Failure of policy regarding smoke-free bars in the Netherlands

Abstract

Background: Tobacco companies consistently work to prevent and undermine smoke-free laws. The tobacco industry and its allies have funded hospitality associations and other third parties to oppose smoke-free laws, argue that smoke-free laws will economically damage hospitality venues, promote ventilation and voluntary smoker 'accommodation' as an alternative to smoke-free laws, and to challenge smoke-free laws in court. In 2008, the Netherlands extended its smoke-free law to hospitality venues.

Methods: We triangulated news articles, government documents, scientific papers, statistical reports and interviews to construct this case study.

Results: Despite widespread public support for smoke-free hospitality venues, opponents successfully represented these laws as unpopular and damaging to small bars. These challenges and related smokers' rights activities resulted in non-compliance among all bars and reinstating an exemption for small, owner-run venues. This policy reversal was the result of a weak implementing media campaign (which failed to present the law as protecting nonsmokers), smoking room exemptions and reactive (vs. proactive) measures by the Ministry of Health and civil society.

Conclusion: The policy failure in the Netherlands is the result of poor implementation efforts and the failure to anticipate and deal with opposition to the law. When implementing smoke-free laws it is important to anticipate opposition, used the media to target non-smokers to reinforce public support, and actively enforce the law.

Figure 1

(A) The Ministry of Health, Welfare and Sports smoke-free media campaign presented the new law from the point of view of an anthromorphized cigarette being forceably ejected from bars rather than stressing the benefits of smoke-free bars for everyone. (The text of this television commercial is in the Supplemental Data.) (B) Free posters provided to hospitality venues by the Ministry of Health also stressed the role of the cigarette rather than the benefits of being smoke free. Source: Ministry of Health Welfare and Sport^[24,25]

Figure 2

Organizational linkages between opponents of the smoke-free hospitality law, including the tobacco companies and KHO and other smokers’ rights activities. Source: Een rokende Gideonsbende^[31]

Figure 3

Percentage of bars and nightclubs observed violating the smoke-free law (observation of smoking in venue or of ashtrays on table). Source: Study commissioned by the VWA of representative sample of catering establishments in the Netherlands visited by INTREVAL^[38,39]