No intention to comply with influenza and pneumococcal vaccination: Behavioural determinants among smokers and non-smokers

I Looijmans-van den Akker, P.M. van den Heuvel, Th J M Verheij, J J M van Delden, G A van Essen, E Hak

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OBJECTIVE: Smoking increases the risk for influenza and pneumococcal disease, but vaccination uptake is lower among smokers than non-smokers. We therefore aimed to determine reasons for not complying with vaccination among smokers and non-smokers.

METHOD: In 2005 a self-administered questionnaire was sent to a random sample of Dutch patients (n=4,000) assessing medical, social and behavioural determinants. Independent factors associated with not complying with influenza and pneumococcal vaccination among smokers and non-smokers were assessed by multivariate logistic regression analysis.

RESULTS: In all, 1,725 of 4,000 patients returned the questionnaire (response rate: 43%), 426 (25%) were smokers. Among smokers self-reported flu vaccine uptake was 42% and among non-smokers 52% among both only 0,2% received both vaccines. Most important predictors of not complying in smokers and non-smokers were patient's beliefs not to be susceptible to disease (odds ratio (OR) 4.0, 95% confidence interval (CI): 2.0, 8.0 and OR 2.8, CI: 2.0, 3.9), finding it difficult to go to the GP for vaccination (OR 2.5, CI: 1.3, 4.8 and OR 1.8, CI: 1.3, 2.6) and being against vaccination (OR 2.4 CI: 1.3, 4.4 and OR 1.8, CI: 1.3, 2.6), respectively.

CONCLUSION: There are no substantial differences in determinants associated with not complying with influenza and pneumococcal vaccination between smokers and non-smokers but there is a trend towards stronger associations in smokers.

Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalPreventive Medicine
Issue number5
Publication statusPublished - Nov-2007
Externally publishedYes


  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Surveys
  • Humans
  • Influenza Vaccines
  • Male
  • Middle Aged
  • Netherlands
  • Patient Compliance
  • Pneumococcal Vaccines
  • Random Allocation
  • Smoking

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