As the tobacco industry continues to innovate to preserve its market appeal, the health sector needs to become even more creative – advocating for new regulations to reduce tobacco’s appeal and increase product costs. Among those: limiting nicotine content, banning filter tips, and joining WHO’s new “3×35 initiative” to raise the price of tobacco products by 50%. 

We’re on the brink. For much of the last 20 years, smoking has been in decline worldwide, saving millions of lives, but we are at an inflection point. Trends point to a flattening in the decline of cigarette sales, and Big Tobacco is responding to two decades of public health progress with insidious innovation. If public health practitioners don’t out-innovate the industry now, we’ll be setting ourselves up to lose.

It is a monumental public health achievement that global tobacco use dropped by a third in the last 20 years. More than 5.5 billion people are now covered by some measure that discourages tobacco use, such as advertising bans, higher taxes and quit programs. For the first time, an entire region, Latin America, has smoke-free laws in place.

But we cannot expect the hard-won anti-tobacco laws of today – those that have created smoke-free spaces, banned advertisements around schools and removed flavors from cigarettes which have saved millions of lives – to protect us from the industry’s plans for tomorrow.

Despite its seemingly anti-cigarette rhetoric, the industry is not slowing down on its core product – monetizing addiction. There are too many signals to ignore: Philip Morris International shipped more cigarettes in the first quarter of 2025 than during the same period last year. British American Tobacco just launched a new cigarette brand in Korea. Japan Tobacco International is building a new factory in Morocco.

Industry is innovating around anti-smoking regulations 

The industry is also innovating its way around current anti-smoking regulations, releasing a barrage of new products like e-cigarettes (vapes), heated tobacco products and nicotine pouches. When laws threaten to restrict or ban these addictive products, tobacco companies try to influence politicians to advocate for them, often as the “lesser evil”. 

These products are increasingly being targeted at the next generation. The industry has lobbied for heated tobacco products to be exempt from the UK’s new Tobacco and Vapes Bill so they can continue to be sold to people who would no longer be able to buy cigarettes. It also wants to continue promoting these products in a wide range of retail outlets, which has included items at children’s eye-level, near sweets in filling stations. 

Meanwhile, there are reports from across the UK of nicotine pouch giveaways at railway stations and tobacco companies sponsoring music events like the Reading and Leeds Festival, where many teens go to celebrate the end of exams.

If nothing is done to counter the industry’s strategies, not only will declines in smoking be reversed, but new epidemics will arise. Indeed, an e-cigarette epidemic already has, with vapes being used more by teens than adults in many countries. We’re risking a future where the next generation won’t have the same protections.

Out-innovating big tobacco 

But tobacco companies aren’t the only ones innovating. New ideas are emerging that can move the needle in the right direction, for good. 

We can require that cigarettes have less nicotine, so that fewer people get hooked for life. We can use technology to blur out tobacco company logos and branding in Formula 1 races, as in France, and address imagery on streaming platforms, like in India. 

We can institute “polluter pays” penalties where tobacco companies compensate for the environmental damage their products cause, like in Spain. We could ban filters to remove a product design element that makes it easier to smoke and eliminate the most littered single-use plastic in the world. We can prohibit the youngest generations from ever being allowed to buy tobacco.

These solutions can be agile and deployed at the national, provincial or city level. The generational end game law, which makes it illegal to sell tobacco to anyone born after a certain date, is being pioneered at the city level in Brookline, Massachusetts, in the United States. A similar law is set to go into effect in the UK soon.

To prevent a backslide into the era of smoke-filled rooms and Joe the Camel, these solutions need to be accelerated and supported in every country.

So there couldn’t have been a better time for the tobacco control community to gather than at the recent World Tobacco Conference in Dublin, Ireland. 

Experts and advocates from around the world convened in a country that itself is wrestling with stalled declines in tobacco use and a rise in youth e-cigarette use. While Ireland aimed to reduce tobacco use to less than 5% by 2025, recent data shows it hovering at 17%. Worryingly, a 2022 survey revealed that two in every five girls and a quarter of boys aged 15-17 had used an e-cigarette.

Convening in Dublin provided an opportunity to double down and renew the push for what we know works: advertising bans, smoke-free laws and – the gold standard – higher tobacco taxes. 

Raising real prices

Following that major meeting, the World Health Organization (WHO) has now launched a big new initiative urging countries to raise real prices on tobacco, alcohol, and sugary drinks by at least 50% by 2035 through health taxes. The “3 by 35” Initiative is based on studies showing that a one-time 50% price increase in these products could prevent 50 million premature deaths over the next 50 years. 

This period between Dublin and the upcoming UN High Level Meeting on Noncommunicable Diseases in September is a time to mobilize action behind these creative new solutions that can counter Big Tobacco well into the future.

The tobacco industry is playing the long game, and we need to, too. No public health win is permanent. If politicians and the public aren’t vigilant, Big Tobacco will continue trying to dismantle laws that protect health, while finding ways to bypass others. The next era of tobacco control requires innovative solutions – they will make all the difference. 

Dr Mary-Ann Etiebet is the President and CEO of Vital Strategies where she leads a team of over 400 people in over 80 countries working to ens

Image Credits: Johannes Zielcke, Filter.