Experiences of policy-advisors in capacity, opportunity and motivation for implementing local tobacco control

Introduction: 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.

Method: 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.

Results: 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.

Conclusion: 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.