SCOTLAND could be the first country in the world to reach “tobacco endgame,” the first stage in becoming entirely smoke free.

That was the conclusion of a group of health professionals, researchers, practitioners, policymakers and advocates who attended a seminar at Edinburgh University late last year.

Details of that event were published yesterday on the blog of the British Medical Journal.

The Scottish Government, in their current tobacco strategy, have an ambition to make the country smokefree, officially recognised as less than five per cent of the population smoking, by 2034.

This is possible, the report says, but there needs to be a number of very difficult, public debates on the issue.

Consideration should be given to making cigarettes harder to find, the government should look at how it can stymie the profits of the big tobacco firms, and issue harsher punishments for adults who help children to smoke.

Endgame, is taken from the stage in chess when the match is reaching its conclusion.

Reportedly, Scotland, New Zealand, Canada, Finland and Ireland are all in the race to see who can get there first.

Though the Scottish Government have the ambition to be smoke free in the next 20 years, there has “been limited discussion of what specific policies ought to be pursued,” the blog’s authors write.

Scotland, they say, has “demonstrated clear public health leadership” in its tobacco strategy, and policies like banning smoking in enclosed public spaces, outlawing vending machines and point-of-sale displays, and, most recently, banning smoking in cars carrying children have had impacts.

“Reflecting these developments, smoking rates are coming down and we now have the lowest rates of smoking among young people and adults that Scotland has seen in decades. There has also been a significant decrease in the proportion of children exposed to second-hand smoke (from 11 per cent in 2014 to 6 per cent in 2015), following a successful government campaign on this topic.“ However, around 21 per cent of Scotland’s population smoke, a figure that is still higher than other parts of the UK.

And those who are stopping smoking tend to come from more well off backgrounds. There has been less of a decline in poorer communities, and people with mental illnesses.

“All of this poses some significant challenges,” the authors write, adding that one of the greatest challenges is “avoiding the stigmatisation of those who find it most difficult to quit smoking. Increasing the price of tobacco is the only specific intervention consistently shown to have a positive equity effect in terms of smoking prevalence.

“Yet, while traditional tobacco taxes are progressive in health terms by promoting cessation, they are regressive in economic terms for those who don’t quit, and such taxes can exacerbate the stresses and material impacts of life on a low income.”

At the seminar, the participants “seemed broadly supportive of the idea that Scotland now needs to develop a clearer conception of a tobacco endgame.”

Scotland’s current tobacco control strategy ends in 2018.

Public Health Minister Aileen Campbell said work had already begun on the new tobacco strategy due to be launched in Spring 2018. The Government, she added, were committed to our ambition to create a tobacco-free generation by 2034.”