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Previous research found that adult smokers increased their smoking in response to the Covid-19 lockdown in spring 2020. This study explored changes in youth's smoking during, compared to before, the partial lockdown in the Netherlands in a cross-sectional sample of 287 adolescents. Smoking prevalence increased from 4.5% to 5.2%. Cigarette consumption remained the same on school days and increased with +1.9 cigarettes per weekend day. The largest increase in cigarette consumption on weekend days was observed for adolescents who 1) did not consider smoking a risk factor for contracting Covid-19 (+4.5), 2) had smoking siblings (+4.1), and 3) had smoking friends (+2.4). Youth without smoking friends (-0.8) and who considered smoking a risk factor for Covid-19 (-0.2) decreased their cigarette consumption. [ABSTRACT FROM AUTHOR]

During major long-term crises, such as the COVID-19 pandemic, news media are crucial sources of information for the public. This study aimed to explore the frequency of COVID-19-related news consumption based on (1) phase of the pandemic, (2) socio-demographic characteristics, and (3) news information channels. The study used a dynamic cohort design with 18 rounds of data collection, including 306,692 responses from 83,180 unique respondents in the Netherlands from 17 April 2020 to 11 September 2022. Results showed that the frequency of general COVID-19-related news media consumption varied throughout the pandemic, following a general decreasing trend with relative spikes often coinciding with periods of stricter behavioural regulations. TV news, newspapers, and online news websites were the most popular news information channels among the respondents. Furthermore, multilevel regression analyses identified several socio-demographic factors influencing news consumption and preferred channels, namely age, migration background, living status, health status, and trust in government — these results remained stable throughout the pandemic. This study highlights the importance of selecting appropriate news channels to effectively reach different socio-demographic groups and shows that during a prolonged crisis, news consumption about the crisis fluctuates with worsening conditions but generally follows a decreasing trend. [ABSTRACT FROM AUTHOR]

Introduction: Many European schools implement smoke-free school policies (SFSPs). SFSPs may decrease adolescent smoking by causing adolescents to perceive stronger antismoking norms, yet there exists no quantitative evidence that indicates for which norms and for whom such effects may occur. This study therefore assessed to what extent adolescents' perceived antismoking norms among best friends, teachers, and society at large were associated with SFSPs, and whether these associations were moderated by adolescents' level of school connectedness.Aims and Methods: Survey data were collected in 2016/2017 on 10,653 adolescents aged 14-16 years old and 315 staff members in 55 schools from seven European cities. Associations of adolescent-perceived SFSPs and staff-reported SFSPs with best friend, teacher, and societal antismoking norms were estimated in multilevel logistic regression models, adjusted for demographics and school-level smoking prevalence. We tested for interaction between school connectedness and SFSPs.Results: Adolescent-perceived SFSPs were positively associated with antismoking norms by teachers (odds ratio [OR]: 1.46, 95% confidence interval [CI]: 1.15-1.85), were negatively associated with antismoking norms by best friends (OR: 0.81, 95% CI: 0.67-0.99), but were not significantly associated with antismoking norms by society at large (OR: 0.87, 95% CI: 0.74-1.02). All interaction tests between adolescent-perceived SFSPs and school connectedness were nonsignificant. Staff-reported SFSPs were not associated with any norm and showed no significant interaction with school connectedness.Conclusions: We found that SFSPs are associated with adolescents' perception of more antismoking norms by teachers, but less antismoking norms by best friends, irrespective of adolescents' level of school connectedness.Implications: Smoke-free school policies, just as many other tobacco control policies, are assumed to foster adolescents' perception of antismoking norms. Still, current evidence does not demonstrate which antismoking norms may be influenced by SFSPs and whether this influence is equal for adolescents with different levels of school connectedness. This study suggests that SFSPs foster adolescents' perception of antismoking norms by teachers, but may concurrently lead to the perception of less antismoking norms by best friends, irrespective of adolescents' school connectedness. SFSPs may therefore need to be complemented with interventions that target antismoking norms in adolescent peer groups. [ABSTRACT FROM AUTHOR]

Background: Secondary schools that implement smoke-free policies are confronted with students who start smoking outside their premises. One solution is to complement smoke-free policies with prohibitions for all students to leave the school area during school hours, technically making school hours a smoke-free period. However, there are strikingly few Dutch secondary schools that implement this approach. This study explores why staff members in the Netherlands decide not to implement smoke-free school hours for all students. Method: We interviewed 13 staff members, with different functions, from four secondary schools. The analysis was informed by the Advocacy Coalition Framework (ACF) to delve into the values, rationales, and assumptions of staff with the aim to identify deep core, policy core, and secondary beliefs. Results: We identified six beliefs. Two deep core beliefs are that schools should provide adolescents the freedom to learn how to responsibly use their personal autonomy and that schools should only interfere if adolescents endanger or bother others. Three policy core beliefs identified included the following: that smoking is not a pressing issue for schools to deal with; that schools should demarcate their jurisdiction to intervene in adolescents' lives in time, space, and precise risk behavior; and that implementing smoke-free school hours would interfere with maintaining positive student-staff relationships. One secondary belief identified was that smoke-free school hours would be impossible to enforce consistently. Conclusion: This paper was the first to demonstrate the many beliefs explaining why schools refrain from voluntary implementing far-reaching smoke-free policies. [ABSTRACT FROM AUTHOR]

Young people frequently display alcohol-related posts (“alcoholposts”) on social networking sites such as Facebook and Instagram. Although evidence exists that such posts may be linked with increases in alcohol consumption, hardly any studies have focused on the content of such posts. This study addresses this gap by applying and extending the alcoholpost-typology previously proposed by Hendriks, Gebhardt, and van den Putte. A content analysis assessed the extent to which alcoholposts were displayed on Facebook and/or Instagram profiles of young participants (12–30 years; N  = 192), and which type of alcoholpost these posts most strongly resembled. Moderate alcoholposts (e.g., in which alcohol was in the background) were most often posted. At times, textual alcoholposts and commercial alcoholposts were also displayed; however, extreme posts (e.g., about drunk people or drinking-games) were almost nonexistent. These findings confirm the previous results by Hendriks et al. that moderate posts are more frequently posted than extreme posts. This could imply that positive associations with alcohol consumption are more visible on social media than negative associations, potentially leading to an underestimation of alcohol-related risks. [ABSTRACT FROM AUTHOR]

Background Physical distancing is an effective preventative measure during respiratory infectious disease outbreaks. Prior studies on distancing behaviors have largely ignored context characteristics (physical, social) and time. Purpose We investigated patterns in physical distancing over time and across situations, as well as sociodemographic variation herein. Methods We employed data from five rounds of a cohort study conducted throughout the pandemic by the Dutch public health institute (RIVM; N ≈ 50.000 per round). We conducted Latent Class Analyses to investigate patterns of physical distancing in a range of situations, followed by regression models to investigate associations between distancing behavior and sociodemographic and context characteristics. Results Participants differed in their general tendency to adhere to distancing guidelines across situations, but there were also substantial differences in distancing behavior between situations, particularly at work, with friends and family and outdoors. Distancing at work was strongly associated with work environment characteristics. Younger age groups reported less distancing behavior, particularly with close relations (friends or family) and at work. In periods when the pandemic situation was most severe, people adhered more strongly to distancing guidelines and age differences were most pronounced during these periods. Conclusions Physical and social context matters for physical distancing, highlighting the importance of developing strategies for pandemic preparedness that improve opportunities for physical distancing (e.g. reducing crowding, one-way traffic) and accommodate young people to safely meet even in times of high pandemic severity and lockdowns. Future studies should account for the physical and social context in which distancing behavior is observed. [ABSTRACT FROM AUTHOR]

This paper first overviews the results of eight experiments that examined the effects of school health communication about alcohol and tobacco on low educated adolescents. Overall, it was found that there was a short term knowledge increase but only among adolescents with less knowledge. Also, the attitude became more negative towards alcohol among adolescents who were more positive towards alcohol at baseline. All of these effects disappeared within a month. There were no effects on intention. Importantly, the format of the health communication did not matter. Results were largely identical for print and audiovisual versions, as well as for informational and narrative versions. Adding testimonials of adolescents to the print and audiovisual informational formats did not make a difference. The second part of this paper focuses on a ninth experiment that tested the effects of connectives in alcohol health education. Studies on school education texts suggested that texts are easier interpretable if sentences are linked by connectives, but so far this has not been tested on health education texts for low educated adolescents. Overall, we found no differential effects on knowledge, attitude, and intention between a condition with connectives and a condition without connectives. [ABSTRACT FROM AUTHOR]

Objective:This study tests the effectiveness of narrative versus informational smoking education on smoking beliefs, attitudes and intentions of low-educated adolescents. Design:A field experiment with three waves of data collection was conducted. Participants (N = 256) were students who attend lower secondary education. At the first and third waves, they completed a questionnaire. At the second wave, 50.8% of the participants read a smoking education booklet in narrative form and 49.2% read a booklet in informational form. After reading, all participants also completed a questionnaire at wave 2. Main outcome measures:Beliefs about negative consequences of smoking, attitudes towards smoking and intentions to smoke were measured. Results:Repeated measures analyses with time as a within-subjects factor and condition as a between-subjects factor showed that beliefs about smoking were more negative at Wave 2 compared to Wave 1, irrespective of condition. However, attitudes towards smoking were more positive at Wave 3 compared to Wave 1 when participants had read the narrative version. Conclusion:These results show that narrative smoking education is not more effective than informational smoking education for low-educated adolescents and can even have an unintended effect for this target group by making attitudes towards smoking more positive. [ABSTRACT FROM PUBLISHER]

Previous research suggests that narrative engagement (NE) in entertainment-education (E-E) narratives reduces counterarguing, thereby leading to E-E impact on behavior. It is, however, unclear how different NE processes (narrative understanding, attentional focus, emotional engagement, narrative presence) relate to different thought types (negative or positive; about the narrative form or about the target behavior) and to E-E impact. This study explores these relations in the context of alcohol binge drinking (BD). Participants (N= 172) watched an E-E narrative showing negative BD consequences, thereby aiming to discourage BD. The main findings were that the E-E narrative had a positive impact on discouraging BD on almost all assessed BD determinants such as beliefs and attitude. It was shown that attentional focus, emotional engagement, and narrative presence were associated with BD-discouraging impact, albeit on different BD-related determinants. No evidence was found that negative thoughts about BD mediated these associations. From this, we conclude that attentional focus, emotional engagement, and narrative presence were important for E-E impact but that negative thoughts about BD did not play a role therein. The study’s empirical and practical implications are discussed. [ABSTRACT FROM PUBLISHER]

This study aims to provide insight into which modality is most effective for educating low-educated adolescents about smoking. It compares the persuasive effects of print and audiovisual smoking education materials. We conducted a field experiment with two conditions (print vs. video) and three measurement times (Time 1, Time 2, and Time 3). A total of 221 high school students in the second year of the lowest levels of education in the Netherlands participated at all three time points of the study. Results showed that participants in both conditions had more negative beliefs about smoking after being exposed to the smoking education than before, but there were no differences between the print and video version in this effect. However, the video version did make the attitude toward smoking more negative at Time 3 compared to baseline, whereas the text version did not, which suggests that the video version was more effective for educating low-educated adolescents about smoking. [ABSTRACT FROM AUTHOR]

Objective: To gain new insights into the relationship between health literacy and evaluation of online health information.Methods: Using a mixed-methods approach, forty-four semi-structured interviews were conducted followed by a short questionnaire on health literacy and eHealth literacy. Qualitative and quantitative data were merged to explore differences and similarities among respondents with different health literacy levels.Results: Thematic analysis showed that most respondents did not question the quality of online health information and relied on evaluation criteria not recognized by existing web quality guidelines. Individuals with low health literacy, despite presenting higher eHealth literacy scores, appeared to use less established criteria and to rely more heavily on non-established ones compared to those with high health literacy.Conclusion: Disparities in evaluation ability among people with different health literacy might be related to differences in awareness of the issue and to the use of different evaluation criteria. Future research should quantitatively investigate the interplay between health literacy, use of established and non-established criteria, and ability to evaluate online health information.Practice Implications: Communication and patient education efforts should aim to raise awareness on online health information quality and to promote use of established evaluation criteria, especially among low health literate citizens. [ABSTRACT FROM AUTHOR]

Background: Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands. Methods: All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km2), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models. Results: 46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km2, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets. Conclusion: In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods. [ABSTRACT FROM AUTHOR]

Background: Traditionally most health education materials are written in an expository non-narrative format. Scholars have argued that the effectiveness of materials may increase when these texts are replaced by narrative texts, and that the non-narrative texts should be replaced by narrative texts. However, no previous studies have tested these claims in the context of school health education for low educated adolescents. This study aims to do so for an existing preventive health education intervention about alcohol for low educated adolescents. Based on the empirical findings of previous studies, it is expected that the claims about narratives being more effective than non-narrative texts are not true for effects on knowledge. Instead non-narrative texts are expected to have a stronger impact on this outcome variable. For attitude towards alcohol and intention to drink alcohol the claims are expected to be true, because participants are expected to be less aware of the persuasive intent of the narrative texts, which would make them less resistant. As a result, narrative texts are expected to have a stronger effect on attitude and intention.Methods: This study compares the effects on knowledge, attitude towards alcohol, and intention to drink alcohol of both information formats in a two-condition (non-narrative vs. narrative information) experiment with repeated measures (pre-measurement, immediate post-measurement, and delayed post-measurement). The experiment was conducted amongst 296 students of the two lowest levels of the Dutch secondary education system.Results: The results showed immediate effects on knowledge and attitude towards alcohol, which did not differ between conditions and school levels. These effects did not persist over time. There were no effects on intention to drink alcohol.Conclusion: It is concluded non-narrative and narrative information are equally effective in the context of school health education, suggesting the claims that scholars have made about the superior effects of narrative texts are not true. Given the fact that narrative texts are more expensive to develop, policy makers may not be advised to prefer these types of texts over the traditionally used non-narrative texts. [ABSTRACT FROM AUTHOR]

To decrease the prevalence and the amount of alcohol consumption among students, health messages advocating responsible alcohol behavior can be used. However, it is unclear whether responsible drinking messages are most effective when they use a gain frame, presenting the advantages of responsible drinking, or a loss frame, presenting the disadvantages of irresponsible drinking. This study tests the effects of framing and the moderating role of involvement with the issue of responsible drinking. A three-wave, between-subjects, experimental study was conducted, in which participants (N = 90) were exposed to either a gain- or loss-framed message about responsible drinking behavior at Wave 2. At all three waves, attitudes, intentions and behavior toward responsible drinking were measured. Results showed that for participants with low issue- involvement, a gain frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a loss frame did not have any effects for them. For participants with high issue involvement, a loss frame led to more positive attitudes and intentions toward responsible alcohol use, whereas a gain frame did not have an effect on attitude and only a delayed effect on intention. However, there were no effects of frame and issue involvement on adhering to the guideline of responsible alcohol use and average drinking behavior. [ABSTRACT FROM PUBLISHER]

Although “evidence” is often used as an important argument in persuasive health campaigns, it remains unclear what type of evidence has the strongest impact on particular outcome variables. We conducted a meta-analysis in which the effects of statistical and narrative evidence on beliefs, attitude, and intention were separately compared. Statistical evidence was found to have a stronger influence than narrative evidence on beliefs and attitude, whereas narrative evidence had a stronger influence on intention. We explain these findings in terms of the match between the specific characteristics of the two types of evidence and those of the outcome variables. Statistical evidence, beliefs, and attitude all relate primarily to cognitive responses, whereas both narrative evidence and intention relate more specifically to affective responses. We conclude that communication professionals developing health campaigns should match the type of evidence to the main communication objectives. [ABSTRACT FROM PUBLISHER]

Background: Previous studies found that tobacco outlets were unevenly distributed by area socioeconomic status (SES). However, evidence from continental Europe is limited. This study aims to assess differences in tobacco outlet presence, density and proximity by area SES in the Netherlands. Methods: All tobacco outlets in four Dutch cities (Amsterdam, and medium-sized cities Eindhoven, Haarlem, and Zwolle) were mapped between September 2019 and June 2020. We estimated associations between average property value of neighbourhoods (as an indicator of SES, grouped into quintiles) and (1) tobacco outlet presence in the neighbourhood (yes/no), (2) density (per km2), and (3) proximity to the closest outlet (in meters), using logistic and linear regression models. Results: 46% of neighbourhoods contained at least one tobacco outlet. Tobacco outlets were mostly situated in city centres, but the distribution of tobacco outlets varied per city due to differences in urban structures and functions. In the medium-sized cities, each quintile higher neighbourhood-SES was associated with lower tobacco outlet presence (OR:0.71, 95%CI:0.59;0.85), lower density (B:-1.20 outlets/km2, 95%CI:-2.20;-0.20) and less proximity (B:40.2 m, 95%CI 36.58;43.83). Associations were the other way around for Amsterdam (OR:1.22, 95%CI:1.05;1.40, B:3.50, 95%CI:0.81;6.20, and B:-18.45, 95%CI:-20.41;-16.49, respectively). Results were similar for most types of tobacco outlets. Conclusion: In medium-sized cities in the Netherlands, tobacco outlets were more often located in low-SES neighbourhoods than high-SES. Amsterdam presented a reverse pattern, possibly due to its unique urban structure. We discuss how licensing might contribute to reducing tobacco outlets in low-SES neighbourhoods. [ABSTRACT FROM AUTHOR]

The present study experimentally investigated the interplay between interpersonal communication and health message exposure in relation to alcohol consumption intentions. Participants were 174 students who took part in a study on the effects of an antialcohol message. At baseline, the authors assessed intention to refrain from binge drinking. At the second wave (2 weeks later), participants were assigned to the conditions of a 2 (antialcohol message or no-alcohol message) × 2 (alcohol conversation or control conversation) between-subjects design, after which intention was again assessed. Results showed that when participants talked about alcohol (instead of the control topic) and were not exposed to an antialcohol message, they were less inclined to refrain from binge drinking, an effect that was not visible when participants talked about alcohol after viewing an antialcohol message. These findings suggest that health campaign exposure moderates the influence of interpersonal communication on health variables. [ABSTRACT FROM PUBLISHER]

Background Legal tobacco tax avoidance strategies such as cross-border cigarette purchasing may attenuate the impact of tax increases on tobacco consumption. Little is known about socioeconomic and country variations in cross-border purchasing. Objective To describe socioeconomic and country variations in cross-border cigarette purchasing in six European countries. Methods Cross-sectional data from adult smokers (n=7873) from the International Tobacco Control (ITC) Surveys in France (2006/2007), Germany (2007), Ireland (2006), The Netherlands (2008), Scotland (2006) and the rest of the UK (2007/2008) were used. Respondents were asked whether they had bought cigarettes outside their country in the last 6 months and how often. Findings In French and German provinces/states bordering countries with lower cigarette prices, 24% and 13% of smokers, respectively, reported purchasing cigarettes frequently outside their country. In non-border regions of France and Germany, and in Ireland, Scotland, the rest of the UK and The Netherlands, frequent purchasing of cigarettes outside the country was reported by 2-7% of smokers. Smokers with higher levels of education or income, younger smokers, daily smokers, heavier smokers and smokers not planning to quit smoking were more likely to purchase cigarettes outside their country. Conclusions Cross-border cigarette purchasing is more common in European regions bordering countries with lower cigarette prices and is more often reported by smokers with higher education and income. Increasing taxes in countries with lower cigarette prices, and reducing the number of cigarettes that can be legally imported across borders could help to avoid cross-border purchasing. [ABSTRACT FROM AUTHOR]

Recent research highlights the superior influence of affect over cognition in health decision making. The present study examined the independent and combined effects of 2 message characteristics that are thought to tap into the cognition-affect distinction: message format (rhetorical vs. testimonial) and argument type (instrumental vs. affective). In this 2 × 2 experiment, 81 college students were randomly assigned to 1 of 4 health messages discouraging binge drinking. The results indicated that messages containing affective arguments were judged more positively and perceived as more effective than were messages containing instrumental arguments. The results further revealed an interaction effect between message format and argument type. Testimonials were more persuasive when they contained affective arguments than when they contained instrumental arguments. Type of arguments did not influence the efficacy of rhetorical messages. Mediation analyses revealed that instrumental arguments reduce the efficacy of testimonials because they prevent individuals from being transported into the story, and increase psychological reactance. In conclusion, testimonial messages more effectively discourage binge drinking among college students when they contain affective, as opposed to instrumental, arguments. [ABSTRACT FROM PUBLISHER]

This study investigated whether the efficacy of affective vs. cognitive persuasive messages was moderated by (1) individuals’ subjective assessments of whether their attitudes were based on affect or cognition (i.e. meta-bases) and (2) the degree individuals’ attitudes were correlated with affect and cognition (i.e. structural bases). Participants (N = 97) were randomly exposed to a message containing either affective or cognitive arguments discouraging binge drinking. The results demonstrated that meta-bases and not structural bases moderated the influence of argument type on message judgement. Affective (cognitive) messages were judged more positively when individuals’ meta-bases were more affective (cognitive). In contrast, structural bases and not meta-bases moderated the influence of argument type on attitude and intention change following exposure to the message. Surprisingly, change was greater among individuals who read a message that mismatched their structural attitude base. Affective messages were more effective as attitudes were more cognition-based, and vice versa. Thus, although individuals prefer messages that match their meta-base, attitude and intention change regarding binge drinking are best established by mismatching their structural base. [ABSTRACT FROM AUTHOR]

We explored the role of exercise self-identity within the framework of the theory of planned behaviour (TPB). Participants were 538 undergraduate students who completed measures of exercise self-identity, exercise behaviour, TPB items, and behavioural and control beliefs. Regression analysis showed that self-identity was the second strongest predictor of exercise behaviour and interacted with exercise intention. Follow-up analysis showed that the intention–exercise relationship was more than three times stronger at high than at low levels of exercise self-identity. Results also showed that only a marginal part of the sample with strong exercise identities had a weak exercise intention, whereas a large part of the sample with a strong exercise intention also reported a strong exercise identity. Nevertheless, only a quarter of the sample that reported strong exercise identity and intention were sufficiently active. The results underline the notion that exercise self-identity may be a useful component for the theory of planned behaviour. [ABSTRACT FROM PUBLISHER]

Objectives: To assess whether affective evaluations of health behaviors moderate or mediate the influence of theory of planned behavior (TPB) variables on intention. Methods: For each of 20 health behaviors, respondents (N=300) completed questionnaire measures of affective evaluation, attitude, subjective norm, perceived behavioral control, and intention. Results: Analyses using path modeling revealed that affective evaluation of the behaviors did not moderate the influence of the TPB variables on intention, but it partially mediated the influence of attitude and perceived behavioral control on intention. Conclusions: These results emphasize the importance of affective evaluation as a target for health communication. [ABSTRACT FROM AUTHOR]

Objectives: To assess whether affective evaluations of health behaviors moderate or mediate the influence of theory of planned behavior (TPB) variables on intention. Methods: For each of 20 health behaviors, respondents (N=300) completed questionnaire measures of affective evaluation, attitude, subjective norm, perceived behavioral control, and intention. Results: Analyses using path modeling revealed that affective evaluation of the behaviors did not moderate the influence of the TPB variables on intention, but it partially mediated the influence of attitude and perceived behavioral control on intention. Conclusions: These results emphasize the importance of affective evaluation as a target for health communication. [ABSTRACT FROM AUTHOR]

Objective To assess the influence of newspaper coverage and a media campaign about Dutch smoke-free legislation on smokers' support for smoke-free bars and restaurants and on secondhand smoke (SHS) harm awareness. Design and main outcome measures A content analysis was conducted of 1041 newspaper articles on the smoke-free legislation published in six Dutch newspapers from March 2008 to April 2009. Smokers who were regular readers of at least one of these newspapers (n=677) were selected from the pre-ban and post-ban waves of the International Tobacco Control Netherlands Survey. Exposure to newspaper coverage and the implementation campaign was correlated with changes in smokers' support for smoke-free bars and restaurants and SHS harm awareness. Results Most newspaper coverage was found to be negative towards the smoking ban (57%) and focused on economic aspects (59%) rather than health aspects (22%). Exposure to this coverage had a small but significantly negative effect on support for smoke-free bars and restaurants (β=0.09, p=0.013). Among higher educated smokers, exposure to positive newspaper coverage had a more positive effect on support for smoke-free bars and restaurants. In addition, exposure to the implementation campaign had a small but significantly positive effect on SHS harm awareness (β=0.11, p=0.001). Conclusions Media attention on smoke-free legislation can influence smokers' support for the legislation and SHS harm awareness. Tobacco control advocates should aim to establish positive media attention that puts forward the health arguments for the legislation. [ABSTRACT FROM AUTHOR]

In the context of health campaigns, interpersonal communication can serve at least 2 functions: (a) to stimulate change through social interaction and (b) in a secondary diffusion process, to further disseminate message content. In a 3-wave prospective study of 1,079 smokers, the authors demonstrate that mass media messages (antismoking campaigns and news coverage relevant to smoking cessation) have an indirect effect on smoking cessation intention and behavior via interpersonal communication. Exposure to campaigns and news coverage prompts discussion about the campaigns, and, in turn, about smoking cessation. Interpersonal communication regarding smoking cessation then influences intention to quit smoking and attempts to quit smoking. The study finds evidence not only for the social interaction function of interpersonal communication, but also for the secondary diffusion function. A substantial number of smokers who are not directly exposed to the antismoking campaigns are nevertheless indirectly exposed via communication with people who have seen these campaigns. These results imply that encouragement of interpersonal communication can be an important campaign objective. [ABSTRACT FROM AUTHOR]

Abstract: Clustering refers to the co-occurrence of behaviour and may be particularly relevant in light of the present obesity epidemic. Since evidence regarding clustering of motivational and habitual constructs within the framework of the Theory of Planned Behaviour (TPB) is limited, clustering effects of TPB cognitions and habit strength regarding soft drink consumption and television viewing were studied in a sample of Dutch adolescents (n =312; mean age=14.62; SD=1.62) using cross-sectional data. Results showed that not only soft drink consumption and television viewing cluster (r =.42), but also their intentional (r =.36) and habitual (r =.37) constructs. Furthermore, unmediated effects were found between habit strength and its respective behaviour, whereas habit strength was associated with its clustered behaviour through decreased perceptions of controllability. Our findings suggest that interventions that aim to change habitual soft drink consumption and television viewing may need to incorporate an environmental component, as well as explore the potential usefulness of synergistic effects of incorporating multiple clustered behaviours, as well as their corresponding beliefs and habits in health behaviour change interventions. [Copyright &y& Elsevier]

Abstract: This study explores the combined effect of message framing, intention to quit smoking, and nicotine dependence on the persuasiveness of smoking cessation messages. Pre- and post-message measures of quit intention, attitude toward smoking cessation, and perceived behavioral control were taken in two separate waves from current cigarette smokers with varying levels of nicotine dependence (N =151). In the second wave, participants were randomly assigned to one of two groups. In the first group, participants read a smoking cessation message which emphasized the benefits of quitting (positive frame). In the second group participants read a message which emphasized the costs of not quitting (negative frame). Results show that smokers'' intentions to quit smoking and their level of nicotine dependence jointly influence the persuasiveness of positive and negative message frames. When nicotine dependence and quitting intention are both high, a negative frame works best. Conversely, a positive frame is preferable when nicotine dependence or quitting intention is low. Smokers'' level of processing is proposed as the underlying mechanism explaining the different effects of message frames. [Copyright &y& Elsevier]

Abstract: Objective: To examine to what extent adolescents’ beliefs, subjective norm and perceived behavioral control predict the amount of parent–adolescent communication about sexuality. In addition, the role of adolescents’ gender, ethnic background, religiosity and educational level on these relationships was assessed as well. Methods: Data were collected from 481 students of four high schools in The Netherlands. A questionnaire assessed adolescents’ beliefs, subjective norm, perceived behavioral control, and self-reported parent–adolescent communication about sexuality. Linear regression analyses were performed to identify predictors of parent–adolescent communication. To assess differences between subgroups, χ 2-analyses, t-tests and analyses of variance were conducted. Results: Being female and having positive beliefs about talking with parents about sexuality were positively related to amount of parent–adolescent communication. In addition, adolescents’ perceived behavioral control and subjective norm were significant predictors as well. Conclusion: Adolescents’ beliefs, subjective norm and perceived behavioral control, are all significant predictors of frequency of parent–adolescent sex communication, with beliefs being the most important. In addition, adolescents’ gender predicted a significant amount as well. Practice implications: Interventions aimed to increase the amount of parent–adolescent communication should primarily target their efforts to changing adolescents’ underlying beliefs about discussing sexuality with their parents. Our results furthermore suggest that it is important to take into consideration gender variations in these beliefs, by designing separate interventions for different groups of adolescents. [Copyright &y& Elsevier]

In studies of advertising, many communication strategies have been formulated, but little research has been carried out on the process of deciding what strategy can be used best in a particular situation. In social psychology, models have been developed that specify a number of behavioral determinants. Though communication practitioners often use these models, scientific proof of the effectiveness of persuasive messages based on these models is largely absent. In this study, knowledge from advertising studies and social psychology is combined in an integrated framework for effective communication. In an experiment on chocolate-bar buying behavior, we prove that by making use of this framework, we can predict which advertising strategy is the most effective. [ABSTRACT FROM AUTHOR]

Abstract: Background : This study brings together the fragmentary knowledge on social influence factors related to smoking cessation. An inventory of social influence variables shows six social influence factors. With the exception of descriptive norm, most of these are rarely studied in the context of smoking cessation. Methods : Regression analysis on the data of 2895 smokers was used to estimate the relative importance of social influence variables as predictors of intention. The moderating effect of quit history was studied by adding interaction terms to the regression analysis. Results : The regression analysis shows that subjective norm and injunctive norm, that is, the social norms on what ought to be done, are more important than descriptive norms, that is, the perceived smoking and smoking cessation behavior of others. This holds especially for smokers whose past cessation attempts quickly failed. Most smokers think that it is acceptable to smoke in most social situations, but simultaneously think that other people approve it if they quit smoking. Conclusions : Results suggest that health campaigns should incite social interaction to increase smokers'' awareness of social norms on the proper behavior. Also, studies into smoking cessation should take account of the various social influence factors outlined in this study. [Copyright &y& Elsevier]

In the February 1987 issue of Sociological Methods and Research several articles were published that dealt with the same data set. These data focused on attitudes toward guest workers. The purpose of that study was to demonstrate the application of measurement models, especially with respect to random measurement error, on large-scale survey data. Since we think that such studies are very valuable, we want to continue the discussion on measurement models by applying alternative models to the same data. We show that quite different models fit the same data set and that these models lead to quite different interpretations. In doing so we will use some tests that we think should be applied in order to differentiate between measurement or true score models and factor analysis models. In this article we show that the resulting models and interpretations of the data can vary quite a lot depending on whether one uses a true score model or a factor model. The substantive result of these analyses is that it seems possible to distinguish two types of opinions. One type we have called the first reaction, and the other type is called a more seriously considered opinion. These two opinions differ systematically from each other and therefore the results of research using the one or the other opinion will also differ. [ABSTRACT FROM AUTHOR]

Scholars commonly plea for the development and evaluation of new tobacco control interventions to further decrease smoking and exposure to second-hand smoke. We, in addition, emphasize there is still much that can be done to improve the impact of current tobacco control interventions. This commentary makes a specific case for improving the implementation of smoke-free school policies across Europe. [ABSTRACT FROM AUTHOR]

Background: The cost of tobacco is one of the most reported reasons to quit smoking. The Netherlands increased tobacco taxes twice in the span of nine months: a €1 increase per pack in April 2020, and a €0.12 increase per pack in January 2021. This study examines to what extent people report to think about quitting due to the upcoming tax increase(s), as well as how it relates to their age, income or educational level. Additionally, we examined whether thinking about quitting was associated with quit intention and quit behaviour, and whether these associations were different for the two tax increases. Methods: Longitudinal data from the International Tobacco Control (ITC) Netherlands Surveys, Cohort 2 were used (N = 5919 observations; wave 1 (February – March 2020): n = 2051; wave 2 (September – November 2020): n = 1919; wave 3 (June – July 2021): n = 1949). Generalised Estimating Equation (GEE) regressions were fit to test the associations between thinking about quitting due to the tax increase and post-tax increases in quit intention, serious quit attempts, and quitting smoking (≤ 1 cigarette a month), as well as sociodemographic variables. Results: Circa half of the people who smoke reported thinking about quitting smoking due to the upcoming tax increase (Wave 1 = 51.3% (n = 1052); Wave 2 = 47.3% (n = 849)). Individuals who reported thinking about quitting smoking due to upcoming tax increase(s) were more likely to have increased their quit intention (aOR: 2.00, p ≤.001) or have carried out a serious quit attempt (aOR:1.48, p ≤.001) post-tax increase. More people attempted to quit smoking between wave 2 and 3 (post 2021 increase) than between wave 1 and 2 (post 2020 increase). We did not find an interaction effect between wave and thinking about quitting for quit intention, quit attempts, and quitting smoking. Conclusions: Tax increases stimulate people to think about quitting. Thinking about quitting due to an upcoming tax increase was associated with more positive quit intention and serious quit attempts. [ABSTRACT FROM AUTHOR]

Young adults are frequently exposed to alcohol posts from their friends on social networking sites, and little research has investigated the influences of these posts on alcohol use. Therefore, this study investigated how exposure to alcohol posts influenced determinants of alcohol use, and whether alcohol posts of close friends influenced these determinants more strongly compared to alcohol posts of distant friends. Students from Dutch universities (N = 210) participated in an experiment with a 2 (post condition: alcohol or neutral) x 2 (friend condition: close or distant) between-subjects design. Participants that were exposed to alcohol posts reported higher intention to use alcohol, F(1, 204) = 4.32, p =.039, willingness to use alcohol, F(1, 204) = 8.15, p =.005, and more positive affective attitudes about alcohol, F(1, 204) = 5.84, p =.017, than participants that were exposed to neutral posts. Additionally, participants who viewed alcohol posts of close friends reported more positive affective attitudes about alcohol compared to participants who viewed alcohol posts of distant friends, F(1, 204) = 5.15, p =.024. Developers of health interventions could use these findings to raise awareness about the unhealthy influences of alcohol posts on determinants of young adults' alcohol use. [ABSTRACT FROM AUTHOR]

Objective: The association between conversational valence (i.e. how positive/negative people perceive their conversations to be) and binge-drinking attitudes and intentions has been well established. However, too few studies have recognised a potential reciprocal association as well as the potential role of the conversation partner. In order to address these gaps, this study explored whether conversational valence and binge-drinking attitudes and intentions were reciprocally associated and whether this association was moderated by conversation partner popularity. Design: Vocational community college students (N = 112, Mage = 18.09) participated in a two-wave study (one month between the waves). Methods. Binge-drinking attitudes and intentions, and popularity were measured at baseline. At the second wave, conversational valence, and binge-drinking attitudes and intentions were assessed. Results: In revealing that only conversational valence was indicative of binge-drinking attitudes and intentions, it was shown that conversational valence and binge-drinking attitudes and intentions were not reciprocally associated. Furthermore, it was shown that conversation-partner popularity moderated the association between conversational valence and binge-drinking attitudes. Conclusion: Conversational valence was shown to be indicative of binge-drinking attitudes and intentions, and not vice versa. Furthermore, after talking to a popular conversation partner, adolescents' attitudes towards binge drinking became more positive. [ABSTRACT FROM AUTHOR]

The present study explored the influence of the Big Five dimensions extroversion and conscientiousness on action control regarding both moderate and vigorous physical activity within the framework of the theory of planned behavior (TPB). Prospective data were available from 186 respondents, who completed measures of intention, cognitive and affective attitude, subjective norm, perceived behavioral control, extroversion, conscientiousness, and physical activity at T1. Four weeks later, physical activity was assessed again. Respondents were grouped into four profiles: nonintenders, successful nonintenders, unsuccessful intenders, and successful intenders. Logistic regression analyses revealed that successful enactment in moderate physical activity was associated with extroversion, subjective norm, and affective attitude, whereas successful enactment in vigorous physical activity was associated with conscientiousness. Findings illustrate the differential role played by personality dimensions and TPB concepts in the explanation of moderate and vigorous physical activity action control. [ABSTRACT FROM AUTHOR]

The large amount of vocational community college students that continue showing binge-drinking behavior might be an indication that interventions targeting this behavior have not been hugely successful. It might be that these interventions targeted beliefs that are less or not related with vocational community college binge-drinking behavior. The aim of this study was to identify vocational community college students` salient beliefs about binge drinking. In the context of the integrative model of behavioral prediction, we applied deductive qualitative content analysis of conversations about binge drinking. The analysis of vocational community college students` conversations about binge drinking revealed a significant amount of salient beliefs, such as cognitive and affective outcome beliefs and efficacy beliefs. These beliefs may be important indicators of vocational community college students` binge drinking. Moreover, to our knowledge, this study was the first to reveal a new set of beliefs, namely social judgment beliefs (i.e., vocational community college students` judgments about their peers` binge-drinking behavior). We believe that our study yielded salient beliefs that may serve as input for future interventions targeting binge drinking among vocational community college students. [ABSTRACT FROM AUTHOR]

Many young people place alcohol-related posts on social networking sites (SNS) which can result in undesirable effects. Although several recent studies have investigated the occurrence of alcohol-related SNS use, it is neither clear (a) what type of alcohol posts are placed on SNS, (b) the motivations to place alcohol posts, nor (c) which young people are most likely to place alcohol posts. This study addressed these three goals. A large cross-sectional study among young participants (12-30 years; N = 561) assessed the posting of different types of alcohol posts, the motivations to (not) post these posts, and potential differences in posting between subgroups (i.e., in terms of age, gender, and religion). Participants reported that they most often placed moderate, instead of more extreme, alcohol posts, in particular, when alcohol was present in the post 'by chance'. Furthermore, they indicated to post alcohol-related content mostly for entertainment reasons. Finally, we found differences in self-reported posting and motivations to post according to age, gender, and religion. These findings provide relevant implications for future interventions aiming to decrease alcohol posts, for example, by making participants aware of their posting behavior and by targeting specific at risk groups. Future research should explore the effectiveness of such intervention strategies and should investigate whether alcohol posts lead to an underestimation of alcohol-related risks. [ABSTRACT FROM AUTHOR]

Background Secondary schools increasingly implement school tobacco policies (STPs) to decrease adolescents' smoking. Recent studies suggested that STPs' impact depends on their implementation. We examined adolescents' cognitive and behavioural responses to STPs that impact adolescents' smoking and how these responses depend on elements of STPs’ implementation. Method To examine STPs and adolescent smoking, we performed a realist review, which is an explanatory approach that synthesizes existing evidence into a program theory that links elements of STPs’ implementation to outcomes by specifying its underlying generative mechanisms. The search was performed in MEDLINE/PubMed, PsycINFO, and Embase between January 1991 and 2016. Thirty-seven English language articles were identified for inclusion, reporting quantitative and/or qualitative primary evidence on STPs at secondary schools, adolescent smoking behaviour, and mechanisms. From these articles, evidence was extracted about mechanisms that decrease smoking and associated countervailing-mechanisms that reduce, nullify, or revert this positive impact. Results The program theory showed that STPs may trigger four mechanisms and seven associated countervailing-mechanisms. Adolescents' smoking decreases if STPs make them feel they can get sanctioned, feel less pressure to conform to smokers, internalise anti-smoking beliefs, and find it easier to stick to the decision not to smoke. This positive impact may reduce, nullify, or revert if the implementation of STPs cause adolescents to find alternative places to smoke, develop new social meanings of smoking, want to belong in smoker groups, internalise beliefs that smoking is not bad or that it asserts personal autonomy, or alienate from schools and schools' messages. The program theory, moreover, provided insights on how elements of STPs’ implementation trigger mechanisms and avoid the countervailing-mechanisms. Conclusion STPs’ impact can be influenced by adequate implementation and embedding them in continuous monitoring and adaptation cycles, so that schools can proactively deal with the cognitive and behavioural responses that lead to suboptimal or adverse outcomes. [ABSTRACT FROM AUTHOR]

Introduction Little is known about smoking cessation among gender minority populations compared to cisgender individuals (whose gender matches their sex assigned at birth). We examined differences between smokers from gender minority populations, cis-women, and cis-men in the heaviness of smoking, quit intentions, use of cessation assistance, quit attempts (ever tried and number), and triggers for thinking about quitting. Aims and Methods We used cross-sectional data from the 2020 International Tobacco Control Netherlands Survey. Among smoking respondents, we distinguished (1) cis-women (female sex, identified as women, and having feminine gender roles; n = 670), (2) cis-men (male sex, identified as men, and having masculine gender roles; n = 897), and (3) gender minorities (individuals who were intersex, who identified as nonbinary, genderqueer, had a sex/gender identity not listed, whose gender roles were not feminine or masculine, or whose gender identity and/or roles were not congruent with sex assigned at birth; n = 220). Results Although gender minorities did not differ from cis-women and cis-men in the heaviness of smoking, plans to quit smoking, and quit attempts, they were significantly more likely to use cessation assistance (20% in the past 6 months) than cis-women (12%) and cis-men (9%). Gender minorities were also significantly more likely to report several triggers for thinking about quitting smoking, for example, quit advice from a doctor, an anti-smoking message/campaign, and the availability of a telephone helpline. Conclusion Despite equal levels of quit attempts and heaviness of smoking, gender minority smokers make more use of smoking assistance, and respond stronger to triggers for thinking about quitting smoking. Implications Smoking cessation counselors should be sensitive to the stressors that individuals from any minority population face, such as stigmatization, discrimination, and loneliness, and should educate their smoking clients on effective coping mechanisms to prevent relapse into smoking after they experience these stressors. Developing tailored smoking cessation programs or campaigns specifically for gender minority populations can also be useful. Based on the results of our subgroup analyses, programs or campaigns for younger gender minority smokers could focus on the availability of telephone helplines and on how friends and family think about their smoking behavior. [ABSTRACT FROM AUTHOR]

Background: The cost of tobacco is one of the most reported reasons for smoking cessation. Rather than quitting, smokers can use also strategies to reduce tobacco expenditure while continuing smoking, such as smoking less or using price-minimising strategies. The Netherlands announced to increase the price of a pack cigarettes from seven (2018) to ten euros (2023), to reduce tobacco prevalence and consumption. This study explores the self-reported strategies to reduce tobacco spending among Dutch smokers, and whether this differed per age, income, and education. Additionally, we analysed among quitters in these subgroups whether price played a role in their decision to quit. Methods: Cross-sectional survey data from the International Tobacco Control (ITC) Netherlands Wave 2 (September–November 2020, N = 1915) was used. Strategies to reduce spending among smokers (N = 1790) were: reducing consumption, bulk buying, switching to cheaper products or buying from low-taxed sources. These were collapsed into: reducing consumption (solely or in combination with other behaviours), solely price-minimising behaviours (such as buying cheaper brands), or no strategies to reduce spending. Associations between strategies and characteristics were analysed through multinomial and binary logistic regression models. Second, we explored which subgroups were more likely to report that price played a role in their decision to quit among quitters (N = 125). Results: The majority of smokers used strategies to reduce tobacco spending: 35.6% reduced consumption and 19.3% used solely price-minimising strategies. 82.1% of quitters reported that price played a role in their decision to quit. Low-income individuals were more likely to report price as a reason for quitting and reduce consumption, but also to buy cheaper products. Highly nicotine dependent smokers were more likely to use price-minimising behaviours, and less likely to reduce consumption. Conclusions: The majority reported using strategies to reduce spending or that price played a role in their decision to quit. Reducing consumption was the most reported strategy. Low-income smokers were more likely to reportedly reduce consumption, buy cheaper products, or quit. Price policies have the potential to reduce socioeconomic inequalities in smoking. To discourage price-minimising behaviours, such as switching to cheaper products, reducing price differences between products should be prioritized. [ABSTRACT FROM AUTHOR]

Introduction: Cigarette affordability, the price of tobacco relative to consumer income, is a key determinant of tobacco consumption. This study examined trends over 12 years in individualised factory-made cigarette affordability in the Netherlands, and whether these trends differed by sex, age, and education.Methods: Data from 10 waves (2008-2020) of the International Tobacco Control (ITC) Netherlands Surveys were used to estimate individualised affordability, measured as the percentage of income required to buy 100 cigarette packs (Relative Income Price, RIP), using self-reported prices and income. The higher the RIP, the less affordable cigarettes are. Generalised estimating equation regression models assessed trends in individualised affordability over time and by sex, age, and education.Results: Affordability decreased significantly between 2008 and 2020, with RIP increasing from 1.89% (2008) to 2.64% (2020) (p≤.001), Except for 2008-2010, no significant year-on-year changes in affordability were found. Lower affordability was found among subgroups who have a lower income level: females (versus males), 18-24 and 25-39 year olds (versus 55 and over) and low or moderate educated individuals (versus high educated). Interactions between wave and education (p=.007) were found, but not with sex (p=.653) or age (p=.295). A decreasing linear trend in affordability was found for moderately (p=.041) and high-educated (p=.025), but not for low-educated individuals (p=.149).Conclusions: Cigarettes in the Netherlands have become less affordable between 2008 and 2020, yet this was mostly due to the decrease in affordability between 2008 and 2010. There is a need for more significant increases in tax to further decrease affordability.Implications: Our findings suggest that cigarettes have become less affordable in the Netherlands between 2008 and 2020. But, this appears to be the result of a steep decrease in affordability between 2008 and 2010. Affordability was lower among groups who have on average lower incomes (females, young adults, low- and moderate educated individuals), and differences in trends across education levels could be explained by per capita income changes. Our individualised measure indicated lower affordability than published aggregate affordability estimations. Future tax increases should be large enough to result in a lower affordability. [ABSTRACT FROM AUTHOR]

Objective: One explanation for the relationship between TV viewing and obesity is that people may (over)eat while watching TV. The current study investigated associations between TV viewing and the time spent on (concurrent) eating in a naturalistic setting among a general population sample. Design: Preregistered secondary data analyses were performed of a diary survey in which respondents reported their time use in 10-min blocks for 7 d. Setting: Concurrent TV viewing and eating was operationalised as all blocks in which TV viewing and eating occurred simultaneously. Furthermore, the TV content respondents watched was coded as food-related (i.e. culinary content) or non-food related. Participants: The sample composed of 2292 adults (58·9 % female) in the Netherlands, aged ≥ 20 years, from all educational levels (18·1 % low, 29·8 % middle and 51·4 % high). Results: More than half of the respondents (51·3 %) reported concurrent TV viewing and eating at least once during the 7-d diary period. The average eating occasion was longer in duration while watching TV (v. without media use), and the total time spent on eating was longer on days of concurrent TV viewing and eating (v. days of eating without media use). The percentage of TV viewing time spent on concurrent eating did not differ between food-related and non-food-related TV content. Conclusions: Eating while watching TV was related to an increased time spent on eating. Even though energy intake was not assessed, these findings from a naturalistic setting provide further evidence that concurrent TV viewing and eating may contribute to overeating. [ABSTRACT FROM AUTHOR]

Aims: Exposure to tobacco products and advertising at the point of sale may be associated with pro‐smoking cognitions. However, previous studies on this topic measured exposure based on self‐report and did not include European countries. The aim of this study was to assess the association between objectively measured exposure to tobacco outlets and non‐smoking adolescents' smoking attitudes, beliefs and norms. Design: This cross‐sectional study combined survey data with Global Positioning Systems data using geographic information system. Setting: The four Dutch cities of Amsterdam, Eindhoven, Haarlem and Zwolle. Participants: We retrieved data of 308 13 to 17‐year‐old non‐smoking adolescents, mainly girls (61%), adolescents attending pre‐university secondary education (71%) and without smoking friends (58%). Measurements Exposure was measured with a smartphone app registering for 2 weeks how often participants were within 10 m of a tobacco outlet. We distinguished between outlets without visible tobacco promotion (i.e. supermarkets), with only internal visibility and with both internal and external visibility. Participants' reported smoking cognitions were dichotomised into pro‐smoking or anti‐smoking. We applied multi‐level logistic regression analyses and adjusted for age, sex, educational level and smoking friends. Findings On average, adolescents were exposed to 1.18 (SD = 1.23) tobacco outlets per day. Higher exposure to tobacco outlets was associated with higher odds of pro‐smoking injunctive norm (OR = 1.35, 95% CI = 1.04–1.75). Associations with attitude (OR = 1.12, 95% CI = 0.91–1.38), social beliefs (OR = 1.15, 95% CI = 0.93–1.43), health beliefs (OR = 1.18, 95% CI = 0.97–1.44) and descriptive norm (OR = 1.15, 95% CI = 0.91–1.44) were also positive, but non‐significant. Overall, associations were strongest for outlets with internal visibility, for instance, for injunctive norm (OR = 1.37, 95% CI = 1.03–1.81). Conclusions: Global Positioning Systems‐measured exposure to tobacco outlets was associated with pro‐smoking cognitions among non‐smoking adolescents in the Netherlands. [ABSTRACT FROM AUTHOR]

School-based health interventions are potentially an effective method to communicate health messages to adolescents. Unfortunately, effectiveness of such interventions is limited. Research in other contexts has shown that interpersonal communication can influence the effectiveness of health programs, but this has not been thoroughly tested for school-based health interventions. Therefore, our study investigated interpersonal communication (i.e., conversational valence and frequency) in a school-based intervention context. We used a three-wave randomized-controlled trial with 1056 students to study three aims. The first aim was to investigate the influence of a health intervention on conversational frequency and valence about drinking, snacking, and exercising. Our second aim was to investigate the influence of conversational frequency and valence on (predictors of) drinking, snacking, and exercising. Our third aim was to investigate whether the health intervention indirectly influenced the program outcomes through conversational frequency and valence. Findings showed that conversational frequency and valence were related to (predictors of) the three behaviors. Additionally, findings showed that the intervention did not influence conversational frequency and valence. Accordingly, findings showed no indirect influence of the intervention on program outcomes through conversational frequency and valence. Our findings show the potential of interpersonal communication for health behaviors and predictors; however, they also stress the importance of a health intervention to properly influence interpersonal communication. If health interventions can successfully influence interpersonal communication, intervention effectiveness can be improved. [ABSTRACT FROM AUTHOR]

Background In 2011, the Netherlands implemented a national policy that ensured that health insurance companies reimbursed behavioural counselling for smoking cessation or the combination of behavioural counselling with pharmacological therapy. Objective To examine the real-world impact of a national reimbursement policy and accompanying media attention on use of cessation treatment and on smoking cessation. Methods We used a four-wave longitudinal survey among 2763 adult smokers that started in September 2010 and was repeated at approximately 3 month intervals until June 2011. Two survey waves were conducted before the implementation of the policy and two survey waves after. Findings There were significant increases in quit attempts (among moderate-to-heavy smokers) and in quit success (among all smokers) following the implementation of the reimbursement policy and the media attention. Use of behavioural counselling did not increase, while use of pharmacological therapy without behavioural counselling (unreimbursed treatment) increased among moderate-to-heavy smokers. Attention to media about the reimbursement was significantly associated with more quit attempts and more quit success. Awareness of the policy was significantly associated with more use of reimbursed treatment among all smokers, while attention to the media coverage was only significantly associated with more use of reimbursed treatment among moderate-to-heavy smokers. Awareness/attention variables were not significantly associated with use of unreimbursed treatment. Conclusions It seems that a national reimbursement policy for smoking cessation treatment that is accompanied by media attention can increase cessation. Our findings suggest that this increase can ( partly) be ascribed to the media attention that accompanied the policy implementation. [ABSTRACT FROM AUTHOR]

Objectives To examine if exclusive Roll-Your-Own (RYO) tobacco use relative to factory-made (FM) cigarette use has been rising over time, to determine the extent to which economic motives and perceptions that RYO cigarettes are less harmful act as primary motivations for use, and to examine the association of income and education with the level of RYO tobacco use among smokers in four European countries. Methods Data were obtained from the International Tobacco Control (ITC) Europe Surveys, and a cohort sample of 7070 smokers from the Netherlands, Germany, France and UK were interviewed between June 2006 and December 2012. Generalised estimating equations (GEE) were used to assess trends in RYO use, and whether RYO consumption varied by socioeconomic variables. Results Exclusive RYO use over the study period has increased significantly in the UK from 26.4% in 2007 to 32.7% in 2010 (p<0.001); France from 12.2% in 2006 to 19.1% in 2012 (p<0.001); and Germany from 12.7% in 2007 to 18.6% in 2011 (p=0.031), with increased borderline significantly in the Netherlands (31.7% to 34.3%, p=0.052), from 2008 to 2010. Over three-quarters of users in each of the study countries indicated that lower price was a reason why they smoked RYO. Just over a fourth of smokers in the UK, less than a fifth in France, and around a tenth in Germany and the Netherlands believed that RYO is healthier. Compared with exclusive FM users, exclusive RYO users were more likely to have lower incomes and lower education. Conclusions Effective tobacco tax regulation is needed in the European Union and elsewhere to eliminate or reduce the price advantage of RYO tobacco. Additional health messages are also required to correct the misperception that RYO tobacco is healthier than FM cigarettes. [ABSTRACT FROM AUTHOR]

Objectives To examine if exclusive Roll-Your-Own (RYO) tobacco use relative to factory-made (FM) cigarette use has been rising over time, to determine the extent to which economic motives and perceptions that RYO cigarettes are less harmful act as primary motivations for use, and to examine the association of income and education with the level of RYO tobacco use among smokers in four European countries. Methods Data were obtained from the International Tobacco Control (ITC) Europe Surveys, and a cohort sample of 7070 smokers from the Netherlands, Germany, France and UK were interviewed between June 2006 and December 2012. Generalised estimating equations (GEE) were used to assess trends in RYO use, and whether RYO consumption varied by socioeconomic variables. Results Exclusive RYO use over the study period has increased significantly in the UK from 26.4% in 2007 to 32.7% in 2010 (p<0.001); France from 12.2% in 2006 to 19.1% in 2012 (p<0.001); and Germany from 12.7% in 2007 to 18.6% in 2011 (p=0.031), with increased borderline significantly in the Netherlands (31.7% to 34.3%, p=0.052), from 2008 to 2010. Over three-quarters of users in each of the study countries indicated that lower price was a reason why they smoked RYO. Just over a fourth of smokers in the UK, less than a fifth in France, and around a tenth in Germany and the Netherlands believed that RYO is healthier. Compared with exclusive FM users, exclusive RYO users were more likely to have lower incomes and lower education. Conclusions Effective tobacco tax regulation is needed in the European Union and elsewhere to eliminate or reduce the price advantage of RYO tobacco. Additional health messages are also required to correct the misperception that RYO tobacco is healthier than FM cigarettes. [ABSTRACT FROM AUTHOR]

This study aimed to assess educational differences in adolescents' exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08-1.98), especially around school (IRR:2.61,95%CI:1.50-4.55). These differences may contribute to socioeconomic inequalities in smoking. [ABSTRACT FROM AUTHOR]

Sharing alcohol-related content on social media has been linked to young adults' alcohol use. Therefore, it is important to understand why these references are shared in the first place. As such, the first aim of this study was to identify the motives (social, entertainment, information/identification) that predict the sharing of alcohol references through an online survey of young Dutch adults (N = 339, Mage = 22.67 years, SDage = 3.04 years, 69.4% women). The second aim was to investigate individual differences in motives by examining whether motives mediate the relationship between personality traits (agreeableness, neuroticism, extroversion) and internal states (need for popularity) and sharing alcohol-related content. Our findings showed that identification/information (and not social or entertainment) motives and extroversion directly predicted the sharing of alcohol-related content. Moreover, respondents with a great need for popularity scored higher on all sharing motives, but only identification/information motives mediated the relationship between the need for popularity and sharing alcohol-related content. Thus, extroverted and popularityoriented individuals are highly likely to post alcohol-related content. Overall, our findings show that certain motives predict the sharing of alcohol references on social media and that certain groups of individuals may be particularly prone to sharing such content, which makes them potential targets for interventions. [ABSTRACT FROM AUTHOR]