The Dutch House of Representatives will debate lifestyle prevention this week – what are we expecting?

Prevention is a current societal theme upon which various organizations and companies express their interests and attempt to exert influence. Attention to prevention also exists among political parties. With the exception of the Forum voor Democratie (populist-rightwing), all parties in their election programs call for more attention to prevention.

This Thursday, the Dutch House of Representatives will debate lifestyle prevention. Diverse topics such as tobacco sales points, hearing damage, and PFAS are on the agenda. Since the installation of the new House of Representatives in December, there has been one previous debate on prevention in the current composition. On February 28, former and current healthcare spokespersons discussed the Healthy and Active Living Agreement (GALA), often in relation to a healthy living environment and socio-economic health disparities that receive insufficient attention in the agreement.

What are we expecting from the debate?

Attention to the effectiveness of the Prevention Agreement

In 2018, over 70 parties, including patient organizations, healthcare providers, health insurers, municipalities, sports associations, companies, funds, educational institutions, social organizations, and the central government, signed the National Prevention Agreement. This agreement aims to reduce the number of smokers, people with overweight, and people with problematic alcohol use by 2040. According to the prevention agreement, these three lifestyle characteristics significantly contribute to the disease burden in the Netherlands.

The lifestyle prevention debate will partly focus on the evaluation of this agreement. To more effectively combat smoking, excessive drinking, and overweight, additional measures and “long-term commitment” are needed. This was written by State Secretary Maarten van Ooijen (Health) earlier this year in a letter to the Dutch House of Representatives, in response to new research from the National Institute for Public Health and the Environment (RIVM) showing that the government’s lifestyle goals are not being met with the Prevention Agreement.

‘#Artsenslaanalarm’ campaigns

One of the significant influencers on this topic is the media. The influence of the media on societal agendas cannot be underestimated. Reporting, campaigns, and education can play a crucial role in creating awareness and stimulating behavioral change.

The ‘#Artsenslaanalarm’ – or ‘#Doctorssoundthealarm’ – campaigns are a good example of this. Since 2017, doctors have come out of their consultation and operating rooms multiple times to sound the alarm about the dangers of smoking and vaping. This year, the Royal Dutch Medical Association (KNMG) and the Trimbos Institute (the national Dutch knowledge institute for mental health, addiction and societal care) are joining forces for the ‘#Artsenslaanalarm’ campaign against vaping. Last year, prominent Dutch doctors like Diederik Gommers used TikTok videos to address influencers and children. This year, (respiratory) physicians are addressing the parents and caregivers of children in a video. The campaign is being highlighted widely on TV, radio, social media, in newspapers, and on the streets.

This campaign, along with other tobacco-related topics on the agenda, will likely receive a lot of attention during the debate, emphasizing the urgency of effective measures against smoking and vaping once again.

The objectives to reduce the number of smokers have been partly achieved through a combination of previous and current policies, such as advertising bans, raising the age limit for tobacco sales, and campaigns like Stoptober. These initiatives have contributed to a downward trend in the number of smokers. Furthermore, the National Prevention Agreement (NPA) has ensured that previous policies, such as “Stoptober” and smoking cessation care, are continued. This is evident from the RIVM’s assessment of the NPA actions.

However, the report also emphasizes the need to combat the use of e-cigarettes, especially among young people. In this context, the ‘#Artsenslaanalarm’ campaign aligns well with the RIVM’s call, forming a broad front to address this concerning trend.

Too broad agenda

Bundling various prevention topics on one agenda indicates that the parliamentary agenda leaves little room for separate debates per theme. The fact that topics such as unintended pregnancies and stroke prevention are included in the same debate on lifestyle prevention illustrates this. As a result, challenges and solutions per dossier are overshadowed.

However, some prevention dossiers will receive specific attention this week through other debates. For example, there will be a plenary debate tonight on the amendment of the Tobacco and Smoking Articles Act. Tonight, there will also be a short debate on the advice of the Technical Working Group on Costs and Benefits of Prevention “Valuing Prevention” on how policymakers can incorporate the costs and benefits of prevention into prevention decisions. This provides an opportunity to table motions on that pressing issue.

Organizations wishing to influence the lifestyle prevention debate would do well to share their input early so that Members of Parliament have the chance to prepare their contributions on various themes. Media attention close to the debate – as outlined above with the ‘#Artsenslaanalarm’ campaigns – is also a known strategy to dominate certain topics in the debate.

A structural solution to a “too broad agenda” may be to debate prevention topics more frequently (and keep medical and lifestyle prevention separate), but achieving this requires prevention to be even higher on the political agenda.