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Changes in lung cancer incidence in south-east Netherlands between 1960 and 1991 were analysed, using data from the Eindhoven Cancer Registry, and related to previous changes in smoking habits. Male lung cancer incidence rates increased markedly from birth cohorts 1890-1899 to 1910-1919, followed by a decline. The peak incidences for both squamous cell carcinoma and small cell carcinoma were reached in 1978, while for adenocarcinoma it was 1985. A rising trend in female lung cancer incidence up to 1988 was found for each successive birth cohort and for every histological type. These changes in lung cancer incidence rates are most likely related to the pattern of past smoking habits: the percentage of male adult smokers in the southern part of the Netherlands decreased from 95% in 1960 to 40% in 1981 and the percentage of female adult smokers increased from 27% in 1960 to 40% in 1967, slightly decreasing only after 1979. In view of the trends in smoking behaviour, the incidence rates for male lung cancer will decline further, whereas female lung cancer incidence may decrease after the year 2000.

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The first survey on adolescent drinking in the European Community in 1990 showed that differences in the prevalences of weekly drinkers by country are large. Prevalences in Italy and Greece are more than twice the average on the one hand, and hardly any child drinks weekly in Ireland on the other. Explanatory variables from three scientific domains, i.e., drinking among friends, drinking by parents, alcohol permissiveness by parents, pocket money, weekly smoking, and disco visits, are related with weekly drinking, confirming the theory of different mechanisms.

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Changes in smoking and drinking behaviour in relation to policy and economic variables were investigated among Dutch secondary schoolchildren in two measurements. The response rate was 82% during the second measurement. In bivariate analyses the policy variables 'pressure by tobacco advertising' and 'incorrect knowledge about dangers of tobacco consumption' and the economic variables 'money' and 'free availability from parents' predicted weekly smoking (among all respondents), and 'the experienced anti-smoking campaigns' predicted weekly smoking (among non-smokers during the first measurement). Only the economic variables predicted weekly drinking. A general and a specific theory of different mechanisms were designed to investigate whether these predictors are independent of other influences. We assumed that changes in smoking and drinking behaviour are predicted at three levels: (a) previous behaviour, (b) socio-demographic variables and (c) possible causes and intermediary factors. In multivariate analyses, only the prediction of weekly smoking by 'experienced anti-smoking campaigns' and weekly drinking by economic variables remained significant. The findings are relevant when policy priorities are developed.

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"In this paper socio-economic differential mortality [in the Netherlands] at the individual level will be analyzed by two national and two local surveys. The purpose is to describe socio-economic differential mortality in several periods....[It is found that] mortality by social classes among males was higher among lower classes in the Netherlands in 1896-1903. The gradient...disappeared in 1947-1952. There was...socio-economic differential mortality again in 1959-1961 and 1972-1981." (SUMMARY IN ITA)

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The purpose is to describe smoking behaviour of physicians and of the general population in the Scandinavian countries. Data on smoking behaviour in physicians and in the population at large were collected from 14 surveys. The smoking prevalence dropped among male and female physicians in the period under study. Changes for the general male population were similar, but smoking among the general female population changed little. If the present changes continue, physicians could be a smokefree profession by the year 2000.

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Data from the first measurement of a cohort study among secondary schoolchildren allowed us to investigate policy correlates to smoking and drinking behaviour to some extent. Regular smoking is related to anti-smoking campaigns among boys and regular drinking is related to alcohol education at primary school. Regular drinking is also related to economic availability (free availability of alcohol and pocket money). The findings on economic availability and health education are directly policy relevant.

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The smoking control, policy implemented at a Barcelona hospital over a 3-year period resulted in a reduction of smoking in the hospital and a raised awareness of the exemplary role health professionals can have. However, participation by health professionals in the project decreased over the 3-year period. Although reduced, the smoking rate in the hospital still is at a high level; this should trigger health professionals to further exploit their potential in smoking reduction efforts.

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Nurses are the largest professional group in health care. Nurses' smoking is not only important to their personal health, but also to the public's health. Analysis of smoking prevalences found among nurses in 21 countries in the period 1959-1988 shows that considerable numbers of both female and male nurses are smokers. More often than not there are found as many smokers among nurses as among the general population, sometimes even more. Only in Canada and Finland female nurses smoked clearly less than the population at large. Nurses' smoking prevalences decreased slowly in industrialized countries. An exemplary role is recognized by many nurses; more so by non-smoking nurses than by their smoking colleagues. Factors influencing nurses' smoking are professional socialization, duality of roles, workstress, discrepant expectancies about nurses' role and lack of social support. Theoretical explanations for nurses smoking by means of the theories of strain, of selection, of social control and of professional subculture are discussed. Future research should be internationally coordinated and aimed at comparability within a cultural and organizational context.

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Current smoking decreased and former smoking increased among a cohort of originally middle-aged men in Zutphen during the period 1960-1985. Cohort analyses revealed two distinct advantages in comparison with the usual cross-sectional analyses: inconsistent answers on never smoking could be eliminated, and former smokers resuming their habit could be traced. Recidivism of smoking increased strongly during the period 1977-1985. If recidivism of smoking affected younger cohorts as well, it could develop into an important health problem.

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