Towards a smoke-free generation: Novel strategies to phase out tobacco use

In order to inform policies aimed at protecting people against the harms of second-hand smoke exposure and decreasing future trends in tobacco use this thesis will investigate smoke-free policies that go beyond indoor public places and workplaces (Part I) and we investigate strategies to incorporate personal characteristics or circumstances into smoking cessation programmes (Part II).
First, I investigated the socioeconomic gradient in trends in smoking-attributable mortality in Europe (Chapter 2). Part I starts with a description the methodology (Chapter 3) and findings (Chapter 4) of a systematic review evaluating public support across the globe for smoke-free policies that go beyond indoor public places and workplaces. Chapter 5 investigates recent trends in support for novel smoke-free policies in the Netherlands specifically. In 2019, Rotterdam was one of the first Dutch cities to launch an outdoor smoke-free zone, which encompasses an area where the Erasmus Medical Center Rotterdam and two school are located. In Chapter 6 we explore how people who smoked in this outdoor smoke-free zone responded to being addressed about their smoking behaviour. In Chapter 7, we describe results from a multidisciplinary team effort to explore various aspects relevant to implementing smoke-free policies in outdoor and (semi)private places and how these apply to the Netherlands specifically.
Part II starts with Chapter 8, in which we examine how gaining control over external stressors impacts (the intention to change) health behaviour among people living in vulnerable circumstances, including smoking. Further, we explored how incentives may most efficiently be implemented to support potential behaviour change (Chapter 9). In Chapter 10, we used that information to design a randomised controlled trial to investigate the effect of personalised incentives on sustained abstinence from smoking among hospital employees (Chapter 10). Chapter 11 presents the findings of this study, including the lessons we learned during its implementation.