PhD Defence Nienke Boderie

Ever since the General Surgeons report on the harmful effects of tobacco in 1964, tobacco control has had major successes and many countries now aim to reach a smoke-free generation. Despite these successes, smoking related mortality remains an important contributor to socio-economic differences, and the peak of smoking attributable mortality has not been reached yet. To further improve tobacco control and contribute to reaching a smoke-free generation, this thesis discusses two strategies. In pat 1 we investigate extending smoke-free policies beyond smoke-free public places and workplaces. Public support is tremendous, not only in the Netherlands but worldwide and not only among smokers, but among non-smokers as well. Especially places with children are low-hanging fruit to implement smoke-free zones. In part 2 we investigated strategies to improve smoking cessation programs through personalization. External circumstances such as poverty related stress might influence (health) behavior, and a stronger focus to alleviate money-related issues may benefit health interventions. Health behavior is also influenced by personal characteristics, which was the focus in the PERSIST trial. Using personalized incentives we tried to improve sustained smoking cessation among health care employees. Combining a personalized advice with the option to deviate from it seems to be an effective strategy, however recruitment was challenging and future research might benefit from more collaboration between researchers and potential participants. Combining the knowledge gained from part 1 and 2, we concluded that by simultaneously targeting the system and aiding the individual, a smoke-free generation should be in reach.