BACKGROUND: While tobacco consumption has decreased in recent years, there has been a surge in e-cigarette usage, particularly among youth. E-cigarette regulation is highly variable across countries, from no regulation to complete bans. Additionally, countries are considering 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: An online survey, with input from the World Federation of Public Health Associations Tobacco Control Working Group and Tobacco Free Ireland, gauged support for 20 endgame measures and e-cigarette regulations. Convenience sampling was used for distribution through international networks.
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 measures. There was majority support for 14 of 20 endgame measures, including restricting tobacco use in public places (70%), increasing tobacco purchasing age to 21 (68%), banning retailer incentive programmes (75%), limiting nicotine content (73%), and mandating sales data publication by tobacco companies (69%). Nearly three-quarters (73%) would favour a tobacco-free generation law in their country, but only 31% expected it would be successful. E-cigarettes were seen as more desirable due to flavours (74%) and better taste/smell (72%), but 83% perceived them as an important health risk and 65% believed harms outweighed benefits. Preferred e-cigarette regulations included advertising restrictions (86%), higher taxation (70%), banning flavoured (73%) and disposable (76%) vapes, and point-of-sale display bans (72%).
CONCLUSIONS: Strong support was expressed for proposed endgame measures. Tobacco-free generation legislation was generally supported, albeit with feasibility concerns. Most young adults recognised health risks of e-cigarettes and favoured stricter regulation. Policymakers can use these findings to take firmer action in protecting populations from the health hazards of smoking and e-cigarettes.