From priority to endgame: the Region of Peel Living Tobacco-Free strategy.

Tobacco use presents a tremendous burden on population health and remains the leading preventable cause of morbidity and mortality worldwide. Building on tobacco control successes to date, public health agencies are increasingly aligning with the international "Tobacco Endgame" initiative targeting decreases in tobacco use to less than 5% by the year 2025. The local implementation of this initiative follows a decade of work at Region of Peel-Public Health (RoP-PH), a local health department in Ontario, Canada, which made "Living Tobacco-Free" (LTF) a strategic priority in 2009 with a tactical framework encompassing Research, Protection, Prevention, and Cessation. This commentary provides an overview of the results observed by this local health department's decision to make LTF a strategic priority and discusses the department's next steps in developing a Theory of Change to systematically align continuing efforts to the call for a "Tobacco Endgame".