A systematic review and synthesis of qualitative research on stakeholder views on commercial tobacco endgame goals and policies

BACKGROUND: As more countries and local jurisdictions set commercial tobacco endgame goals, evidence on stakeholders' views about endgame policies has expanded. We reviewed and synthesized evidence from qualitative studies on stakeholders' views about tobacco endgame goals and policies. METHOD: A systematic review of articles published until 20 August 2025 was conducted using seven academic databases: PubMed, Web of Science, CINAHL, Embase, Medline, Scopus and ProQuest Dissertations and Theses Global. We supplemented these searches with a grey literature search. Studies reporting qualitative data on stakeholders' attitudes, beliefs, or knowledge about one or more tobacco endgame goals or policies were included. Stakeholders included members of the public, retailers, and government or NGO representatives. Data were analysed using a thematic synthesis approach. RESULTS: The searches returned 5970 unique articles that were screened, with 46 meeting the inclusion criteria. Most studies were conducted in Aotearoa/New Zealand and the US, and the most common policies explored were nicotine reduction and retail restrictions. Six overarching themes were identified: 1) values and philosophy, 2) beliefs about tobacco and addiction, 3) communication strategies and narrative, 4) comparison with other products and policies, 5) barriers and facilitators to implementation, and 6) practical implementation considerations. CONCLUSIONS: There is limited research exploring stakeholders' views of institutionally focused endgame policies (e.g., 'polluter pays' levy on tobacco companies); in addition, evidence on stakeholder views of endgame policies from low-and-middle income countries is lacking. Addressing potential barriers identified by stakeholders may increase the feasibility of introducing and maintaining tobacco endgame policies.