Last Friday, everyone involved in tobacco research in the Netherlands came together for the third NNvT conference in Utrecht. Besides researchers, there were also many practitioners and policy makers present. Although the Netherlands is a relatively small country, there were as many as 40 presentations of recent studies about smoking.
One of the major themes of the conference was vulnerable groups and socioeconomic inequalities in smoking. The day started with a keynote by Prof. Johan Mackenbach, who had the disheartening message that more tobacco control means more socioeconomic inequalities. An exception is reimbursing and targeting smoking cessation treatment to low socioeconomic status groups, like in the United Kingdom. Another exception may be tobacco tax increases, but Prof. Mackenbach and one of the other speakers of the day were not entirely sure anymore that tobacco tax increases reduce socioeconomic inequalities. What did became clear during the day is that new solutions are needed for vulnerable groups who experience more life stress and a more pro-smoking social network than others. Individual counseling with motivational interviewing remains important, but innovative approaches like rewarding smoking cessation are worthy of further investigation.
Almost one third of the presented studies dealt with tobacco control policy. The importance of societal support for tobacco control policies was emphasized many times. Several presentations focused on policies that are part of the ‘smokefree generation’ strategy of the Dutch Alliance for a Smokefree Society such as a tobacco display ban and outdoor school ground smoking bans. A very interesting finding was that a focus on protecting children from tobacco can unite people with very different ideologies and political beliefs in supporting these policies. Other presentations focused on the smoking ban in bars, for which one of the main messages was that smoking rooms undermine the effectiveness of the law. This is an important point, because the Netherlands Food and Consumer Product Safety Authority announced on the same day that the number of smoking rooms in bars has increased in the last year.
More literature reviews and meta-analyses were presented than during the previous NNvT conference. I think this is an excellent development. It is not always needed to start new research in the Netherlands, sometimes we can learn enough from previous research. Interesting was that quite a few researchers applied the realist review methodology. This is a relatively new method that examines how and why interventions or policies have certain effects instead of only examining whether and how much effects occur. It gives important insights into mechanisms and contexts, which can be used to improve tobacco control strategies.
A lot of research presented at the conference also focused on smoking cessation. A new clinical guideline for the treatment of tobacco addiction was released at the end of 2016, which made this conference an ideal opportunity to discuss the changes in these guidelines. An important topic remains how to increase commitment for smoking cessation advice and treatment among health professionals. Keynote speaker Prof. Daniel Kotz argued that health professionals should give opportunistic stop smoking advice without first selecting smokers who are already motivated to quit. E-cigarettes were also a point of discussion at the conference. Use among smokers seems to be motivated mainly by harm reduction and the intention to quit smoking, but there is now also evidence that Dutch youth who experiment with e-cigarettes are more likely to start using tobacco. The e-cigarette is not actively recommended as smoking cessation treatment in the new clinical guideline.
The day ended with a plenary discussion about priorities in Dutch tobacco research and the possibility of creating a national center of tobacco research with a shared research agenda. As part of the research agenda, the following topics were mentioned by the panel and public: smoking prevention, improving the reach and use of evidence-based interventions, social and political determinants of national and local tobacco policy, vulnerable groups and inequalities in smoking, and how to increase commitment among health professionals.
In sum, a very interesting conference with important discussions between researchers, practitioners, and policy makers. All attendees voted in favor of a yearly NNvT conference, so see you next year!