Young adults’ support for tobacco endgame strategies and e-cigarette regulations: findings of an international survey
1
Tobacco Working Group, World Federation of Public Health Associations, Geneva, Swaziland
2
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
3
School of Public Health, University College Cork, Cork, Ireland
4
University College London, UK, Bath, United Kingdom
5
Institute of Public Health of Serbia, Belgrade, Serbia
6
Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany
7
Hebrew University of Jerusalem, Israel, Beit Hashmonay, Center District, Israel
8
University of Rome "La Sapienza", Rome, Italy
9
Karkinos Healthcare, Mumbai, India
10
Young World Federation of Public Health Associations, Geneva, Switzerland
11
Hospital Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
12
HSE National Health Intelligence Unit, Ireland, Dublin, Ireland
13
University College Cork, Ireland, Cork, Ireland
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Recent years have seen a decrease in global tobacco consumption while e-cigarette usage has surged, particularly among young people. E-cigarette regulation is variable internationally, ranging from no regulation to a complete ban. Additionally, countries are considering various tobacco endgame strategies, such as tobacco-free generation legislation. This survey of 18-34-year-olds evaluated opinions on tobacco endgame measures and e-cigarette regulations to guide policy development.
METHODS:
With input from the World Federation of Public Health Associations and Tobacco Free Ireland, an online cross-sectional survey was designed for 18-34-year-olds from global backgrounds, to measure awareness and support for tobacco endgame, specific support for 20 endgame measures and for possible e-cigarette regulations. Convenience and snowball sampling was used for distribution through international networks in 2024.
RESULTS:
There were 295 respondents from 34 countries, of whom 72% never smoked and 56% never used e-cigarettes. A third (31%) were aware of tobacco endgame. There was majority support for 14 of 20 endgame measures, including mandating tobacco companies pay for smoking-related health costs (74%), banning tobacco sales near schools/playgrounds (73%), reducing nicotine content (73%), limiting sales to licensed shops (70%) and increasing tobacco purchasing age to 21 years (68%). Nearly three-quarters (73%) supported tobacco-free generation legislation, but only 31% expected success. E-cigarettes were seen as more desirable due to flavours (74%) and taste/smell (72%). They were perceived as an important health risk by 83% and 65% believed harms outweigh benefits. Preferred e-cigarette regulations included advertising restrictions (86%), banning flavoured e-cigarettes (73%), point-of-sale display bans (72%) and higher taxation (70%).
CONCLUSIONS:
Most endgame measures were supported by this young adult cohort, including tobacco-free legislation, albeit with feasibility concerns. Most recognised health risks of e-cigarettes and favoured stricter regulations. These findings can support policymakers to take firmer action in protecting populations from health hazards of smoking and e-cigarettes.
Recent years have seen a decrease in global tobacco consumption while e-cigarette usage has surged, particularly among young people. E-cigarette regulation is variable internationally, ranging from no regulation to a complete ban. Additionally, countries are considering various tobacco endgame strategies, such as tobacco-free generation legislation. This survey of 18-34-year-olds evaluated opinions on tobacco endgame measures and e-cigarette regulations to guide policy development.
METHODS:
With input from the World Federation of Public Health Associations and Tobacco Free Ireland, an online cross-sectional survey was designed for 18-34-year-olds from global backgrounds, to measure awareness and support for tobacco endgame, specific support for 20 endgame measures and for possible e-cigarette regulations. Convenience and snowball sampling was used for distribution through international networks in 2024.
RESULTS:
There were 295 respondents from 34 countries, of whom 72% never smoked and 56% never used e-cigarettes. A third (31%) were aware of tobacco endgame. There was majority support for 14 of 20 endgame measures, including mandating tobacco companies pay for smoking-related health costs (74%), banning tobacco sales near schools/playgrounds (73%), reducing nicotine content (73%), limiting sales to licensed shops (70%) and increasing tobacco purchasing age to 21 years (68%). Nearly three-quarters (73%) supported tobacco-free generation legislation, but only 31% expected success. E-cigarettes were seen as more desirable due to flavours (74%) and taste/smell (72%). They were perceived as an important health risk by 83% and 65% believed harms outweigh benefits. Preferred e-cigarette regulations included advertising restrictions (86%), banning flavoured e-cigarettes (73%), point-of-sale display bans (72%) and higher taxation (70%).
CONCLUSIONS:
Most endgame measures were supported by this young adult cohort, including tobacco-free legislation, albeit with feasibility concerns. Most recognised health risks of e-cigarettes and favoured stricter regulations. These findings can support policymakers to take firmer action in protecting populations from health hazards of smoking and e-cigarettes.
| eISSN: | 2654-1459 |
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