title: No intention to comply with influenza and pneumococcal vaccination: behavioural determinants among smokers and non-smokers.
abstract: OBJECTIVE
  Smoking increases the risk for influenza and pneumococcal disease, but vaccination uptake is lower among smokers than non-smokers. We therefore aimed to determine reasons for not complying with vaccination among smokers and non-smokers.
  
  
  METHODS
  In 2005 a self-administered questionnaire was sent to a random sample of Dutch patients (n=4,000) assessing medical, social and behavioural determinants. Independent factors associated with not complying with influenza and pneumococcal vaccination among smokers and non-smokers were assessed by multivariate logistic regression analysis.
  
  
  RESULTS
  In all, 1,725 of 4,000 patients returned the questionnaire (response rate: 43%), 426 (25%) were smokers. Among smokers self-reported flu vaccine uptake was 42% and among non-smokers 52% among both only 0,2% received both vaccines. Most important predictors of not complying in smokers and non-smokers were patient's beliefs not to be susceptible to disease (odds ratio (OR) 4.0, 95% confidence interval (CI): 2.0, 8.0 and OR 2.8, CI: 2.0, 3.9), finding it difficult to go to the GP for vaccination (OR 2.5, CI: 1.3, 4.8 and OR 1.8, CI: 1.3, 2.6) and being against vaccination (OR 2.4 CI: 1.3, 4.4 and OR 1.8, CI: 1.3, 2.6), respectively.
  
  
  CONCLUSIONS
  There are no substantial differences in determinants associated with not complying with influenza and pneumococcal vaccination between smokers and non-smokers but there is a trend towards stronger associations in smokers.
authors: Julius Center for Health Sciences and Primary Health Care, University Medical Center Utrecht, The Netherlands. i.looijmans@umcutrecht.nl
authors: I
authors: I
authors: Looijmans-van den Akker
authors: P M
authors: PM
authors: van den Heuvel
authors: Th J M
authors: TJ
authors: Verheij
authors: J J M
authors: JJ
authors: van Delden
authors: G A
authors: GA
authors: van Essen
authors: E
authors: E
authors: Hak
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011897:Random Allocation; D012907:Smoking
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines