The Gallup survey was conducted in collaboration with the World Health Organization (WHO) and Bloomberg Philanthropies. The Gallup World Poll survey data are representative of 95% and employs rigorous methodology to ensure representation.
The survey covered 7000 participants from across five countries – Colombia, India, Jordan, the United Republic of Tanzania and the United States of America.
The poll addressed a variety of issues including awareness of the term ‘noncommunicable’; understanding of the diseases and risk factors; perceptions of harmfulness and agency in preventing the diseases; levels of public support for selected policy measures; and trust in different health information sources.
Many people have personal experience with NCDs, either directly or indirectly. Across the five economically and culturally diverse countries an average of 66% of adults said they have had or know a friend or family member who has had an NCD. In the United States, this figure is 90%.
The survey illustrates that most respondents rank NCD risk factors as the biggest health problem in their country. And it revealed strong and broad support for alcohol tax increases among the world’s adult population.
The survey found most respondents rank an NCD or NCD risk factor as the biggest health problem in their country. At the same time, it found that self-reported awareness of the links between NCDs and major risk factors – including tobacco and alcohol consumption, unhealthy diets, and lack of physical activity – was low.
These findings come from a new international survey of people’s perceptions of NCDs and their risk factors, which was conducted in late 2021 and early 2022 by Gallup in collaboration with Bloomberg Philanthropies and the World Health Organization (WHO). The respondent-level data are now available for independent research.
The full survey dataset for all countries can be downloaded here.
Harm from NCDs and risk factors remains underrated
The global study illustrates that people under-estimate the harm caused by NCDs and their risk factors – especially concerning alcohol’s role in driving NCDs, such as cancer, heart disease, and others.
When people were asked to assess the risk of getting an NCD from using tobacco, alcohol, or consuming unhealthy foods or drinks (high in fat, salt, sugar) they expressed their understanding of the links between these health harmful products and NCDs.
| Colombia | India | Jordan | Tanzania | USA | |
| Tobacco products | 68% | 64% | 77% | 76% | 83% |
| Alcohol products | 56% | 63% | 78% | 68% | 44% |
| Regularly eating foods high in salt | 59% | 44% | 59% | 54% | 64% |
| Regularly eating foods high in fat | 64% | 47% | 72% | 67% | 72% |
| Regularly consuming high-sugar foods or drinks | 66% | 52% | 68% | 65% | 76% |
In two countries, Colombia and the United States, people were less aware of the link between alcohol and NCDs, compared to other risk factors.
In three countries, India, Jordan, and Tanzania, people were more aware of the NCDs risks due to alcohol than of the risk from unhealthy foods and drinks.
Awareness of the NCDs risk due by alcohol is lower than awareness of the NCDs risk due to tobacco in all countries.
This shows the importance of changing the pervasive alcohol norm in most countries and of increasing the public’s recognition of the real effects of alcohol.
But it also underscores the finding that people support alcohol policy change, such as raising alcohol taxes.
People support alcohol taxation and other NCDs Best Buys
The international survey shows that a broad majority of people from the five countries strongly supports all nine specific policies tested in the survey, such as incorporating more green spaces in urban health design and increasing taxes on tobacco and alcohol.
Alcohol taxation is the single most cost-effective alcohol policy solution to prevent and reduce alcohol harm. The data show that a broad majority overall and in each of the five countries support raising alcohol taxes.
- People broadly support increasing pro-health taxes.
- Higher taxes on alcohol and tobacco products receive similar levels of support (simple five-country averages of 69% and 66%, respectively), while 59% support higher taxes on high-sugar drinks.
Policy or regulatory measures that legally limit or prevent harmful practices of unhealthy industries, such as Big Alcohol, also receive substantial support. For example:
- Laws that limit actions such as smoking in public: simple five-country average of 69% support,
- Laws that would ban advertising of harmful high-sugar foods and drinks to children (72%), and
- Laws that would ban advertising of unhealthy foods, either ban the advertisement or promotion of the product or require processed fats to be removed from these types of foods (72%).
- Three policies that focus on empowering the public through such measures as creating healthy spaces like public parks, raising awareness via media campaigns and increasing access to health services all receive nearly universal support.
Pervasive alcohol marketing around the world
The survey also reveals that a majority of people see alcohol advertisements. This exposes people to harm and affects their perception and recognition of alcohol harm.
| Question | TOTAL | YES | NO | DON’T KNOW | |
| Have you seen ANY advertisements for alcohol in the last 12 months, or not? | TOTAL | 53,1% | 46,4% | 0,4% | |
| COLOMBIA | 73,9% | 25,8% | 0,1% | ||
| INDIA | 45,8% | 53,8% | 0,3% | ||
| TANZANIA | 56,5% | 43,4% | 0,1% |
Implications
Crucially, there is broad support for policy measures that can help prevent and reduce NCDs at the national level.
Even policies that might be considered controversial or even impossible to get public support for, such as taxes on alcohol, receive large support. This is an important finding because most people in those five countries support alcohol tax increases without having been exposed to public discussions about alcohol harm and policy solutions. Instead most of them are exposed to the glorification and glamorization of alcohol through marketing campaigns by alcohol companies.
The results show that people do support government actions that will ultimately boost the overall health of the population, especially given how many people have said they have been directly or indirectly affected by an NCD.
Better communication about the individual noncommunicable diseases and their risk factors is a vital part of the effort to prevent and reduce NCDs and risk factor incidences.
In May 2023, the World Health Organization (WHO) decided to expand the list of NCDs Best Buys. The updated list was approved at the 76th World Health Assembly.
WHO’s “Best Buys” are policy solutions that are highly cost-effective, evidence-based, and yield a significant return on investment for governments. The NCDs Best Buys target the main drivers of non-communicable diseases, such as tobacco use, unhealthy diets, alcohol use and lack of physical activity.
The three alcohol policy Best Buys have also been reconfirmed.
How WHO will use the results of the survey
The results and insights from this survey will be used to:
- Improve public awareness and understanding of NCDs and their risk factors by developing more effective communication.
- Bridge the knowledge gap between the NCD technical scientific community and the general public.
- Support advocacy efforts and encourage policymakers to prioritize interventions that address NCDs and their modifiable risk factors.
More illustrations
Data set
The full survey dataset for all countries can be downloaded here.
Gallup World Poll Methodology
To ensure that the Gallup World Poll survey data are representative of 95% of the world’s adult population, the following methodology is employed:
- The target population is the entire civilian, non-institutionalized, aged 15 and older population.
- With some exceptions, all samples are probability based and nationally representative.*
- There is a standard set of core questions used around the world.
- In some regions, supplemental questions are asked in addition to core questions. For example, the questions used in heavily indebted poor countries are tailored toward providing information about progress on the Millennium Development Goals.
- The questionnaire is translated into the major languages of each country.**
- Interviewing supervisors and interviews are trained not only on the questionnaire, but also on the execution of field procedures. This interviewing training usually takes place in a central location.
- Telephone surveys are used in countries where telephone coverage represents at least 80% of the population or is the customary survey methodology. In countries where telephone interviewing is employed, Random-Digit-Dial (RDD) or a nationally representative list of phone numbers is used. Telephone methodology is typical in the United States, Canada, Western Europe, Japan, Australia, etc.
- In the developing world, including much of Latin America, the former Soviet Union countries, nearly all of Asia, the Middle East, and Africa, an area frame design is used for face-to-face interviewing.
- Face-to-face interviews are approximately 1 hour, while telephone interviews are about 30 minutes.
- Quality control procedures are used to validate that correct samples are selected and that the correct person is randomly selected in each household.
- The typical World Poll survey includes at least 1,000 surveys of individuals. In some countries, oversamples are collected in major cities or areas of special interest. Additionally, in some large countries, such as China and Russia, sample sizes of at least 2,000 are collected. Although rare, in some instances the sample size is between 500 and 1,000.
Sources
World Health Organization: “Public perceptions of noncommunicable diseases: awareness and understanding“
Gallup: “Global Study: Harm From Noncommunicable Diseases Underrated“
Gallup: “World Poll Methodology“
