Narratives for a commercial tobacco endgame: a qualitative analysis of consultation submissions

Background Commercial tobacco remains widely available despite its preventable harms and inequitable effects, including among Aboriginal and Torres Strait Islander peoples and other populations exposed to racism, discrimination and socioeconomic exclusion. Commercial tobacco endgame policies seek to change the structural conditions that sustain these harms, including product availability, addictiveness and industry power. This study examined support for endgame and industry-eradication policies among organisations shaping Australian tobacco policy discourse. It also examined narratives used to define policy problems, assign responsibility and legitimise solutions. Implications for equity-oriented policy discourse were also identified. Methods We analysed a purposive sample of 20 organisational submissions to consultations informing Australia's National Tobacco Strategy 2023-2030. Submissions were coded using Template Analysis informed by the Narrative Policy Framework and the Decolonising Framework. Indigenous perspectives were prioritised through Indigenous researcher involvement in coding and interpretation, reporting order, quotation selection and the dedicated decolonising analysis. Results Aboriginal Community Controlled Health and National Health Advocacy organisations framed commercial tobacco use through structural, commercial and colonial determinants. Their narratives emphasised power and control, industry responsibility, health equity and community authority. They supported supply reduction, product regulation, reduced outlet density, phasing out commercial tobacco supply, co-designed targets and community-controlled implementation. Commercial and industry-aligned actors instead emphasised consumer choice, regulatory burden and illicit trade, and promoted expanded access to electronic cigarettes as a solution, despite accumulating evidence of health risks and continuing uncertainty regarding long-term and population-level effects. These narratives assigned limited responsibility to commercial industry practices. Themes concerning power-sharing, self-determination and community control were largely absent from these submissions. Conclusions The Australian endgame debate is a contest over constructs of responsibility, legitimate authority and the boundaries of possible policy action. The findings suggest that a coherent equity-oriented narrative would connect documented industry conduct with structural reform, Indigenous sovereignty and practical implementation, while clearly distinguishing commercial industry abolition from consumer prohibition. Aboriginal and Torres Strait Islander leadership is central to the legitimacy and equity of endgame policy development. This qualitative analysis does not establish the effectiveness or feasibility of any single policy intervention.