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Background: Scientific evidence shows that climate change is very likely the product of human behaviour and lifestyle. The effects of climate change on human health are diverse in nature and range from direct effects due to extreme weather events such as heat waves, floods and storms, to indirect effects such as those caused by water and food shortages. Methods: A telephone survey was conducted between January and February 2009, on a stratified representative random sample of the Maltese population over the age of 18 years (N = 310 819). Results: Five hundred and forty-three individuals successfully participated in the survey giving a response rate of 92.7%. The respondent sample was very similar to the target population by gender ( P = 0.977), age (P = 0.767) and district (P = 0.812). The results of the study demonstrate a very strong relationship between the perception of climate change as a threat to health and well-being, support for climate change mitigation policy and a willingness to implement measures to address climate change. Conclusion: The findings of this study show that the perception that climate change may claim lives, cause disease, reduce the standard of living and worsen water shortages, may be the strongest driver behind support for climate change mitigation policy and a willingness to act. It is recommended that, in order to gain more public support, climate change campaigns and risk communication strategies should frame climate change as a threat to human health and general well-being. [ABSTRACT FROM PUBLISHER]