Jooren Sophie J A, Geuke Gemma, Willemsen Marc C, Jansen Maria W J, Bommelé Jeroen
Department of Health Promotion, School of Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands.
The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, The Netherlands.
BMC Public Health. 2024 Dec 23;24(1):3569. doi: 10.1186/s12889-024-21099-z.
Due to decades of decentralisation of public health policies, local governments have been given increased tobacco control responsibilities across European countries. Previous studies suggest that implementing local tobacco control policies is not without challenges (e.g., lack of resources and enforcement capabilities). This study investigates the policy implementation of both smoke-free environments and smoking cessation support services by local public health professionals in the Netherlands.
We interviewed 24 officials of regional public health departments about the barriers and facilitators of implementing local tobacco control policies. Interviews were transcribed, analysed and classified using the Behaviour Change Wheel model (COM-B) comprising of the three components capability, opportunity, and motivation.
Personal motivation was an important condition for public health professionals to work on specific subtopics within tobacco control. Smoke-free environments were generally considered most motivating to work on, but also involve practical obstacles such as a lack of enforcement capabilities. Smoking cessation support services were reported to be less attractive to work on, as there are no clear guidelines on what public health professionals could and should do regarding smoking cessation support.
Municipalities and local public health departments may contribute to tobacco control by creating smoke-free areas and offering services to help people stop smoking. The national government of the Netherlands could support local governments by providing clearer guidelines on creating smoke-free spaces and on how to improve local smoking cessation support services.
由于数十年来公共卫生政策的权力下放，欧洲各国的地方政府在烟草控制方面承担了更多责任。先前的研究表明，实施地方烟草控制政策并非没有挑战（例如，缺乏资源和执法能力）。本研究调查了荷兰地方公共卫生专业人员在无烟环境和戒烟支持服务方面的政策实施情况。
我们采访了24名地区公共卫生部门的官员，了解实施地方烟草控制政策的障碍和促进因素。使用由能力、机会和动机三个组成部分的行为改变轮模型（COM-B）对访谈内容进行转录、分析和分类。
个人动机是公共卫生专业人员致力于烟草控制特定子主题的重要条件。无烟环境通常被认为是最有动力去开展工作的，但也存在实际障碍，如缺乏执法能力。据报道，戒烟支持服务对开展工作的吸引力较小，因为对于公共卫生专业人员在戒烟支持方面可以做什么和应该做什么没有明确的指导方针。
市政当局和地方公共卫生部门可以通过创建无烟区域和提供帮助人们戒烟的服务来促进烟草控制。荷兰国家政府可以通过提供关于创建无烟空间以及如何改善地方戒烟支持服务的更明确指导方针来支持地方政府。
