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Is the public ready for a tobacco-free Ireland? A national survey of public knowledge and attitudes to tobacco endgame in Ireland
  1. Ellen Juliet Cosgrave1,
  2. Martina Blake1,
  3. Edward Murphy1,
  4. Aishling Sheridan1,
  5. Frank Doyle2,
  6. Paul Kavanagh1,3
  1. 1HSE Tobacco-Free Ireland Programme, Health Service Executive, Dublin, Ireland
  2. 2Department of Health Psychology, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
  3. 3Department of Public Health and Epidemiology, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland
  1. Correspondence to Dr Ellen Juliet Cosgrave, HSE Tobacco-Free Ireland Programme, Health Service Executive, Dublin, Ireland; ellen.cosgrave{at}


Aim Ireland will not meet the tobacco endgame goal set in its 2013 Tobacco-Free Ireland (TFI) policy of reducing smoking prevalence to less than 5% by 2025. Public opinion on tobacco endgame, a key lever to realise this goal, is uncharted in Ireland. This study aimed to measure public knowledge and attitudes to tobacco endgame.

Methods A telephone-administered cross-sectional survey of 1000 randomly dialled members of the general public was conducted in 2022. Prevalence of awareness, perceived achievability and support for the TFI goal and tobacco endgame measures was calculated and compared across tobacco product use status. Logistic regression identified factors independently associated with goal support.

Findings Although TFI goal awareness was low (34.0%), support was high (74.6%), although most (60.2%) believed it achievable beyond 2025. Product-focused measures were popular while support for supply-focused measures was mixed: for example, 86.1% supported nicotine content reduction while 40.3% supported user licencing. Phasing out tobacco sales was highly supported (82.8%); for most, this was contingent on support for currently addicted users. TFI goal support was independently associated with female sex (adjusted odds ratio (aOR) 1.47, 95% CI 1.05 to 2.07), higher education (aOR 1.80, 95% CI 1.21 to 2.66) and non-tobacco product use (aOR 2.67, 95% CI 1.66 to 4.30).

Conclusions Despite low awareness, tobacco endgame support is strong in Ireland. Public appetite for radically reducing tobacco product appeal and availability combined with public views on endgame achievability subject to extended timelines should be used to re-invigorate tobacco endgame discussion and planning in countries at risk of failing to meet declared targets.

  • End game
  • Prevention
  • Public opinion
  • Public policy

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  • Contributors EJC and PK conceptualised and designed the study; led the acquisition, analysis and interpretation of data; and drafted the manuscript based on the work. EJC conducted the background literature research and conducted the analyses and PK provided oversight of data analyses. AS, EM and MB made substantial contributions to the acquisition of data and analysis of the work. FD made substantial contributions to the conception, design and interpretation of the work. All authors provided final review and edits of the manuscript.

  • Funding The fieldwork for the survey was funded by the Health Service Executive Tobacco-Free Ireland Programme and conducted by IPSOS MRBI.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.