The government believes we should get rid of cigarettes. All kinds of measures are making it increasingly difficult for smokers, but is it enough? Not according to the Trimbos Institute, which therefore wants more focus on guidance during a quit attempt.
In 2018, the government concluded the National Prevention Agreement. Part of this is the ‘smoke-free generation’: by 2040, every child must grow up in a smoke-free environment. In addition, the number of adults who smoke must have fallen to less than 5 percent.
‘Measures have an effect’
Since then, many dissuasive measures have also been taken. For example, cigarettes are only available in neutral packaging, smoking areas have disappeared and smoking is no longer allowed around schools and other educational institutions. This year, a sales ban for supermarkets will be added and excise duties on tobacco products will increase again.
These measures have an effect, Marc Willemsen sees. He is tobacco program manager at the Trimbos Institute and conducts research into the discouragement of tobacco products, such as cigarettes and roll-your-own tobacco. “We even received a compliment from the World Health Organization.”
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Decline in smokers is stagnating
Also out Numbers Statistics Netherlands, RIVM and Trimbos Institute show that things are going in the right direction: 10 years ago, more than a quarter of Dutch people smoked, by 2022 that number had fallen to about 19 percent. “But you see that this figure is stagnating slightly again and that smoking is increasing slightly again, especially among young people,” says Willemsen.
The popularity of e-cigarettes and vapes plays a major role in this. For a long time, they were allowed to contain all kinds of sweet flavors, allowing the tobacco industry to reach a new target group. To put a stop to this, there has been a ban on these types of flavors since January 1, only the flavor of tobacco is still allowed.
‘Cigarettes still very affordable’
But according to Willemsen, that is not enough to keep young people (and others) from smoking. “An increase in excise duties is the most important thing,” he emphasizes. “Cigarettes are actually still very affordable in the Netherlands. It is important that the price of cigarettes continues to rise and that this happens annually by at least 10 percent, as the WHO advises.”
He sees another important point of attention: “Of course you also have to help smokers to quit smoking.” According to him, it is ‘very important’ that smokers receive ‘much more generous’ support. “So that healthcare will also participate much more. That GPs advise smokers to stop smoking and refer them to specialized quit support.”
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Guidance on quitting
This is already happening in various places in the country, including Nijmegen. There, Willem and Miriam receive guidance from coach Fianne Eijkman in their attempt to quit smoking. Through exercise they work towards a healthy lifestyle, which does not include smoking.
“I have a concussion, which means I can’t work or play sports at the moment,” says Miriam. “As a result, my social life is very different, so I started smoking again. Coincidentally, I had to go to the doctor, who told me that I could join such a group. She said that at exactly the right time.”
Last longer
At Eijkman, participants receive a total of six group sessions, spread over a number of weeks, the coach explains. “The first three are very much about: how do you stop smoking? What is my motivation? What are my impulses? And what are my pitfalls? How do you maintain that in the longer term?”
“After that it becomes much more about: how can I relax?” she continues. Many smokers experience a relapse. This also applies to 73-year-old Willem, who started smoking at the age of fifteen. Like Miriam, he tried to quit a few times before, but without success. “Until my urologist said, ‘I’m giving you up now.’ I had nothing to say against it.”
‘Peer pressure helps’
No sooner said than done. During the training, Miriam and Willem learn to recognize their impulse moments and to move at such moments, so that they can more easily push aside the urge for a cigarette. After six sessions, they are both convinced that they have now stopped for good.
“It helps that you are with several people,” says Willem. “I really can’t say that I’ve learned one if the rest don’t either,” Miriam adds. Willem: “And we have a group app in which we all cheer each other up a bit, that helps.”
Miriam and Willem follow a stop training with coach Fianne Eijkman (left)
Four times greater chance of stopping
The Trimbos Institute has calculated that this type of guidance in combination with nicotine aids such as patches or tablets increases the chance of quitting by four times. Since 2020, everyone has been able to attempt to quit once a year for free, as health insurers do not charge a deductible for guidance during the first quit attempt.
But according to the knowledge center, compensation should not only apply to the first quit attempt. “Because smokers often relapse, you should be able to stop whenever you want,” says program manager Willemsen. “And you shouldn’t postpone that because you have already attempted to quit that year.”
Funded with excise duties
A broader compensation does not have to cost much, the excise tax revenues can be used for that, he suggests. “Now the proceeds from tobacco sales often end up in pots for other problems in the country, but that should be used much more in large public campaigns so that people can find that support.”
The excise duty on cigarettes will increase by 60 cents in April, meaning that a pack will cost an average of 10.70 euros. It has not yet been decided whether tobacco products will subsequently be made even more expensive. If it is up to the Trimbos Institute, that will happen.
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‘Takes a really long time’
Willemsen simultaneously emphasizes that other measures that discourage smoking are also important and that they must therefore be taken more quickly. For example, stricter sales rules: e-cigarettes will only be available for sale in specialty stores from next year, but this will only apply to tobacco from 2032.
“That takes a really long time. Then you give entrepreneurs a lot of space and opportunity to come up with all kinds of ways so that they can continue to sell,” he says. “And a smoke-free generation in 2040: why does that have to take so long? That is in 16 years. Politics can bring that forward. After all, it is about public health.”
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Smoking will be further discouraged this year, but are the measures enough?
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2024-01-09 06:00:01
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