Is the Public Ready for a Tobacco-Free Ireland? A National Survey of Public Knowledge and Attitudes to Tobacco Endgame in Ireland

Tobacco-Free Ireland (TFI) policy sets a tobacco endgame goal to reduce smoking prevalence to less than 5% by 2025. However, public opinion on this goal, an important policy lever, is uncharted in Ireland. This study aimed to inform policy planning by measuring public knowledge and attitudes to tobacco endgame. A telephone-administered cross-sectional survey of 1,000 randomly-dialled members of the general public was conducted. Prevalence of awareness, perceived achievability, and support for the TFI goal and potential tobacco endgame measures was calculated and compared across tobacco/e-cigarette user 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 2025. Goal support was higher among non-tobacco/e-cigarette users (adjusted Odds Ratio (aOR) 2.68, 95%CI 1.83-3.90), women (aOR 1.55, 95%CI 1.13-2.14) and higher social class members (aOR 1.48, 95%CI 1.03-2.12). 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 users. Despite low awareness, there is strong support for tobacco endgame in Ireland and views on achievability are more realistic than the current goal of 2025. Supporting currently addicted tobacco users and engaging groups with lower support will be important policy planning and communication considerations. The Irish public are ready for tobacco endgame. These findings should re-invigorate policy planning to translate endgame ambition into action.