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Evidence and policy making in health promotion policy in Israel

By: Laura (Leah) Rosen1, David Rier2, Robert Schwartz3
Completed By: July 2011


Scientific Background
The gap between the demonstrated need for resources for disease prevention and health promotion, and low levels of governmental investment, is well-documented. We consider perspectives of decision makers and the public on tobacco control.


The main goals of this research were to understand the influences on policy makers in the area of tobacco control, and to examine how policy makers and the public view tobacco use and governmental responsibility for its control.


In order to understand tobacco-control policy, face-to-face semi-structured interviews were conducted with a wide range of policy makers, Purposive sampling was employed to ensure broad representation of the policy-making population. Respondents included past and present members of Knesset, ministers, senior ministerial personnel, activists, academics, and HMO personnel.  Views of the Israeli public regarding responsibility for tobacco control, risk perceptions, and support for smoke-free areas were investigated by using a nationally-representative survey (n=505). The response rate was 61%.


a. Policy makers:  Many, but not all, respondents thought tobacco-control should be a governmental priority.  Major obstacles to effective tobacco-control policy included: weakness of the Health Ministry relative to the Finance Ministry; relative weakness of public health within the Health Ministry; and poor municipal-level enforcement.

b. Public: Support for the governmental interventions studied for tobacco control was high. The public believed that primary responsibility for tobacco control was with the smokers and that the main responsibility for prevention of youth initiation was with parents. Support for smoke-free areas often high, and varied with specific area. Knowledge and perception of risk was substantial but incomplete.


Israelis support both governmental intervention and individual responsibility for tobacco control.


Policy Implications / recommendations
These findings should help formulate national policy which is consistent with public attitudes, and should strengthen the Ministry of Health's case for its upcoming comprehensive tobacco control initiative.


Research number: R/98/2007


1) Tel Aviv University
2) Bar Ilan University
3) University of Toronto, Greg Connolly, Harvard University