General discussion 397 12 contact often spend less time behind their computers compared to support staff or those working in management. Recruitment via email or intranet thus reaches a specific group of employees. Furthermore, the nature of the smoking cessation programme at stake also recruits a specific type of participants. Those favouring a group-based smoking cessation programmes might be more aware of their nicotine addiction and are more ready to do something about it, i.e. are in the preparation phase according to Prochaska’s stages of change model (Chapter 10). Pre-contemplators, e.g. individuals not yet ready to change their behaviour, might benefit more from individual counselling, as this might have a lower (perceived) barrier. Tailoring cessation programmes to smaller, more homogeneous, groups of employees might have as an additional value that peer support is more effective. One of the smoking cessation trainers within the PERSIST study noted that training sessions at Erasmus MC felt similar as group trainings with strangers, because most participants did not know each other nor worked at similar departments. What if? The however question remains: “What if?” How would our results have looked if recruitment was successful and no barriers to participation were perceived? Personally, I still believe in the sophistication of personalised prevention and I am convinced there can be an added value of personalisation within incentives, especially combined with free choice. A nudged advice has been used plenty in behavioural economics.14 Furthermore, personalisation is being applied in many more health and prevention fields, such as for example screening.15 One size does not fit all and therefore I still see the advantages of personalised incentives. Whether we could have proven this within PERSIST with a sufficient sample size remains unclear. However, if a large sample would have also meant a more unbiased sample, i.e. not only recruiting highly motivated participants, I would have expected to have larger differences between intervention and control group. Recruitment, especially for smoking cessation programs, is and will remain challenging however. Better awareness of these challenges and development of successful approaches to tackle these might help improve future studies. Smoke free policies The research in Part 1 comes with methodological challenges as well. We argue that the implementation of a policy in which cars must be smoke-free if children
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