Trends and socioeconomic differences in policy triggers for thinking about quitting smoking: Findings from the International Tobacco Control (ITC) Europe Surveys.
BACKGROUND
The aim of the current study is to investigate trends and socioeconomic differences in policy triggers for thinking about quitting in six European countries.


METHODS
Data were derived from all available survey waves of the International Tobacco Control (ITC) Europe Surveys (2003-2013). France conducted three survey waves (n=1420-1735), Germany three waves (n=515-1515), The Netherlands seven waves (n=1420-1668), Ireland three waves (n=582-1071), Scotland two waves (n=461-507), and the rest of the United Kingdom conducted seven survey waves (n=861-1737). Smokers were asked whether four different policies (cigarette price, smoking restrictions in public places, free or lower cost medication, and warning labels on cigarette packs) influenced them to think about quitting. Generalized Estimating Equation (GEE) models were estimated for each country.


RESULTS
Cigarette price was mentioned most often in all countries and across all waves as trigger for thinking about quitting. Mentioning cigarette price and warning labels increased after the implementation of price increases and warning labels in some countries, while mentioning smoking restrictions decreased after their implementation in four countries. All studied policy triggers were mentioned more often by smokers with low and/or moderate education and income than smokers with high education and income. The education and income differences did not change significantly over time for most policies and in most countries.


CONCLUSIONS
Tobacco control policies work as a trigger to increase thoughts about quitting, particularly in smokers with low education and low income and therefore have the potential to reduce health inequalities in smoking.
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands. Electronic address: Karin.Hummel@maastrichtuniversity.nl.
Karin
K
Hummel
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands; Dutch Alliance for a Smokefree Society, The Hague, The Netherlands.
Gera E
GE
Nagelhout
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands; Dutch Alliance for a Smokefree Society, The Hague, The Netherlands.
Marc C
MC
Willemsen
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Pete
P
Driezen
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.
Linda
L
Springvloet
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany; Unit Cancer Prevention, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Ute
U
Mons
Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
Anton E
AE
Kunst
Scientific Affairs Department, National Institute for Health Promotion and Health Education (INPES), Saint-Denis, France.
Romain
R
Guignard
Department of Public Health and Primary Care, Trinity College Dublin, University of Dublin, Dublin, Republic of Ireland.
Shane
S
Allwright
Department of Communication, University of Amsterdam (ASCoR), Amsterdam, The Netherlands; Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands.
Bas
B
van den Putte
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.
Ciska
C
Hoving
Department of Psychology, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada.
Geoffrey T
GT
Fong
King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK Centre for Tobacco and Alcohol Studies, London, UK.
Ann
A
McNeill
Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA.
Mohammad
M
Siahpush
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands.
Hein
H
de Vries
D000293:Adolescent; D000328:Adult; D005060:Europe; D005260:Female; D015438:Health Behavior; D006291:Health Policy / Q000191:economics* / Q000639:trends*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000191:economics / Q000523:psychology*; D012959:Socioeconomic Factors; D055815:Young Adult
Cessation; Public policy; Socioeconomic status