Tobacco Control Playbook

Is there public support for tobacco control measures?

August 25th, 2017

Key message: There is strong public support for tobacco control measures, even from people who smoke. Surveys in various countries show that comprehensive measures such as smoke-free indoor and outdoor areas, bans on point-of-sale tobacco displays, plain packaging and tobacco taxation are welcomed by the public.

What is the issue?

The tobacco industry often argues that there is public opposition to tobacco restrictions and that people do not want governments to implement measures such as clean indoor air laws, tobacco tax and plain packaging.

What is the evidence for concern?

  • A common tobacco industry tactic is to create an impression of public opposition to tobacco regulations. As part of this, tobacco companies often use third parties or front groups.
  • Astroturfing is a common approach, in which industry-funded groups are made to appear as a grassroots movement. This includes 'smoker's rights' groups such as the 'Freedom Organisation for the Right to Enjoy Smoking Tobacco' (FOREST). FOREST frames itself as a grassroots movement to support smoker's rights, but it was created with tobacco industry funding [1], and still receives the vast majority of its funding from tobacco companies [2][3].
  • Another tobacco industry tactic is generating responses to public consultations. In the UK's consultation on plain packaging, for example, 87% of the opposition was from tobacco companies or third parties financially linked to them. The tobacco companies lobbied government, while public communication and research activities were outsourced to third parties. These third parties were not transparent about their links to tobacco companies [4].

What is the reality?

  • Most people, including those who smoke, support tobacco control measures.
  • There is strong public support for clean indoor air laws and this support is increased if the law is comprehensive, and after implementation when people have experienced the benefits [5]. Before smoke-free workplaces (including bars and restaurants) were implemented in Ireland, 67% of the general public and 40% of smokers supported the law. Only a few months after the law was implemented, 82% were in support [6], and 83% of Irish smokers rated it as 'good' or 'very good' [7].
  • There is strong majority public support for measures such as smoke-free outdoor regulations [8], and smoke-free cars carrying children. A review of 15 studies from 1988-2008 found that most people supported smoke-free cars carrying children, and that support increased over time. In surveys in or after 2005, support was 77% or more among smokers [9]. Most people also support smoking bans in outdoor settings, especially where children are present [10].
  • There is strong public support for plain packaging. Australia was the first country to implement this measure in 2012; even before its implementation there, three quarters of the general public and two thirds of smokers supported the measure [11].
  • There is public support for stronger regulations on the retail environment. A point of sale tobacco display ban is supported by 73% of the UK's general public [12], and most smokers in Canada [13]. There is also majority support in the UK (77%) for a ban on tobacco sales from vending machines [12].
  • There is good public support for tobacco taxation if the money is used to fund tobacco control activities. A survey in the UK in 2008-2009 found that 71%, including 47% of smokers, supported this measure [14].
  • In the USA, where several states have implemented 'Tobacco 21', there is strong public support for raising the minimum age of tobacco sales to 21. A 2013 survey of over 3,200 people showed that most (71%) supported Tobacco 21 [15].
  • Public attitudes towards tobacco control tend to be more favourable where there are already comprehensive tobacco regulations in place [16][17]. However, even where there are weak tobacco regulations, the public is generally welcoming of more government action. In a 2007 survey in Russia, before effective tobacco regulations were implemented, 86% of the general public thought tobacco control in Russia was inadequate and over 70% supported a ban on tobacco sales from street kiosks [18].
  • Public support for tobacco control, as well as people's intentions to quit can be maximized by denormalizing the tobacco industry [19].

Key messages

  • The tobacco industry – often via front groups, third parties and fake grassroots organizations – often argues that there is strong public opposition to tobacco regulations. However, this opposition tends to be funded primarily by tobacco companies, and is usually not as 'grassroots' as it appears.
  • Public support is strong, including among those who smoke, even for very comprehensive tobacco control measures such as plain packaging, smokefree outdoor areas, and comprehensive bans on tobacco advertising and promotions including bans on point-of-sale tobacco displays.
  • Public support for any given tobacco control measure can be increased by educating the public on its rationale, making sure the measures are part of a comprehensive approach, and denormalizing the tobacco industry.
Show References
  1. Foxley-Norris, C. Chairman's Interim Report. FOREST; 1981 ( ↩︎

  2. The hunt for pro-smokers. BBC; 10 March 2004 ( ↩︎

  3. [website] Forest. Tobacco Tactics; 2016 ( ↩︎

  4. Hatchard J, Fooks G, Gilmore A. Opposition to standardized packaging in the UK: who, what, when and how? ASH Scotland Conference 18/6/2015. URL: Jenny Hatchard.pdf ↩︎

  5. Hyland A, Higbee C, Borland R, et al. Attitudes and beliefs about secondhand smoke and smoke-free policies in four countries: findings from the International Tobacco Control Four Country Survey. Nicotine Tob Res 2009;11:642-649. ↩︎

  6. Howell F. Smoke-free bars in Ireland: a runaway success. Tob Control 2005;14:73-74. ↩︎

  7. Fong GT, Hyland A, Borland R, et al. Reductions in tobacco smoke pollution and increases in support for smoke-free public places following the implementation of comprehensive smoke-free workplace legislation in the Republic of Ireland: findings from the ITC Ireland/UK Survey. Tob Control 2006;15:iii51-iii58. ↩︎

  8. Thomson G, Wilson N, Collins D, Edwards R. Attitudes to smoke-free outdoor regulations in the USA and Canada: a review of 89 surveys. Tob Control 2015. doi: 10.1136/tobaccocontrol-2015-052426. ↩︎

  9. Thomson G, Wilson N. Public attitudes to laws for smoke-free private vehicles: a brief review. Tob Control 2009;18:256-261. ↩︎

  10. Thomson G, Wilson N, Edwards R. At the frontier of tobacco control: a brief review of public attitudes toward smoke-free outdoor places. Nicotine Tob Res 2009;11:584-590. ↩︎

  11. Rosenberg M, Pettigrew S, Wood L, Ferguson R, Houghton S. Public support for tobacco control policy extensions in Western Australia: a cross-sectional study. BMJ Open 2012;2:e000784. ↩︎

  12. Cancer Research UK. Press release: huge public support to remove cigarette vending machines and tobacco displays in shops. 25 July 2010. Accessed 28/3/2017. URL: ↩︎ ↩︎

  13. Brown A, Boudreau C, Moodie C, et al. Support for removal of point-of-purchase tobacco advertising and displays: findings from the International Tobacco Control (ITC) Canada survey. Tob Control 2012;21:555-559. ↩︎

  14. Gardner B, West R. Public support in England for raising the price of cigarettes to fund tobacco control activities. Tob Control 2010;19:331-333. ↩︎

  15. Winickoff JP, McMillen R, Tanski S, Wilson K, Gottlieb M, Crane R. Public support for raising the age of sale for tobacco to 21 in the United States. Tob Control 2016;25:284-288. ↩︎

  16. Laforge RG, Velicer WF, Levesque DA, et al. Measuring support for tobacco control policy in selected areas of six countries. Tob Control 1998;7:241-246. ↩︎

  17. Martinez-Sanchez JM, Fernandez E, Fu M, et al. Smoking behaviour, involuntary smoking, attitudes towards smoke-free legislations, and tobacco control activities in the European Union. PLoS One 2010;5:e13881. ↩︎

  18. Danishevski K, Gilmore A, McKee M. Public attitudes towards smoking and tobacco control policy in Russia. Tob Control 2008;17:276-283. ↩︎

  19. Malone RE, Grundy Q, Bero LA. Tobacco industry denormalisation as a tobacco control intervention: a review. 2012;21:162-170. ↩︎


References accessed on August 24th, 2017.

Modified on June 20th, 2018. See History and Revisions