The Next Step For A Smoke-Free Generation: a multidisciplinary study of opportunities for expanding smoke-free environments in the Netherlands (translated from Dutch) 251 7 Discussion This multidisciplinary collaboration has led to further insights in terms of creating smoke-free cars and playgrounds. International research shows that exposure to tobacco smoke in children decreases after introducing smoke-free policies in cars, and that hospital admissions of children with asthma also decrease. The health benefits of smoke-free playgrounds have not yet been formally evaluated. An overwhelming majority of the population, both internationally and in the Netherlands, supports the introduction of such measures, and there are several legal frameworks at different regulatory levels that justify taking health-protective measures. It is important here to put children’s health at the centre. It is also important to opt for a coherent strategy consisting of several measures, as they are more difficult to combat by the tobacco lobby than a single measure. With the approaching goal of a Smoke-Free Generation in 2040, it is more important than ever to give tobacco control a central and structural place on the national political agenda. A strength of this study is its multidisciplinary nature and broad approach, involving health professionals, epidemiologists, lawyers and sociologists. An extensive search of various databases brought together all studies that evaluated the impact of smoke-free policies on tobacco smoke exposure and health in children. Although the number of studies is limited, there are indications that such measures can lead to health gains in children. Through interviews with professionals working in research, policy and politics, a dynamic picture emerged of the interplay of key people and factors that played a role before and behind the scenes in the expansion of smoke-free environments. The study also has its limitations. Key people from one case study were interviewed for the introduction of smoke-free cars and playgrounds. Other success factors and barriers may also play a role in introducing similar smoke-free policies in other countries. Given the findings from abroad, it can be expected that introducing legislation aimed at smoke-free cars will also result in health gains in the Netherlands. The expected magnitude of health gains is linked, among other things, to the number of children regularly exposed to tobacco smoke in places where new legislation is introduced. Research from 2016-2017 among spring 10- to 17-year-olds from Amersfoort showed that one in seven teenagers was exposed to tobacco smoke in the car on a weekly basis.9 Creating smoke-free environments has the potential to
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