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Pathways of change explaining the effect of smoke-free legislation on smoking cessation in the Netherlands. An application of the ITC Conceptual Model.
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Pathways of change explaining the effect of smoke-free legislation on smoking cessation in the Netherlands. An application of the ITC Conceptual Model. Gera Nagelhout, Hein de Vries, Geoffrey Fong, Math Candel, James Thrasher, Bas van den Putte, Mary Thompson, Michael Cummings, & Marc C. Willemsen Presentation at WCToH pre-conference workshop ‘Effective implementation of FCTC policies’, Singapore, March 2012
Smoke-free legislation and cessation “Legislative bans reduced exposure to secondhand smoke. (…) There are fewer data measuring smoking prevalence and smoking behaviour with either no change or a downward trend reported” (Cochrane review Callinan, Clarke, Doherty, & Kelleher, 2010)
Smoke-free legislation and cessation “The introduction of comprehensive smoke-free legislation has increased the rate at which smoking prevalence was declining in some locations, but in the majority of jurisdictions had no measurable impact on existing trends in smoking prevalence” (Bajoga, Lewis, McNeill, & Szatkowski, 2011)
Smoke-free legislation and cessation ITC studies Effect • Fong, Hyland et al., 2006 • Nagelhout, de Vries et al., 2012 No effect • Hyland, Hassan et al., 2009 • Cooper, Borland et al., 2010
Smoke-free legislation and cessation Smoke-free Smoking legislation cessation
Smoke-free legislation and cessation Smoke-free Smoking legislation cessation ? ? sometimes...
Smoke-free legislation and cessation Smoke-free Smoking legislation cessation ? ? pathways of change?
Methods Four waves of ITC Netherlands Survey One pre-ban, three post-ban waves Smokers aged 15 or older 56% participating in 4th wave (n=1,012) Structural Equation Modelling
Conclusion • Policies influence smoking cessation through policy-specific variables and psychosocial mediators. • Support for smoke-free legislation and attitudes about quitting are crucial in increasing intention to quit. • Subjective norms about quitting can be changed by creating awareness of the harm of (second-hand) smoking.
Future research • Behavioural mediators (e.g. voluntary smoking bans, compliance with smoke-free legislation). • Implementation characteristics(e.g. comprehensive vs. partial, media attention). • Other countries and other policies.
Policy implications Aim to increase support forsmoke-free legislation and attitudes favourable to quitting (e.g. with media campaigns andmedia advocacy)
Thank you for your attention! More information: Gera.Nagelhout@MaastrichtUniversity.nl www.itcproject.org