Banning Tobacco Smoking in Public Places via Customized Tobacco Control Vaccine Framework: Experience From Tigray, Ethiopia.

Tobacco use remained the most preventable cause of premature morbidities and deaths. Despite notable decrement of tobacco use prevalence globally, the prospect of the low- and middle-income countries lies at crossroads due to government's complacence and increased influence of the tobacco industry. Tigray regional state in Ethiopia which received World Health Organization recognition in 2017 spearheaded the tobacco control endeavor using cost-effective and whole-government approach via customized tobacco control vaccine framework. The job required interrelated endeavors of law making, advocacy, and law enforcement, but all with an effective community engagement and ownership framework. It did not require re-inventing the wheel but synthesizing available evidence and exhibiting the potential to reverse the course; enlisting challenges alone do not bear fruit. Tigray's notable achievement and Ethiopia's promising results should be supported by rigorous law enforcement and accountability mechanisms. The evolving tobacco industry influence and illicit tobacco trade pose a serious concern.