It comes and goes in waves: evaluation of inconsistently implemented tobacco control policies in the Netherlands

Measures to discourage tobacco use can be effective in reducing smoking. In the Netherlands, some of these measures were changed or even temporarily or permanently reversed after implementation. This dissertation evaluates inconsistencies in the implementation process and the socioeconomic differences found. The study results show that inconsistent implementation of measures can affect the outcome. For instance, adjustments to the regulations regarding e-cigarettes are associated with changes in e-cigarette use. It is also shown that there are socioeconomic differences between the effects of some of these measures. Social acceptance of smoking in public places and at home is higher among smokers from low socioeconomic backgrounds. Low-income smokers of low education are more frequently encouraged to consider stopping by various measures to discourage tobacco use. In this dissertation, the validity of various instruments measuring intention to stop smoking is assessed. The three instruments that are studied are shown to be good predictors of attempts to stop smoking. They are also shown to be useful for future studies based on questionnaires.