Shifting focus

During the past year, I have been shifting my focus to include other research topics than smoking cessation, I have learned new research methodologies, and started focusing more on teaching. Is it a smart move to change so much and ‘start over’ with having to learn many new things? I honestly don’t know. Is it always a conscious decision that these kinds of changes happen during your academic career? Definitely not. But more importantly: Is it fun and interesting to learn new stuff? For me it certainly is!

My new experiences
challenges-experience-signAfter a PhD study and a first post-doc study on the impact of tobacco control policies on smoking cessation, I started a second post-doc study last year on the impact of economic recessions on illegal drug use. A very interesting study in which we used the realist review method to describe the mechanisms that explain how economic recessions may change individuals’ illegal drug use. A publication on this topic is on its way, and I will definitely mention it here when it’s published. Meanwhile, if you are interested in the realist review method (which is relatively new and gaining popularity fast), read the book or paper by Ray Pawson. If you are interested in our project, check out our website or this short video.

After years of mainly focusing on doing my own research at Maastricht University, I am now supervising four PhD students there and I became a lecturer at a University of Applied Sciences (de Haagse Hogeschool). The PhD students that I supervise all study (different aspects of) smoking cessation, but at the Haagse Hogeschool I teach research methodology at the study program Nutrition and Dietetics. It turns out that I really like the supervision and teaching role and I also like it very much to learn things about Nutrition and Dietetics.

Finally, I started a few months ago with a new research project about health behavior change among multi-problem families. Multi-problem families have to cope with multiple problems and stressors in their family lives, such as socio-economic problems (e.g. financial problems, unemployment), psycho-social problems (e.g. domestic violence, psychiatric disorders), and problems associated with the upbringing of their children (e.g. neglect, maltreatment). In this project we examine smoking behavior, but also alcohol abuse, unhealthy nutrition, and physical inactivity. I have now started a series of qualitative interviews with members of multi-problem families to talk about their experiences with health behavior change. Both the new topics and learning to do qualitative research has been very inspiring.

What about you?
Should you change research topics or methods after your PhD or should you stick to what you know? It’s hard to say. Changing topics might increase your chances when you are looking for a new job, because you can show that you are versatile. However, sticking to your topic might increase your chances when you are applying for a grant, because grant reviewers and funding organizations have the trust that you know what you’re doing. But you should probably not worry too much about this, because more often than not it isn’t a conscious decision. In my case, I wrote two large grant proposals last year. One was about tobacco control policy and one about health behavior change among multi-problem families. The last one was accepted and the first one was not, which made the choice for me what I was going to do.

Time for Change - ClockIf you do have the choice, I would say: Go for it! It is fun and interesting to learn new stuff. Sometimes you feel a bit like you have to ‘start over’, like you are in the first year of your PhD again. But why would you be afraid of that? And you might feel like this, but in the end you have learned a lot of research skills already, which makes you learn and pick up new things much faster than when you just started. Are you considering a change to an entirely different research field? Then this blog post might be of interest to you.

Should you be afraid to lose everything you build up in the years that you worked on your previous topic? My experience is that you don’t have to stop working on your previous topic when you are starting new things. I am still involved in many smoking cessation research projects and in the network that comes with that. You don’t have to work twice as hard to work on two (or more) topics, you just have to learn to divide your attention.

As always, I am interested to learn about other people’s experiences. Feel free to post your experience, thoughts or questions below.

Good newsWe often focus on the bad news for tobacco control in the Netherlands. Smoking prevalence has stagnated at a quarter of the population. Socioeconomic inequalities in smoking are widening. The Dutch government is mediocre in implementation of tobacco control policies and when they do implement policies they sometimes reverse them later. But in the last couple of months some good news about tobacco control in the Netherlands came to light and that is the focus of my blog today.

In June of this year, Maastricht University, RIVM, and the Trimbos Institute completed a social cost-benefit analysis of tobacco control in the Netherlands. The analysis showed that tobacco control can decrease the number of smokers substantially and this gives a positive financial net benefit for society. Although the health benefit is the main reason why we should implement tobacco control policies, financial gains may help convince policy makers.

In July, the Trimbos Institute reported a sharp decline in smoking among schoolchildren aged 12 to 16 years between 2011 and 2015. Not only tobacco smoking declined, but also cannabis smoking and alcohol use. Use of e-cigarettes did increase, but most schoolchildren only try that once and do not become regular users. Moreover, a ban on the sales of e-cigarettes to minors has been implemented after this study came out.

In August, two scientific papers were published with good news for tobacco control in the Netherlands. The first paper was published in BMC Public Health and dealt with the prevalence of ‘hardcore smoking’. Smokers were considered ‘hardcore’ if they smoked every day, smoked on average 15 cigarettes per day or more, had not attempted to quit in the past 12 months, and had no intention to quit within 6 months. The prevalence of hardcore smoking decreased among smokers as well as among the general population. Therefore, the idea that as smoking prevalence declines, the smoking population becomes hardened and more difficult to reach was not supported for the Netherlands.

The second scientific paper that came out in August was published in Nicotine & Tobacco Research. It showed that the social acceptability of smoking has been decreasing over the past ten years in the Netherlands. Nowadays, smoking is only considered socially acceptable on the street, on a terrace, and in a bar. This last finding can be explained because smoking is still allowed in smoking rooms in bars and some bars do not comply with the smoke-free legislation. Additionally, the exception on the smoking ban for small bars was still in place when this study ended. The study also showed that the number of people with a home smoking ban increased.

More good news is expected in the coming months, because the Stoptober campaign will again take place in the Netherlands this year. Last year, almost 70,000 people participated in the Dutch version of Stoptober. Although Stoptober is about temporarily stopping smoking for 28 days in October, most participants were still stopped two months after Stoptober. The mean number of cigarettes per day of those who did go back to smoking decreased from 17 to 10 cigarettes per day.

Of course there are also downsides to the positive news. The report about smoking in schoolchildren and both scientific papers that came out this month showed large socioeconomic differences. People with a lower socioeconomic status smoke more, are more often hardcore smokers, think it is more socially acceptable to smoke, and less often have a smoke-free home. Targeted interventions are needed to prevent smoking initiation and stimulate smoking cessation among groups where smoking prevalence is still high, such as people with a low socioeconomic status and people with mental health conditions. Another issue is that people should not be stigmatized when they really cannot quit or don’t want to quit. This is something that needs increasing attention in a society in which smoking is no longer considered socially acceptable, where people talk about a smoke-free generation, and where Stoptober makes you believe that quitting smoking can be easily done. We should not forget that tobacco is highly addictive, that some people really cannot quit, and that they are victims who made a wrong decision when they were young.

Although theRaise tobacco taxesre are now several media campaigns that discourage smoking and smoking bans are being strengthened in the Netherlands, the most important policy to decrease smoking ánd decrease socioeconomic differences in smoking is large increases in tobacco taxes. Without large tax increases we will not reach the reduction in smoking prevalence that the social cost-benefit analysis has calculated. Thus, so much positive news does not mean that no further action is needed.

A few weeks ago I read aBusy-cover2-193x300 short interview with Tony Crabbe about his book ‘Busy – how to thrive in a world of too much’. Normally, I wouldn’t have bought the book, because I seldomly make time to read books. But the timing was right because I was going on a skiing vacation and I would have plenty of time to read a book on how to become less busy. So I ordered the book and took it with me on my skiing trip. It turned out to be a great read that I would recommend to everyone, but especially to early-career academics, although the book is not written for academics at all.

Crabbe is a business psychologist and many examples in the book are about commercial companies. But it is written for people who can (to some degree) make their own choices on what kind of work they do, how much they do, and/or how they do it. My guess is that this is true for more people in academia than in business. Crabbe uses numerous scientific theories and principles to back up his recommendations and he describes in a simple but effective way how the brain works and that it needs recovery periods and cannot deal with constant busyness. This makes his argumentation quite convincing for academics.

Of course Crabbe realizes that the people who want to read his book are too busy to read books. Therefore, the book brilliantly starts with ten short and simple suggestions that help to create enough time and space to read the book. For example: turn off the email notifier of your computer and phone, cancel a meeting, create a ‘braindump’ (something that you always carry with you on which you can easily jot down ideas and things you shouldn’t forget), and, last but not least: smile more.

The book is filled with recommendations that can help you to change how you do your work and I will not repeat all of them here. An eye-opener for me was the proposition that time management is not a real solution. Time management helps you to do more, but there is too much to do, so it will only make you busier. Crabbe recommends to shift your focus from getting things done to making an impact and differentiating yourself. Instead of feeling that you have to be in control again, you should let go of your need for control and gain a sense of mastery by making choices and managing your attention. Most people in academia have at least some freedom to choose on which topics/projects they work. Especially when you have obtained your PhD and start working on research that you have designed yourself. At that point, Crabbe recommends to make more ‘which’ choices (‘which things do I want to focus on?’) and less ‘whether or not’ choices (‘do I want to do work on the project/task that someone else asked me to work on?’). You cannot control the ‘whether or not’ questions that other people ask you, but you can gain mastery by focusing on the projects and tasks that are important to you.

After reading a book like this it is easy to feel very inspired to change a lot of things but never really do it. Therefore, one of the last chapters of the book deals with the difficulty of behavior change. Crabbe recommends to plan to change only one small thing in your behavior after reading the book and gives tips and tricks on how to ensure that you will really change your behavior. What I want to change after reading the book? I supervise several PhD students and I get a lot of email, so if I’m not careful I fill my days completely with meetings and email without working on my own research projects and I do want to (and need to!) work on my own research projects. Crabbe recommends to get really clear and specific about the behavior you want to change: I want to start each working day with a period of email-free and meeting-free time to work on my own research. Crabbe recommends to start really small, so I will do this for at least half an hour each day before opening my email and looking at my ‘to do’-list. One way of ensuring that you will stick to your promise is using social influence (hence this blog!). Finally, you should get back on the horse if you fail, which was what happened to me when I came back from my skiing trip and felt overwhelmed by a full email inbox with a lot of ‘whether or not’ questions which I started to answer right away. This week is already going a lot better! And my next goal? Making more time to read good books!

I am currently involved in setting up a research study on smoking cessation in Dutch companies. Smoking cessation group therapy is an effective method to quit smoking and it is sometimes used in a company setting. Although this is a scientifically proven effective smoking cessation method, not everyone who participates succeeds in smoking cessation on the long term because tobacco use is very addictive. Click here for our brochure with more information about study participationReason for us to test novel approaches to increase smoking cessation success rates.

Previous research from the United States has shown that rewarding employees for smoking cessation success with monetary incentives increases their success rates. The Dutch Cancer Society wanted to know whether such an intervention could also be effective in the Dutch company setting and thus funded our research that is carried out at the Department of Family Medicine of Maastricht University.

Although rewarding smoking cessation success may be effective in most cultures, it is not accepted everywhere. The Dutch company setting and Dutch social norms towards smoking are very different from the United States. In the Netherlands, giving smoking employees monetary incentives will be considered tremendously unfair for non-smoking employees. To illustrate, a recent opinion poll showed that only 9% of the Dutch population agreed that smoking cessation support should be fully reimbursed by health insurance. People argued that smokers have chosen to smoke themselves and thus it is their own fault that they need support. It is of course questionable whether people chose to smoke, because most people start when they are young and then get addicted, but not a lot of people in the Netherlands are aware of that.

In our research we will not give smoking employees monetary incentives for successful smoking cessation. Instead, we will reward them with coupons that they can exchange for healthy products, getaways, activities, and gifts. Also, the monetary value will be lower than what was done in the US in order to test an intervention that is more culturally appropriate for the Netherlands. We will not only examine the effectiveness of the intervention, but also the cost-effectiveness. This is of course vitally important considering the dominant sentiment that smokers should pay for smoking cessation themselves and that smokers don’t need to get rewarded for quitting.

We are now in the final stages of preparation of the study and will start with the smoking cessation group therapy sessions soon in numerous Dutch companies. We work together with highly experienced smoking cessation counselors who provide evidence-based group sessions. If you know a company that may be interested in participating in our study, then please contact us. If you want more information about study participation you can find our brochure through this link (in Dutch). The protocol of our study is published in BMC Public Health.

Every PhD program has an academic writing course. And numerous blogs have been written about how to write journal articles, how to write with co-authors, and even about conflicts about author positions. However, nobody teaches you how you can be a good co-author. After writing one or more articles yourself you may be asked to be a co-author on someone else’s paper. This blogs contains six important tips on how to handle this responsibility.

Before you say ‘yes’
You are probably flattered for being asked as a co-author. But think for a minute before you say ‘yes’. Being a co-author has appealing benefits. Someone else (the first author) does most of the work, you give comments on a few drafts, and you have an extra publication on your publication list. A co-authorship can also extend your academic network, it may give you the opportunity to work on additional research topics, and it may broaden your methodological or statistical knowledge. However, you should realize that there is a considerable time investment. More often than not articles take more than a year before they are published. Co-authors should not only give some bright ideas at the beginning of the writing process, but they should also be available once the first author is working on a revision for a journal. It may be a good idea to discuss expectations about your contribution before you start. Being a co-author can range from helping out with the analyses and writing sections of the article to just commenting on two or three drafts of the article.


Six tips for being a good co-author
1) First of all: be friendly and respectful when commenting. Do you remember the first time you sent your article to your co-authors or supervisors? You probably felt a little scared about what they would say. Although you may not be co-authoring someone’s first article, it can never hurt to be friendly. This may seem like unnecessary advice, but it happens a lot that people forget to be friendly because they are focusing on what should be changed to a paper. Try to pinpoint what you like most about the article and tell this to the first author. And try to be helpful when making comments. Do not only say that something is wrong, but also come with solutions on how to fix things. Finally, if you have a critical remark you should definitely make it, but NEVER USE CAPSLOCK or multiple exclamation points!!!

2) Rewriting parts of the article is often not a good idea. Make you sure you never rewrite parts of the article when you are asked to comment on a very first draft. Using comments instead of editing in the text or simply writing your main comments in an email is often enough for a first draft. You or other co-authors may suggest things that change the entire article and thus the texts that you would rewrite will change too. In later stages, editing is okay, but always keep in mind that this is not your paper. People have personal preferences and a personal writing style which you do not have to change.

3) It can be quite discouraging to get more than thirty comments on your draft paper from one co-author. See whether you can give some overall comments instead of giving the same comment on several places in the article. It may also be helpful to separate major comments from minor comments. Major comments can be given during a meeting or in the body text of an email. And minor comments can be handed out on paper at the end of the meeting or can be added to the attachment of the email.

4) Don’t be shy to tell that you didn’t understand something that was written in the article. Oftentimes, this does not mean that you are not smart enough but that the first author did not properly explain. The first author fully understands what was done and thus misses the fact that the explanation in the text is not clear. It is very helpful when you point that out.

5) Try not to delay the process. If the first author gives you a deadline, try to stick to it. If you really cannot do it, tell the first author as soon as possible. Perhaps the first author doesn’t mind when you send it a few days later or when you skip a round. Also, for a smooth process with multiple co-authors, it may be helpful to respond to all co-authors when emailing about the article. You can add your comments to the draft in which another co-author already added comments and you can respond to comments from other co-authors if appropriate. If the first author asked for your opinion on a specific section of the paper, make sure you don’t forget to give it.

6) Know that there are international rules for when you can be mentioned as a co-author and when not. You should have made a substantial contribution to the conception and design of the study, or analysis and interpretation of the data, AND you must have drafted the article or revised it critically for important intellectual content, AND you should provide final approval of the version to be published. If you know you don’t have the time or expertise to do these things, don’t say ‘yes’ to the co-authorship. If you find out after you have said ‘yes’, just explain to the first author that it would be better to mention your name in the acknowledgements.


Do you have any other important tips for being a good co-author? They can be added in the comments section below.

The SRNT Europe conference was organized in Maastricht last week. I really liked the conference, because it had a very interesting and diverse program. Below is a short account of what I thought was particularly interesting to hear on the conference.


The theme of the conference was ‘the bigger picture: towards multidisciplinarity in nicotine and tobacco research’. The theme was especially present in the special symposium about e-cigarettes. Four presenters told about e-cigarettes from different perspectives. The epidemiological perspective (by Esther Croes), the clinical perspective (by Pierre Bartsch), the public health perspective (by Luke Clancy), and the producer perspective (by Gerard Hastings). This gave a very complete overview of where we stand in terms of evidence and practice. For me, it was interesting to hear more about the clinical perspective. As researcher you are inclined to wait until enough evidence is available to make an evidence-based decision about whether to recommend e-cigarette use. However, clinicians get questions about e-cigarettes from their patients right now and need to recommend something before all evidence is available. Pierre Bartsch explained he does advise the use of e-cigarettes for smoking cessation, but only when everything else fails and the patient asks about e-cigarette use.

Harm awareness
Several keynote speakers addressed the topic of awareness of the harms of smoking and how we can improve this. Robert West advised us to not just tell people about the harms of smoking, but telling it in a way that is compelling and motivational. For example, use the statistic that for every day you carry on smoking after your mid-thirties, you will lose an average of six hours of life. Paul Cairney had a similar message: use simple messages that people can understand and remember. Paul Aveyard argued that we need to learn what smokers believe first before we can come up with effective communication strategies.

In an ITC Project symposium, striking findings about harm awareness of Dutch smokers were presented. Compared with 15 other countries studied, the Netherlands had the lowest percentage of smokers reporting that they often think about the harm of smoking to themselves or others. A report in which these and other findings were reported was distributed at the conference.

New ideas
There were some interesting new ideas put forward on the conference. Amanda Amos argued for a tobacco industry levy in her keynote lecture. Although the idea of a levy is not new, Amanda framed it as an intervention to reduce inequalities in smoking. The money that is raised with the levy should be used to fund measures to help smokers quit and it should be distributed in proportion to the volume of tobacco sales in different areas of countries. This way, the areas where tobacco sales is highest – the areas where most disadvantaged smokers live – get more help.

The keynote lecture from Jacqueline Vink was about the genetics of smoking behavior. She proposed to examine gene-environment interactions. According to Jacqueline, understanding the balance between genetic and environmental causes may hold the key to further reductions in smoking.

Furthermore, one of the symposia was about smartphone apps for smoking cessation. There are hundreds of smartphone apps available, but they are often not evidence-based. Ildiko Tombor presented an innovative factorial design (with 32 experimental groups) to test the additive effects of different components of a smartphone app.

Finally, new at this SRNT conference were practical workshops as part of the parallel sessions. Participants could learn about missing data analyses, economic evaluations, dealing with the media, and about writing and publishing scientific papers. I only attended one of them, but think it is a great idea and it would be nice if future conferences could also offer similar workshops.

I hope you enjoyed the conference as much as I do. Or, if you have not attended the conference, I hope you feel you were a little bit there too after reading this blog.

Some tweets from SRNT Europe:

Tweets SRNTA Dutch opinion piece about the SRNT conference published in Dagblad de Limburger can be read here.

I am not totally sure why it first happened, but for the past few years I have been regularly asked by friends and family to help modernize their resume. Some of those that I helped were invited for a job interview soon after that and got complimented about their clear resume. This helped spread my reputation of ‘resume modernizer’ and I got asked by more friends and family to help them. So, I thought: why not write a blog about it and maybe help even more people out?

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1. Make it clear
Once upon a time a resume just needed to contain information about your work experience and education. But times have changed. Nowadays, a resume needs to be scannable. Sometimes, hundreds of people apply for one position. The selection committee then may only have a few seconds up to a minute to skim over each resume for the first selection. They don’t have time to read the whole thing line by line. If your resume is structured and clear, the selection committee will know immediately where they can find the information that they are looking for.

Make clear subheadings on your resume, with the most important information on the first page. Whether your education or your work experience is most important, depends on your experience. If you nearly or just finished your education, you should start with that. But if you finished your education years ago and have relevant work experience, start with your work experience.

A resume should have enough white space (for readability), should not have spelling mistakes or track changes, and should use a readable font. Send your resume in the form of a pdf file, which makes sure that things look the same on the computer screen of the selection committee as it looked on your own screen.

2. Make it personal
A modern resume starts with a personal profile or summary statement. It is a short text that explains who you are. You can mention your past experience, your main professional motivation, your professional interests, or your skills, but do not make it too long. There are several good dedicated blogs about writing a personal profile, for example this one and this one. But most importantly, you should write something that fits with who you are. Place your personal profile immediately after your personal details (name, contact information, etc.) and before your work experience and education.

In some countries, modern resumes contain a picture of the applicant. You should probably not include a picture if you are applying for a job in the US or the UK (unless you are an actor or a model), but you should seriously consider this if you apply for a job in Germany or the Netherlands. If you do it, make sure it is a good picture, in which you look confident and reliable, and in which you wear an appropriate outfit for the job you are applying for. Make sure the picture is large enough so people can see it, but do not make it so big that you seem vain.

Another way to personalize your resume is to do something more with your work experience section. Make sure it contains more information than the name of the company and your job title. Tell what YOU did in your jobs, not just what everyone with that job title does at that company. Write down your specific tasks and achievements with bullet points or in full sentences, depending on your personal preference, but do not make it too long. You can read more about good job descriptions for resumes here and here. You can also do this for your education. Write down what your thesis was about (if this is still relevant) and what specialization you did.

If you want, you can also include your hobbies on your resume. This may help to make you stand out from the other applicants and lets your personality shine through. However, if you only have hobbies that everyone has and are not memorable (reading, walking, gardening, dining with friends), just leave them out. Also, make sure this kind of personal information is not too obtrusive in your resume. A single line with three to five hobbies at the end of your resume is enough.

3. Make every word count
A standard (non-academic) resume is one or two pages. Early in your career, one page is enough. Therefore, it is important to make every word count. For every detail on your resume, ask yourself whether it is needed. For most jobs, your gender, marital status, birth place, nationality, and driver’s license is not relevant. If you have college education, you can leave out high school. If you are 35 years or older, you no longer need extracurricular activities on your resume that you did when you were in college. Irrelevant work experience (student jobs, summer jobs, and internships) can be left out once you have enough relevant working experience. The sentence ‘references available on request’ is also pretty redundant.

If you have left all irrelevant things out of your resume, you have space to include extra relevant subheadings, such as courses, language skills, committees, or publications (depending on your work field). Make sure there is more than one thing under one subheading or leave the subheading out. Additionally, make sure there is at least one thing recent under the extra subheading or leave it out. It looks better if you don’t have a course list on your resume than to have a course list that shows that you did a lot of courses five years ago and then stopped doing courses. A computer skills section that only contains basic computer programs (Word, Excel, Powerpoint), can better be left out.  Do not use the subheading ´other´, this will not spark anyone’s interest and thus will simply not be read.

4. Customize
A resume should be customized for every job you apply for. This does NOT mean you should lie, but you can emphasize different aspects of your experience. Read the job description for which you apply carefully to know what the selection committee is looking for.

If you apply at a trendy company with mostly young people or if you apply for a creative position, consider designing a creative resume in the form of an infographic or even a video. Don’t do this if you apply at a very traditional company for a position that does not involve creativity.

If you apply for an academic job, forget about the one or two page maximum. An academic CV can get lengthy (depending on your experience), because you are expected to list all received grants and published papers. If you have more than two pages, make sure you use page numbers (one of four, two of four, etc.) and a footer with your name, so the pages don’t get mixed up in the printer.

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Of course, every job interviewer has personal preferences and some of them may not even like a modern resume. There are also country differences in what is acceptable for a resume. I have written this blog in English, but I am mostly familiar with Dutch resumes. I expect that many of the tips and tricks above will apply to resumes from other countries, but invite you to leave a comment below if you know of any differences. Also, please leave a comment if you have other tips and tricks!