The successes of tobacco control in some countries and locales have led to discussions of ending the tobacco epidemic, often called the endgame. In this paper, we recommend articulating the endgame goal as phasing out sales of cigarettes, a goal once called unthinkable. We develop a logic and argumentation for ending cigarette sales intended to move the discussion beyond the shadow of prohibition, proposing an approach that appeals to consumer protection standards and suggesting that the effort be led by low-prevalence communities. While phasing out cigarettes will not happen everywhere all at once, and may unfold differently along several lines, we argue that the gradual phase-out approach we propose will reduce the likelihood of the negative consequences often predicted to come with such a policy. To continue permitting widespread sales of the single most deadly consumer product in history is a public health failure that must be addressed.

Tobacco 'endgame' discourse has emerged in recognition of the nature of the global public health emergency created by tobacco use and tobacco promotion. This discourse is a promising development, but translating it into action requires developing some consensus, at least by countries or regions. It also requires negotiating some of the recurring tensions within the tobacco control movement, contributing to risks for the movement as visionaries clash with pragmatists. This paper outlines one combination of approaches that might hold promise for the US situation. Every significant achievement in tobacco control was preceded by many influential people saying it couldn't be done, wouldn't work, or would create new problems. The risks of not envisioning an endpoint for the tobacco epidemic are far greater than the risks of attempting any endgame solutions and failing.