Fifty year perspective of social change for sustainable tobacco control in Finland

Abstract To reduce the high rate of smoking and related mortality, the Finnish Parliament passed in 1976 the first Tobacco Act. For 50 years there has been no tobacco advertising or sales promotion in the country. After that the Act has been amended eight times and it matches well with the best global and WHO recommendations. The prevalence of daily smoking has greatly reduced: currently among adults around 10 % and among youth (14-20 years) 5 %. After the success in smoking control, Finnish Parliament added to the Act the goal of tobacco-free Finland in 2010. With the emergence of new nicotine products, the Parliament expanded this goal in 2016 to encompass a “tobacco- and nicotine-free Finland.” The Finnish Tobacco Act currently regulates e-cigarettes largely with the same regulations as conventional cigarettes and nicotine pouches will also be included. Strong advocacy efforts are underway to push for stricter regulation of all novel nicotine products, to counteract the industry pressure. A ministerial working group has proposed further amendments to the Tobacco Act, including raising the minimum age for purchasing tobacco and nicotine products to 20 years. The success of tobacco control in Finland has been result of active work and co-operation among many partners together with good monitoring and engagement with media. Key factors have included continuous political commitment, robust legislation, and taxation policy. The country's tobacco and nicotine policy aims at endgame with full implementation of the WHO/FCTC provisions, strong leadership and collaboration. Over the 50 years the work involving broad health promotion and strong policies has resulted in major social chance with greatly reduced rates of smoking and related diseases. The future challenges include maintaining political support for tobacco and nicotine policies and resisting interference from nicotine companies. Key messages • Key factors have included continuous political commitment, robust legislation, and taxation policy. • Over the 50 years the work involving broad health promotion and strong policies has resulted in major social chance with greatly reduced rates of smoking and related diseases.