Creating smoke free environments by local policy

Abstract   In The Netherlands, around 20.000 people die each year from the effects of smoking and passive smoking. Every week, hundreds of children become addicted to smoking. To improve the overall public health in the Netherlands, it is important to substantially reduce the prevalence of smokers. Until recent years, municipalities played next to no role in helping to reduce smoking in the Netherlands. The start of a large campaign that aims a smokefree generation by 2040 has changed that. Part of that campaign is to create smoke-free environments. In a two-year program, 90% of the Dutch municipalities started policy and actions to ban smoking from public places, as part of the National Prevention Agreement. The participating municipalities were supported by all 25 Regional Health Services (GGDs) by providing knowledge and manpower on a regional level, together with national, regional and local organisations. The project has a number of successful elements: the GGD received a (very small) budget to actively participate in the region; knowledge was shared between the regions and from national to local level and legal issues were dealt with by the Nat Assoc of Municipalities (VNG). In 2021, 317 out of 352 Dutch municipalities were active in this project. There is a significant increase of smoke-free environments, mostly schoolyards, playgrounds, sports facilities, smoke-free bus stops and municipal institutions. Other results are integrated plans for smoking cessation care and accessible stop smoking service, e.g. in GGD Fryslan the number of registrations for smoking cessation care increased dramatically and 80% actually quit smoking. All parties involved agree that the strength of this project is its positive approach and the broad social support it generates for the Smokefree Generation. It is about persuasion, not compulsion. Working from a national focus towards a smoke-free environment, while taking into account local differences and needs, makes this project a success. Key messages • This project resulted in more local and regional partnerships and an increase of smoke-free environments, bringing the ultimate goal of a Smokefree Generation closer. • 90% of Dutch municipalities have created smoke-free environments with the guidance of the regional GGD, financed by Ministry of Health: multilevel governance works.


Background:
In 2013 'Tobacco-Free Ireland' (TFI) shifted Irish national policy from tobacco control to ''tobacco endgame'': policies, plans and interventions seeking to end the tobacco epidemic completely.Recent trends suggest the current 2025 TFI goal will not be achieved.This cross-sectional study is a timely assessment of public knowledge and attitude to re-focus Irish ''tobacco endgame'' planning.

Methods:
A literature-informed, pre-tested survey instrument was telephone-administered to a representative sample of 1000 members of the Irish public aged 15 years recruited via random digit dialling in February 2022.Prevalence of ''tobacco endgame'' views was measured; logistic regression determined factors associated with key responses.

Conclusions:
While achievement by 2025 is increasingly unrealistic, findings strongly affirm Irish public opinion is ready for ''tobacco endgame''.Recognition of the needs of currently addicted tobacco users and focusing on subgroups with lower support levels should be integral to equitable ''tobacco endgame'' planning and communication.This study should mobilise renewed Irish political commitment to bold actions aimed at ending smoking-related harm.

Key messages:
There is strong support for tobacco endgame measures among the Irish population, which is a supportive factor for bold political leadership to make these radical ideas a reality.Public preference for product and non-user-focused measures aligns with tobacco endgame discourse and should aid policy reframing to tackle structures and dynamics sustaining the tobacco epidemic.
Abstract citation ID: ckac129.035Creating smoke free environments by local policy

Selinde Rouwenhorst
iii18 European Journal of Public Health, Volume 32 Supplement 3, 2022 S Rouwenhorst 1 , A Koornstra 1 1 GGD GHOR Nederland, Utrecht, Netherlands Contact: srouwenhorst@ggdghor.nl In The Netherlands, around 20.000 people die each year from the effects of smoking and passive smoking.Every week, hundreds of children become addicted to smoking.To improve the overall public health in the Netherlands, it is important to substantially reduce the prevalence of smokers.Until recent years, municipalities played next to no role in helping to reduce smoking in the Netherlands.The start of a large campaign that aims a smokefree generation by 2040 has changed that.Part of that campaign is to create smoke-free environments.In a two-year program, 90% of the Dutch municipalities started policy and actions to ban smoking from public places, as part of the National Prevention Agreement.
The participating municipalities were supported by all 25 Regional Health Services (GGDs) by providing knowledge and manpower on a regional level, together with national, regional and local organisations.The project has a number of successful elements: the GGD received a (very small) budget to actively participate in the region; knowledge shared between the regions and from national to local level and legal issues were dealt with by the Nat Assoc of Municipalities (VNG).In 2021, 317 out of 352 Dutch municipalities were active in this project.
There is a significant increase of smoke-free environments, mostly schoolyards, playgrounds, sports facilities, smoke-free bus stops and municipal institutions.Other results are integrated plans for smoking cessation care and accessible stop smoking service, e.g. in GGD Fryslan the number of registrations for smoking cessation care increased dramatically and 80% actually quit smoking.All parties involved agree that the strength of this project is its positive approach and the broad social support it generates for the Smokefree Generation.It is about persuasion, not compulsion.Working from a national focus towards a smoke-free environment, while taking into account local differences and needs, makes this project a success.

Key messages:
This project resulted in more local and regional partnerships and an increase of smoke-free environments, bringing the ultimate goal of a Smokefree Generation closer.90% of Dutch municipalities have created smoke-free environments with the guidance of the regional GGD, financed by Ministry of Health: multilevel governance works. Abstract

Background:
The World Health Organization defined smoking as the fastest spreading and longest lasting epidemic globally.It has been reported that two-thirds of all tobacco consumption in the world is in developing countries, and with today's technology, the use of electronic cigarettes (e-cigarettes) has increased rapidly among young people and adults, especially in recent years.The study aimed to evaluate the factors associated with dual use of e-cigarettes (e-cigarette plus one of the tobacco products) in university students.

Methods:
This study was carried out with the participation of 2477 students at Eskis ¸ehir Osmangazi University in the 2019-2020 academic year, and it was designed as a nested case-control study from a study in which 49 were determined to be dual smokers.A randomized 1:3 for age and gender with 147 nonsmokers (NS) and 147 classic cigarette smokers (CSS) selected by the propensity score matching method was performed, with the final sample consisting of 343 participants.Chi-square and multinomial logistic regression analyzes were used in the study.

Results:
In the multinomial logistic regression, the belief that ecigarettes do not help quit classical cigarette smoking was 4.0 (95% CI; 1.7 -9.6) times higher in NS and 4.1 (1.6 -10.0) times higher in CCS compared to dual smokers, while the belief that e-cigarettes may suppress the desire to smoke was 4.4 (1.7 -11.2) times higher in NS and 6.8 (2.6 -17.6) times higher in CCS.

Conclusions:
The study determined that dual smokers were less likely to believe that e-cigarettes are more innocent than other tobacco products.While dual smokers believed that e-cigarettes might not suppress the desire to smoke, CCS believed e-cigarettes could even increase classical cigarette smoking.

Key messages:
Since the effects of e-cigarette use on human health are controversial, it is still a significant public health problem in developing countries.
Although it was initially marketed to help quit or reduce the use of classical cigarettes, it should be noted that e-cigarettes are also a type of tobacco product addiction.
.004) and unemployment rate (p = 0.017).The greatest market increase of FCCs was observed in the Americas region and among upper-middle income countries.In Europe, there was a decrease of 0.64 percentage points from 2019 to 2020.
Conclusions:Overall, FCCs experienced substantial global growth in the recent decade, with the exception of Europe whose slight decrease may be attributable to the European Union ban on flavours in cigarettes.Findings indicate that there is a need for increased efforts to address flavours and innovative features used in tobacco products, which are known to appeal to youth.15thEuropean Public Health Conference 2022