Background:
In Belgium, much of the reduction in the prevalence of tobacco use can be attributed to long-term policies, most of them adopted during the last twenty years at federal and regional level. Implementing the FCTC MPOWER model, restrictive legislation on accessibility to tobacco products, protection of non-smokers at work place and in indoor public spaces, adoption of neutral packaging, total ban on advertisements, protection of minors in cars, support of tobacco-dependence services through quit lines and first line assistance centers, and gradual increase in taxation, has been the main achievement of tobacco control policies.

Objective:
To denormalize tobacco use across all income groups.

Methods:
A social process to denormalize tobacco use has been implemented that produced results. However, new measures and strategies are required to cover all income groups.

Results:
In the region of Wallonia, smoking prevalence is currently at 18.8% (daily smokers) while in the northern part of the country the prevalence is even less at 13.4%. Nevertheless, in an apparently favorable context, the prevalence rate of tobacco use between 1997 and 2018 remained steady in Wallonia in the lowest income group (>500 and <1380€), fluctuating between 29.7% and 31.5%. It fell substantially from 21.6% to 13.4% in the highest income group (>3800€). The prevalence gap between the lowest and the highest income groups more than doubled in twenty years, from 8.1% to 18.1%.

Conclusions:
Denormalization of tobacco use is not a reality for all, as measures taken in the past seem to have been ineffective in reducing a widening gap between income groups. Despite good results for high/middle SES populations, will efforts of denormalization allow the target of <5% in adult smokers by 2037, as the Belgium Alliance aims, without new measures and strategies to cover all income groups?