Feb 27, 2025, marks the 20th anniversary of the WHO Framework Convention on Tobacco Control (FCTC) coming into force. This legally binding international treaty, the first negotiated by WHO, rapidly became one of the most widely embraced in UN history. The 183 parties to the FCTC, covering more than 90% of the world's population, have committed to “preventing and reducing tobacco consumption, nicotine addiction and exposure to tobacco smoke” through implementing the measures in the treaty. As the treaty enters its 21st year, we reflect on its achievements and identify the need for a step change in ambition if the treaty is to continue to effectively address the tobacco epidemic, alongside the emergent nicotine and multiple product use (poly-use) epidemics.