EVALUATION OF A DUTCH COMMUNITY-BASED SMOKING CESSATION INTERVENTION

Background. Until 1990, smoking cessation interventions in the Netherl ands were limited. The utility and effectiveness of community-based sm oking cessation programs have not been examined. Methods. In a treatme nt city (Den Bosch) a multicomponent community-based smoking cessation intervention was implemented in which local mass media and general pr actitioners draw smokers' attention to a local quit line. Telephone co unselors advised applicants on their choice between self-help and grou p treatment and optional telephone counseling. Another Dutch city (Ape ldoorn) sewed as a control. Population samples of smokers (n = 547 and n = 546) were interviewed three times at approximately 7-month interv als. Self-help manual requesters (n = 84) and group participants (n = 83) were interviewed before and 6 months after treatment. Results. Tre atment modalities were successful; 13% of self-help manual requesters and 22% of group participants were abstinent after 6 months. On a popu lation level the intervention resulted in significantly higher recall of self-help manual and group program in the treatment city. A modest intervention effect on prevalence of abstinence was found at the commu nity level. Conclusions. Treatment modalities were effective within th eir participants, but the intervention effectiveness on a community le vel was limited. No significant difference was found between quit rate s after 14 months (7% in treatment city and 9% in control city). Sever al system failures could be identified. However, probably the interven tion effect was seriously confounded by two national governmental publ icity campaigns introducing and reinforcing a mandatory smoking ban an d a series of national campaigns initiated by the united Dutch tobacco producers opposing the ban. (C) 1995 Academic Press, Inc.