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Introduction

1. Tobacco use continues to be one of the greatest threats to global public health. In addition to generating a heavy social, economic, and environmental burden for countries, tobacco use exacerbates household poverty and increases inequalities. Tobacco is harmful in all its forms, and there is no safe level of exposure to tobacco smoke. Tobacco use constitutes a preventable risk factor for the four main groups of noncommunicable diseases (NCDs): cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. In the Region of the Americas, NCDs are the leading cause of death and disability, accounting for 81% of deaths each year. Tobacco use causes one million deaths annually in the Region and disproportionately affects those living in low- and middle-income countries (1). There is now a large body of evidence showing how the tobacco epidemic can be tackled in highly cost-effective ways by applying the mandates of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) (2) and the Protocol to Eliminate Illicit Trade in Tobacco Products (the Protocol) (3), as well as the WHO MPOWER package guidance (4). WHO has recognized five measures contained in the FCTC as best buys for the prevention and control of NCDs (5); their implementation, together with other measures that go beyond those required by the Convention and its protocols in order to better protect human health (6), is important for all Member States, irrespective of whether or not they are States Parties to the FCTC. 

2. Although considerable progress has been made in recent years in the fight against the tobacco epidemic in the Region (4, 7), and the economic, political, legal, and social feasibility of measures to combat it has been demonstrated, most Member States have not fully met their international commitments in this area (8). This document proposes a roadmap for the period up to 2030 that prioritizes key actions to accelerate the implementation of the FCTC and enable Member States to meet the targets established for the reduction of tobacco use and premature death from NCDs. This strategy and plan of action incorporates an equity perspective, with special attention to groups in situations of vulnerability. It is aligned with regional and global decisions and mandates, incorporates the lessons learned from unmet targets of the Strategy and Plan of Action to Strengthen Tobacco Control in the Region of the Americas 2018–2022 of the �Ӱɴ�ý (PAHO) (8), and covers both conventional and emerging tobacco products, as well as electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery system (ENNDS), commonly referred to collectively as “e-cigarettes.”