BACKGROUND: Bold “endgame” strategies are increasingly being considered globally, as countries adopt innovative policies towards elimination of the tobacco pandemic. In August 2023, the Israel Ministry of Health proposed a plan that encompasses several endgame strategies. This study examined support for various endgame approaches among a representative sample of adult Israelis.
METHODS: Data for this cross-sectional study are from 1790 adults (aged ³18) who participated in the 2024 International Tobacco Control Israel Survey. The data were weighted for population characteristics, including (age, sex, population sector, and smoking status). Measures included: support for restrictions on sales and marketing, restrictions on nicotine content and additives, restrictions on disposable e-cigarettes, and requiring the tobacco industry to pay for smoking-related health costs. We examined support versus oppose/don’t know by current smoking status.
RESULTS: Some measures received very high support: 91.9% supported a crackdown on smuggling, and 87.6% supported lower nicotine content in cigarettes. Strong support was observed for a ban on print press advertising (86.2%), reduction in number of shops selling smoking products (83.7%), requirement that tobacco companies pay for health-related costs (81.7%), increase in the age of sale of tobacco and nicotine products to age 21 (80.0%); ban on point of sale advertising (79.6%), requirement of health warning inserts on all smoking products (79.7%), adoption of graphic health warnings (78.3%), a ban on cigarette additives in (70.8%), warnings on individual cigarette sticks (70.7%), plain packaging ( 64.8%), and smoke-free generation (64.5%). On all outcomes, support was higher among people who do not smoke compared with those who smoke (p<.0001). Even among those who smoke, strong support (>70%) was observed for most policy approaches.
CONCLUSIONS: Findings demonstrate strong public support for far-reaching endgame policies. These findings can guide the selection of policies to end the tobacco epidemic in Israel, and globally.