Chapter 12 392 The last smoker In 1991, the renowned Dutch author Willem Frederik Hermans wrote a short novel titled “The Last Smoker”. Set in a dystopian Netherlands in the year 2021, the narrative envisions a world where the Dutch language has been replaced by English, mandatory mask-wearing is in effect, and smoking is prohibited. Despite the prohibition, protagonist Vroegindewey gets his hands on a real cigarette, a Gauloise, which causes his unexpected death two weeks later. While the prediction of mask usage in 2021 was surprisingly accurate, the novel served as a cautionary tale of what can happen in the realm of tobacco control when two factors are in play: inadequate public support for tobacco control policies and insufficient support for current smokers seeking to quit. In order to have an actual smoke-free generation in 2023, rather than the scenario depicted by Hermans, a focus on public support and improved quit attempts is needed. This thesis investigated levels of public support for novel smoke-free policies and the use of personalisation methods to improve quit attempts. In this concluding chapter, I will reflect on the primary findings, discuss methodological challenges, and provide recommendations for future research and policy development. Reflection on results Over the past three decades, the proportion of daily smokers has declined substantially. In the Netherlands smoking rates more than halved; the number of daily smokers reduced from 30% in 1990 to 13% in 2022.1 This reduction however, strongly differed by educational level, with a stronger decline in those in higher as compared to lower -educational groups. Therefore, smoking has been the most important single risk factor contributing to socioeconomic inequalities in mortality since decades.2 Even nowadays, after years of declining smoking rates and a decline in the contribution of smoking-attributable mortality to socioeconomic inequalities in mortality among men, smoking remains to play a significant role in socioeconomic inequalities in life expectancy, as seen in Chapter 2. These insights underscore the persistence of tobacco-related mortality, particularly among women, and highlight the continuing need for long term tobacco control measures. Part 1: support for smoke-free policies To further reduce the prevalence of smoking, effective legislation is of utmost importance. In addition to reducing prevalence rates, smoke-free policies have
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