Analysis of grant proposals from municipal health services for local tobacco control policies in the Netherlands
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Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
Trimbos Institute, The Netherlands Expertise Centre for Tobacco Control, Utrecht, The Netherlands
Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, The Netherlands
Sophie J. A. Jooren   

Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
Publication date: 2023-04-25
Tob. Prev. Cessation 2023;9(Supplement):A157
Although local governments have an important role in protecting present and future generations from tobacco use in the Netherlands, a relatively small body of literature is concerned with local tobacco control (TC) policies. Also, most studies focus on what happens after a policy on a socially relevant problem has been formulated and adopted, how the policies are enforced, and how effective they are. This study investigates the content of municipal health service (MHS) policy plans in the Netherlands.

Material and Methods:
We analysed grant proposals of MHSes by using the first two stages of the rational policy cycle, a four-stages policy model about the decisions made by policy makers during the policy process (Bekker et al., 2004; Jansen, 2007). The first two stages are: (1) identifying and placing a problem on the policy agenda (2) policy formulation including plans about policy implementation and evaluation.

Regarding the first stage, there are three topics in the subsidy proposals which include information about: (1) relevance of the topic and supporting the smoke-free generation, (2) putting TC on the municipal policy agenda, (3) supporting specific target groups or themes within TC. Regarding the second phase, the MHSes have three aims: creating smoke-free (child) environments, developing and improving access to smoking cessation care (SCC) and participate in campaigns. With regard to the implementation and evaluation plans, MHSes differ in their intended roles and MHSes provide little structured information about this.

The first two phases of the policy cycle provide insight into the policy choices of the MHSes, in which mainly children and vulnerable groups are mentioned. Plans for actual policy implementation are thinly formulated. Possible explanations for this include differences in the municipal context, grant requirements, and the unclear division of roles in SCC.

There is no conflict of interest.