Smoking cessation in the Netherlands Occupational settings and nationwide policies

During the past decades, smoking has been increasingly recognised as an unprecedented population health problem, due to its negative influence on health status, work productivity, and societal costs. This thesis aimed to contribute to the development of smoking cessation services in national, local and occupational settings, by evaluating the potential effects of smoking cessation policies and interventions at national and local levels, including occupational settings. We found evidence that smoking increases both the risk and number of sickness absence days in the working population, but did not find evidence that smoking cessation improves work-related outcomes. Therefore, more research is needed on the relation between smoking cessation and work-related outcome in different populations. The smoking ban in the hospitality industry, the reimbursement of smoking cessation support, and the yearly Stoptober campaign were associated with increases in searching for information on smoking cessation in the Dutch population. We found that about half of the Stoptober participants had quit smoking after three months and that the campaign supported its participants according to its theoretical principles. In order to further reduce smoking prevalence, employers should offer smoking cessation interventions at the workplace, further smoke-free legislation should be implemented, and the costs of smoking cessation services should be reimbursed. Furthermore, the reach and effectiveness of the Stoptober campaign could be increased by cooperating with employers, local smoking cessation services, and primary care givers.