not the next generation…but are the ‘now generation’.
From amazing presentations I was able to attend to amazing personalities I was able to connect with, the 2025 WCTC was a remarkable event and I am already looking forward to the next.
I sincerely thank the organizers and funders for granting me a full scholarship to attend the conference.
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