Is the public ready for a tobacco-free Ireland? A national survey of public knowledge and attitudes towards tobacco endgame
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HSE Tobacco-Free Ireland Programme, Health Service Executive, Dublin, Ireland
HSE Department of Public Health South East, Health Service Executive, Kilkenny, Ireland
Department of Health Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
Publication date: 2023-04-25
Corresponding author
Ellen Cosgrave   

HSE Tobacco-Free Ireland Programme, Health Service Executive, Dublin, Ireland
Tob. Prev. Cessation 2023;9(Supplement):A160
Tobacco-Free Ireland (TFI) policy sets an ambitious tobacco endgame goal of reducing smoking prevalence to less than 5% by 2025.1 However, Irish public opinion on tobacco endgame, a key potential policy lever,2 is largely uncharted. This study aimed to measure public knowledge and attitudes to tobacco endgame to inform, support and influence tobacco policy planning.

Material and Methods:
A cross-sectional, telephone-administered survey of 1,000 randomly dialled adults was conducted. Literature review and stakeholder engagement informed survey development. Prevalence of awareness, perceived achievability, and support for the TFI goal and tobacco endgame measures was calculated and compared across tobacco/e-cigarette use status. Logistic regression identified factors independently associated with TFI goal support.

Although TFI goal awareness was low (34.0%), support was high (74.6%), albeit most (60.2%) believed it achievable beyond the current 2025 target. Goal support was higher among non-tobacco/e-cigarette users (adjusted Odds Ratio (aOR) 2.68, 95% Confidence Interval (CI) 1.83-3.90), females (aOR 1.55, 95% CI 1.13-2.14) and those of higher social class (aOR 1.48, 95% CI 1.03-2.12). Of the 22 potential tobacco endgame measures assessed, product-focused measures were popular while views on user-focused measures were mixed: e.g. 86.1% supported nicotine content reduction while 40.3% supported user licensing. Phasing-out tobacco sales was highly-supported (82.8%); however, for most, this was contingent on support for currently-addicted tobacco users.

Despite low awareness, this study identified strong public support for tobacco endgame, which the public viewed as achievable. Increased supports for currently-addicted tobacco users and engagement with groups with lower support will be important for policy planning and communication. Findings should re-invigorate national and international policy planning to translate endgame ambition into action.

Previous communication of the work: High-level and summarised content of the study has been published as a policy brief and shared by the Health Service Executive Tobacco Free Ireland Programme with key national stakeholders; in addition, the lead author has presented the findings orally at the European Public Health Meeting in 2022 (abstract based on the conference proceedings were published here: Cosgrave, E., Blake, M., Murphy, E., Sheridan, A., Doyle, F., & Kavanagh, P. (2022). Is Ireland ready for tobacco endgame? A national survey of knowledge and attitudes to tobacco endgame: Ellen Cosgrave. The European Journal of Public Health, 32(Suppl 3), ckac129.034. However, in light of the high degree of relevance of the content of this research study to the scope of the ECTOH conference, and the potential relevance of findings from this nationally representative study to other European nations the author believes presentation of the study to the expert audience attending the ECTOH conference would be a worthwhile contribution to the conference.

No authors have any conflict of interest to declare.
Department of Health in Ireland. Tobacco Free Ireland. Report of the Tobacco Policy Review Group. Dublin: Department of Health; 2013.
Burstein P. The Impact of Public Opinion on Public Policy: A Review and an Agenda. Polit Res Q. 2003;56(1):29-40.
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