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Original research
Support for banning sale of smoked tobacco products among adults who smoke: findings from the International Tobacco Control Four Country Smoking and Vaping Surveys (2018–2022)
  1. Michael Le Grande1,
  2. Ron Borland1,
  3. Shannon Gravely2,
  4. Michael Cummings3,
  5. Ann McNeill4,
  6. Hua H Yong5,
  7. Coral E Gartner6
  1. 1Melbourne Centre for Behaviour Change, The University of Melbourne Melbourne School of Psychological Sciences, Melbourne, Victoria, Australia
  2. 2Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
  3. 3Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  4. 4UK Centre for Tobacco Control Studies, National Addiction Centre, Institute of Psychiatry, King’s College London, London, UK
  5. 5Department of Psychology, Deakin University, Burwood, Victoria, Australia
  6. 6School of Public Health, The University of Queensland Faculty of Medicine, Herston, Queensland, Australia
  1. Correspondence to Michael Le Grande, Melbourne Centre for Behaviour Change, The University of Melbourne Melbourne School of Psychological Sciences, Melbourne, VIC 3052, Australia; mlegrande{at}unimelb.edu.au

Abstract

Background Many people continue to smoke despite strong policies to deter use, thus stronger regulatory measures may be required. In four high-income countries, we examined whether people who smoke would support a total ban on smoked tobacco products under two differing policy scenarios.

Methods Data were from 14 363 adults (≥18) who smoked cigarettes (≥monthly) and participated in at least one of the 2018, 2020 or 2022 International Tobacco Control Four Country Smoking and Vaping Surveys in Australia, Canada, England and the USA. In 2018, respondents were asked whether they would support a law that totally bans smoked tobacco if the government provides smoking cessation assistance (Cessation Assistance scenario). In 2020 and 2022, respondents were asked a slightly different question as to whether they would support a law that totally bans smoked tobacco if the government encourages people who smoke to use alternative nicotine products like vaping products and nicotine replacement products instead (substitution scenario). Responses (support vs oppose/don’t know) were estimated on weighted data.

Results Support was greater for the cessation assistance scenario (2018, 36.6%) than the nicotine substitution scenario (2020, 26.9%; 2022, 26.3%, both p<0.0001). In the longitudinal analysis, there was a significant scenario by country interaction effect with lower support in Canada, the USA and Australia under the substitution scenario than in the cessation scenario, but equivalent levels in England under both scenarios. The strongest correlates of support under both scenarios were planning to quit smoking within 6 months, wanting to quit smoking ‘a lot’ and recent use of nicotine replacement therapy.

Conclusions Opposition to banning smoked tobacco predominates among people who smoke, but less with a cessation assistance scenario than one encouraging nicotine substitution. Wanting to quit a lot was the strongest indicator of support.

  • Nicotine
  • End game
  • Public policy
  • Cessation

Data availability statement

Data are available on reasonable request. In each country participating in the International Tobacco Control Policy Evaluation (ITC) Project, the data are jointly owned by the lead researcher(s) in that country and the ITC Project at the University of Waterloo. Data from the ITC Project are available to approved researchers 2 years after the date of issuance of cleaned data sets by the ITC Data Management Centre. Researchers interested in using ITC data are required to apply for approval by submitting an International Tobacco Control Data Repository (ITCDR) request application and subsequently to sign an ITCDR Data Usage Agreement. The criteria for data usage approval and the contents of the Data Usage Agreement are described online (http://www.itcproject.org).

https://doi.org/10.1136/tc-2023-058532

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    Data availability statement

    Data are available on reasonable request. In each country participating in the International Tobacco Control Policy Evaluation (ITC) Project, the data are jointly owned by the lead researcher(s) in that country and the ITC Project at the University of Waterloo. Data from the ITC Project are available to approved researchers 2 years after the date of issuance of cleaned data sets by the ITC Data Management Centre. Researchers interested in using ITC data are required to apply for approval by submitting an International Tobacco Control Data Repository (ITCDR) request application and subsequently to sign an ITCDR Data Usage Agreement. The criteria for data usage approval and the contents of the Data Usage Agreement are described online (http://www.itcproject.org).

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    Footnotes

    • X @kingsNRG, @CoralGartner

    • Contributors MLG and RB drafted the manuscript. MLG conducted all analyses. RB, SG and HHY advised on the data analyses. All authors contributed to reviewing and editing and approving the final manuscript. RB is the guarantor for the study and manuscript.

    • Funding This study was supported by grants from the National Cancer Institute of the US (P01CA200512), the Canadian Institutes of Health Research (FDN 148477) and by the National Health and Medical Research Council of Australia (GNT1106451). CG is supported by an Australian Research Council Future Fellowship (FT220100186).

    • Competing interests MC has served as a paid expert witness in litigation filed against cigarette manufacturers. AM is a UK National Institute for Health Research (NIHR) Senior Investigator.

    • 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.