Compared with fifteen other countries studied, the Netherlands has the lowest percentage of smokers reporting that they often think about the harm of smoking to themselves (22%) or to others (9%). And fewer Dutch smokers than smokers in other countries realize that heart disease, stroke and lung cancer can be caused by smoking and that heart disease in non-smokers can be caused by exposure to second hand smoke

The Netherlands is obliged since 2005 to take measures to reduce smoking. In that year, the Netherlands signed the Framework Convention on Tobacco Control of the World Health Organisation. But how effective are tobacco control policies in the Netherlands? In a comparative study - the ITC Project – conducted in 22 countries, allowed the Dutch findings to be compared to countries all over the world. On 12 September, the ITC Netherlands National Report was released. Researchers from University of  Maastricht, University of Amsterdam (UvA), and the University of Waterloo in Canada presented recommendations based on seven survey waves conducted from 2008 to 2014 among a cohort of two thousand Dutch smokers.

Only 21% of smokers have negative attitudes toward smoking, which is the second lowest among thirteen countries of the ITC Project. In addition, the researchers call the relative poor knowledge of the dangers of smoking and exposure to secondhand smoke disturbing. In many other countries where this was examined, the perception of risk was greater.

The researchers see this as a direct result of cutting back on education campaigns. They call on the Dutch government to make new and stronger investments in educational  campaigns to reduce tobacco use. According to the researchers, The Netherlands can and should do much more in tobacco control than it did recently. In some aspects of tobacco control there is progress, but there is still much that needs to be done.