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Sophie Jooren - Compliance to local tobacco policies

Nice to meet you: Sophie Jooren

Even people who have smoked for a long time know better than to light up a cigarette in a train, plane or restaurant. National campaigns and strict legislation have changed people’s behaviour to such an extent that smokers and non-smokers now share the same indoor spaces without issue. The same applies to universities, where smoking indoors is obviously a thing of the past. But in any given outdoor environment, even at universities, it’s a different story: compliance with smoke-free rules becomes less straightforward. 

Whether a specific intervention to create a smoke-free outdoor environment is effective or not has been widely studied. However, to improve compliance, policymakers need to understand how smokers react to those interventions and the factors influencing their compliance. Sophie Jooren, a PhD student at the Care and Public Health Research Institute, used her background in anthropology and curiosity towards humans to research those reactions and published a realist review called “Effective elements of local tobacco policy in the Netherlands”. 

Triple threat

Sophie’s research was funded by ZonMw, the Netherlands Organisation for Health Research and Development. ZonMw called upon researchers to address three important health threats: alcohol, obesity and smoking. To cover smoking, a collaboration between Maastricht University and Trimbos Institute was founded to research the effective elements of local tobacco policies; one of the studies conducted was a realist review. “Sophie, we chose a realist review on smoking interventions in outdoor environments to find out the underlying mechanisms of (non-)compliance. We dived into the literature from the past 25 years and focused our findings on the Netherlands.” Sophie’s findings will be compiled into a magazine that regional public health services can use to improve their own smoking interventions. “For the time being, we wrote a blog with our findings, which is available to everyone.”

We are fortunate in the Netherlands that there is a nationwide and recognisable campaign called The Smoke-free Generation.

No argument against healthy children

Narrowing the results to the Netherlands was necessary for effective policy recommendations, as each country uses their own set of measures with different reactions. “We are fortunate in the Netherlands that there is a nationwide and recognisable campaign called The Smoke-free Generation which emphasises the importance of children growing up in smokefree outdoor environments, a message that acts as an effective argument.” 

We just need your compliance

Whatever the interventions are, Sophie researched the contexts that make smokers either comply with or oppose the interventions. Sophie: “Our research followed a Context – Mechanism (reaction of people who smoke) – Compliance approach. By the end, we were able to summarise what leads smokers to comply or not with such policies.

Clear communication, accessible smoking cessation support and acceptance of policies are the most important factors to comply in an outdoor environment. “Each factor is explained in the blog article with tips such as removing ashtrays that are still present in smoke-free areas, regular reminders of policies, and the amount of help given to people who want to quit smoking.” 

Of course, some mechanisms antagonise smokers. “Addiction, stigma, thinking the policy is exaggerated and low confidence in the policy’s effectiveness or enforcement can contribute to non-compliance.”

Translation to Randwyck

Sophie was contacted because the Faculty of Health, Medicine and Life Sciences and the Faculty of Psychology and Neuroscience and the Faculty of Science and Engineering are renewing the communication of the smoke-free campuses. Many students and staff are unaware that the entire area surrounding the campus building is smoke-free. Sophie’s research was the academic foundation needed to further develop UM’s own interventions. “We came across universities in our research and found that peer-to-peer contact was effective as well as tutors recognising their role-model position when it comes to smoking on campus.” The results of Sophie’s research will be implemented in the follow-up actions of our own smoke-free outdoor campus policy.

If you have any questions regarding the smoking policy of the campuses in Randwyck, please contact communicatie-fhml@maastrichtuniversity.nl

Text: Ruben Beeckman

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