Going Once, Going Twice: Using Willingness-to-Accept Auctions to Promote Smoking Cessation

2020 ◽  
Vol 22 (9) ◽  
pp. 1632-1635
Author(s):  
Amanda J Quisenberry ◽  
Shreya Shaw ◽  
Amy K Ferketich ◽  
Jay R Corrigan
Keyword(s):  
Smoking Cessation ◽  
Cost Effective ◽  
Willingness To Accept ◽  
Promising Tool ◽  
Quit Smoking ◽  
Self Help ◽  
Program Budget ◽  
Promote Smoking Cessation ◽  
The Cost ◽  
To Receive

Abstract Introduction Incentive-based smoking cessation interventions increase quit rates. The optimal incentive, however, is unknown. We used a willingness-to-accept (WTA) auction where smokers submitted bids indicating the incentive they would need to receive for 1 week of smoking cessation. Aims and Methods Smokers ready to quit (n = 35) participated in a WTA auction, naming the amount they needed to be paid to quit for 1 week. Auction winners received an incentive if they successfully quit. All smokers received nicotine replacement therapy and self-help cessation materials. Carbon monoxide concentrations were monitored remotely three times during the week and in person at the final session. Results Participants who smoked their first cigarette within 5 min of waking demanded a significantly larger incentive in exchange for quitting than those who waited (p < .05). About 45% of auction winners quit smoking compared to 20% of nonwinners (p < .05). The cost per quit was $466 among auction winners compared to $894 among nonwinners. Conclusions WTA auctions may be an effective way to determine the amount smokers need to be paid to quit, which would allow researchers to estimate the most cost-effective payment to offer as part of incentive-based smoking cessation programs. Replication evaluating longer-term cessation outcomes with larger samples is warranted. Implications Incentive-based smoking cessation interventions increase quit rates. However, the optimal incentive is unknown. We found that a WTA auction is a feasible technique for estimating the amount smokers need to be paid to quit. Incentives are a surprisingly cost-effective way to facilitate smoking cessation because they are only paid to those who successfully quit. WTA auctions are a promising tool for determining the incentive that strikes the optimal balance between being large enough to motivate cessation, but small enough that it can be offered to the largest possible population of smokers for a given program budget.

scholarly journals Evaluating the utility of a Smoking Cessation Clinical Pathway tool to promote nicotine prescribing and use among inpatients of a tertiary hospital in Brisbane, Australia

2020 ◽  
Vol 15 (4) ◽  
pp. 214-218
Author(s):  
Keshia R. De Guzman ◽  
Centaine L. Snoswell ◽  
Cheneal Puljevic ◽  
Deepali Gupta
Keyword(s):  
Smoking Cessation ◽  
Clinical Pathway ◽  
Statistical Significance ◽  
Tertiary Hospital ◽  
Quit Smoking ◽  
Pathway Tool ◽  
Chi Squared ◽  
Promote Smoking Cessation ◽  
The Impact ◽  
Hospital Inpatients

AbstractIntroductionDue to the burden of tobacco-related illnesses among hospital inpatients, an evidence-based smoking cessation brief intervention tool was developed for clinicians working in hospitals in Queensland, Australia. The tool, called the Smoking Cessation Clinical Pathway (SCCP), is used by clinicians to support inpatient smoking cessation and manage nicotine withdrawal in hospital.AimsTo investigate the impact of completed SCCP on nicotine replacement therapy (NRT) prescribing and use, and to explore clinician involvement in smoking cessation interventions.MethodsA retrospective review was conducted to examine data regarding SCCP responses and NRT offering, prescribing and use. The statistical significance of the results was assessed using chi-squared and Fisher's exact tests.ResultsPatients with a completed SCCP were more likely to be offered NRT (P < 0.0001). NRT prescribing on admission and discharge was higher in patients with a completed SCCP (P = 0.001 and P = 0.027). Intention to quit had no effect on whether NRT was offered (P = 0.276) and NRT acceptance was higher for patients that intended to quit smoking (P < 0.0001).ConclusionsThe SCCP prompted clinicians to offer NRT to patients, leading to increased NRT prescribing and use. These findings demonstrate the utility of the SCCP to assist clinicians to promote smoking cessation among hospital inpatients.

scholarly journals Smoking cessation counselling practices of family physicians in Jordan

2013 ◽  
Vol 8 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Mousa Abdullah Alomari ◽  
Yousef Saleh Khader ◽  
Ali Shakir Dauod ◽  
Khaled Adel Abu-Hammour ◽  
Adi Harbi Khassawneh ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Smoking Status ◽  
Nicotine Patch ◽  
Family Physicians ◽  
Smoking Cessation Counselling ◽  
Quit Smoking ◽  
Self Help ◽  
Stop Smoking ◽  
Two Factors ◽  
Structured Questionnaire

Objectives: To assess the smoking cessation counselling practices of family physicians in Jordan and assess their perception about the availability of smoking cessation resources and about the barriers to effective smoking cessation practices. Methods: A pre-structured questionnaire was distributed to 124 family physicians practicing in teaching and Ministry of Health medical centres in Jordan. All participants were asked about their smoking cessation practices and about the barriers to effective smoking cessation practices. Results: Only 39.8% reported that they assess the willingness of the patients to quit smoking and 28.2% reported that they discuss counselling options with smokers. Considerably fewer percentages of physicians reported that they prepare their patients for withdrawal symptoms (11.6%), discuss pharmacotherapies (4.9%), describe a nicotine patch (5.0%), and provide patients with self-help materials (6.7%). The two factors cited most often by physicians as significant barriers to smoking cessation counselling were lack or too few available cessation programmes (90.3%) and limited training for physicians on tobacco and cessation interventions (90.3%). Conclusion: While a high proportion of Jordanian family physicians reported that they usually ask patients about smoking status and advise them to stop smoking, they do not regularly provide extensive assistance to help their patients to quit smoking. Lack or too few available cessation programmes and limited training for physicians on smoking cessation interventions were identified as the two major barriers to effective smoking cessation counselling.

scholarly journals Exploring the cost-effectiveness of a Dutch collaborative stepped care intervention for the treatment of depression and/or anxiety when adapted to the Australian context: a model-based cost-utility analysis

2021 ◽  
Vol 30 ◽  
Author(s):  
Y. Y. Lee ◽  
M. G. Harris ◽  
H. A. Whiteford ◽  
S. K. Davidson ◽  
M. L. Chatterton ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Health Outcomes ◽  
Cost Effective ◽  
Stepped Care ◽  
Primary Care Settings ◽  
Self Help ◽  
Australian Context ◽  
Treatment Of Depression ◽  
The Cost

Abstract Aims Depression and anxiety are among the most common mental health conditions treated in primary care. They frequently co-occur and involve recommended treatments that overlap. Evidence from randomised controlled trials (RCTs) shows specific stepped care interventions to be cost-effective in improving symptom remission. However, most RCTs have focused on either depression or anxiety, which limits their generalisability to routine primary care settings. This study aimed to evaluate the cost-effectiveness of a collaborative stepped care (CSC) intervention to treat depression and/or anxiety among adults in Australian primary care settings. Method A quasi-decision tree model was developed to evaluate the cost-effectiveness of a CSC intervention relative to care-as-usual (CAU). The model adapted a CSC intervention described in a previous Dutch RCT to the Australian context. This 8-month, cluster RCT recruited patients with depression and/or anxiety (n = 158) from 30 primary care clinics in the Netherlands. The CSC intervention involved two steps: (1) guided self-help with a nurse at a primary care clinic; and (2) referral to specialised mental healthcare. The cost-effectiveness model adopted a health sector perspective and synthesised data from two main sources: RCT data on intervention pathways, remission probabilities and healthcare service utilisation; and Australia-specific data on demography, epidemiology and unit costs from external sources. Incremental costs and incremental health outcomes were estimated across a 1-year time horizon. Health outcomes were measured as disability-adjusted life years (DALYs) due to remitted cases of depression and/or anxiety. Incremental cost-effectiveness ratios (ICERs) were measured in 2019 Australian dollars (A$) per DALY averted. Uncertainty and sensitivity analyses were performed to test the robustness of cost-effectiveness findings. Result The CSC intervention had a high probability (99.6%) of being cost-effective relative to CAU. The resulting ICER (A$5207/DALY; 95% uncertainty interval: dominant to 25 345) fell below the willingness-to-pay threshold of A$50 000/DALY. ICERs were robust to changes in model parameters and assumptions. Conclusions This study found that a Dutch CSC intervention, with nurse-delivered guided self-help treatment as a first step, could potentially be cost-effective in treating depression and/or anxiety if transferred to the Australian primary care context. However, adaptations may be required to ensure feasibility and acceptability in the Australian healthcare context. In addition, further evidence is needed to verify the real-world cost-effectiveness of the CSC intervention when implemented in routine practice and to evaluate its effectiveness/cost-effectiveness when compared to other viable stepped care interventions for the treatment of depression and/or anxiety.

scholarly journals A smoking cessation program as a resource for bladder cancer patients

2012 ◽  
Vol 6 (5) ◽  
Author(s):  
Daniel Vilensky ◽  
Nathan Lawrentschuk ◽  
Karen Hersey ◽  
Neil E. Fleshner
Keyword(s):  
Bladder Cancer ◽  
Smoking Cessation ◽  
Cost Effective ◽  
Smoking Cessation Program ◽  
Cross Sectional ◽  
Quit Smoking ◽  
Patients At Risk ◽  
Effective Program ◽  
Managing Stress

Background: Continued tobacco use following a bladder cancer(CaB) diagnosis puts patients at risk for other tobacco-associateddiseases and has also been associated with heightened risks oftreatment-related complications, tumour recurrence, morbidity andmortality. Our aim was to determine if patients with CaB who continueto smoke warrant a smoking cessation program as a resourcefor improving their prognosis and long-term health.Methods: A cross-sectional quantitative questionnaire-based studywas performed between January and April 2009. We surveyedpatients with a pathologically confirmed diagnosis of CaB duringtheir cystoscopy appointments at a single cancer centre.Results: One hundred patients completed the survey with 72% ofthem admitting to smoking in their lifetime. A third of respondentssmoked at the time of their diagnosis; 76% of patients who hadbeen active smokers at the time of their diagnosis (n = 33) reportedsmoking at some point thereafter and 58% continued to smoke. Among continued smokers, they were classified in the following categories: 26% were in “precontemplation,” 5% in “contemplation,”16% in “preparation,” and 53% in “action;” 37% of patientswho continued to smoke were interested in a hospital-based smokingcessation program. Overall, 70% reported smoking as a risk factor for a poor CaB prognosis. The two most common barriersto quitting were “trouble managing stress and mood” and “fear ofgaining weight.”Conclusion: Based on the data from our centre, patients with CaBwho continue to smoke after their diagnosis warrant a smoking cessationprogram as a resource for improving prognosis and long-term health. Further research should focus on establishing an efficacious and cost-effective program that provides these patients with theresources they need to quit smoking.

scholarly journals Smoking and Mental Illness: Prevalence, Patterns and Correlates of Smoking and Smoking Cessation among Psychiatric Patients

2020 ◽  
Vol 17 (15) ◽  
pp. 5571
Author(s):  
P. V. Asharani ◽  
Vanessa Ai Ling Seet ◽  
Edimansyah Abdin ◽  
Fiona Devi Siva Kumar ◽  
Peizhi Wang ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Psychiatric Patients ◽  
Descriptive Analysis ◽  
Self Determination ◽  
Policy Changes ◽  
The Past ◽  
Quit Smoking ◽  
Educational Programmes ◽  
Readiness To Quit ◽  
The Cost

This study aims to understand (a) the prevalence and correlates of smoking in a psychiatric population, (b) factors that encourage smoking cessation, and (c) awareness towards cessation programmes. This study captured data (n = 380) through a modified version of the Global Adult Tobacco Survey (GATS). A descriptive analysis of the data was performed. The prevalence of smoking was 39.5% (n = 150) and 52.3% of the smokers were dependent on nicotine. More than half of the smokers had made at least one attempt to quit in the past 12 months and 56% reported no immediate plans to quit smoking. The awareness towards institutional smoking cessation programmes was fair (44%), with 49.7% of smokers having indicated that they were willing to use the service upon referral. Smokers endorsed that increasing the cost of cigarettes, restricting availability, and increasing knowledge of health harms could encourage smoking cessation. Past smokers reported that self-determination/willpower followed by substitution of smoking with other types of foods and drinks were factors that helped them achieve successful cessation. Given that the readiness to quit and awareness towards cessation programmes are low among the smokers, concerted efforts through educational programmes and policy changes are crucial to achieve successful cessation.

Cost-Effectiveness of Pharmacological Interventions for Smoking Cessation: A Literature Review and a Decision Analytic Analysis

2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 26-37 ◽  
Author(s):  
Fujian Song ◽  
James Raftery ◽  
Paul Aveyard ◽  
Chris Hyde ◽  
Pelham Barton ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Decision Analytic Model ◽  
Relative Cost ◽  
Pharmacological Interventions ◽  
Relative Cost Effectiveness ◽  
Life Years ◽  
The Uk ◽  
The Cost

To evaluate the relative cost-effectiveness of nicotine replacement therapy (NRT) and bupropion SR for smoking cessation, the authors reviewed published studies and developed a decision analytic model from the UK National Health Services perspective. Irrespective of the methods or assumptions involved, the results of published studies consistently indicated that NRT for smoking cessation is cost-effective. No published studies have evaluated the relative cost-effectiveness of bupropion SR for smoking cessation. The results of the decision analyses indicated that, as compared with advice or counseling alone, the incremental cost per life-years saved is about $1,441~$3,455 for NRT, $920~$2,150 for bupropion SR, and $1,282~$2,836 for NRT plus bupropion SR. The cost-effectiveness of adding NRT and bupropion SR to advice or counseling for smoking cessation is better than many other accepted health care interventions.

Evaluation of a Web-Based Training in Smoking Cessation Counseling Targeting U.S. Eye-Care Professionals

2017 ◽  
Vol 45 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Taghrid Asfar ◽  
David J. Lee ◽  
Byron L. Lam ◽  
Ann P. Murchison ◽  
Eileen L. Mayro ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Participation Rate ◽  
Care Providers ◽  
Eye Care ◽  
Smoking Cessation Counseling ◽  
Web Based ◽  
Quit Smoking ◽  
Promote Smoking Cessation ◽  
Counseling Practices

Background. Smoking causes blindness-related diseases. Eye-care providers are uniquely positioned to help their patients quit smoking. Aims. Using a pre-/postevaluation design, this study evaluated a web-based training in smoking cessation counseling targeting eye-care providers. Method. The training was developed based on the 3A1R protocol: “Ask about smoking, Advise to quit, Assess willingness to quit, and Refer to tobacco quitlines,” and made available in the form of a web-based video presentation. Providers ( n = 654) at four academic centers were invited to participate. Participants completed pretraining, posttraining, and 3-month follow-up surveys. Main outcomes were self-reported improvement in their motivation, confidence, and counseling practices at 3-month follow-up. Generalized linear mixed models for two time-points (pretraining and 3-month) were conducted for these outcomes. Results. A total of 113 providers (54.0% males) participated in the study (17.7% response rate). At the 3-month evaluation, 9.8% of participants reported improvement in their motivation. With respect to the 3A1R, 8% reported improvement in their confidence for Ask, 15.5% for Advise, 28.6% for Assess, and 37.8% for Refer. Similarly, 25.5% reported improvement in their practices for Ask, 25.5% for Advise, 37.2% for Assess, and 39.4% for Refer to tobacco quitlines ( p < .001 for all except for Refer confidence p = .05). Discussion. Although participation rate was low, the program effectively improved providers’ smoking cessation counseling practices. Conclusions. Including training in smoking cessation counseling in ophthalmology curriculums, and integrating the 3A1R protocol into the electronic medical records systems in eye-care settings, might promote smoking cessation practices in these settings.

Cost-Effectiveness of Behavior Activation Versus Supportive Therapy on Adherence to Eye Exams in Older African Americans With Diabetes

2016 ◽  
Vol 32 (6) ◽  
pp. 661-667 ◽  
Author(s):  
David Winters ◽  
Robin Casten ◽  
Barry Rovner ◽  
Ann Murchison ◽  
Benjamin E. Leiby ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Supportive Therapy ◽  
Cost Effective ◽  
Care Utilization ◽  
Diabetic Patients ◽  
Cost Effectiveness Ratio ◽  
Eye Exams ◽  
The Cost ◽  
To Receive

Although the importance of ophthalmologic screening in diabetic patients is widely recognized by clinicians, the cost-effectiveness of strategies aimed at improving eye care utilization in this population is not well established. A cost-effectiveness analysis was performed comparing behavior activation (BA) to supportive therapy (ST) in activating patients to receive a dilated fundus exam (DFE) and promoting healthy management of diabetes. Two hundred six subjects were randomized to receive either BA or ST between 2009 and 2013. Cost-effectiveness was calculated as incremental cost-effectiveness ratio (ICER) of BA versus ST. Total costs for BA and ST per participant were $259.02 and $216.12, respectively. At the 6-month follow-up, 87.91% of BA subjects received a DFE compared to 34.48% of ST subjects. The ICER for BA versus ST was $80.29/percent increase in DFE rate. In terms of improving DFE rates, BA was found to be more cost-effective than ST.

scholarly journals Smoking cessation support for regular smokers in Hungarian primary care: a nationwide representative cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018932
Author(s):  
Valéria Sipos ◽  
Anita Pálinkás ◽  
Nóra Kovács ◽  
Karola Orsolya Csenteri ◽  
Ferenc Vincze ◽  
...  
Keyword(s):  
Primary Care ◽  
Smoking Cessation ◽  
Nicotine Dependence ◽  
Brief Intervention ◽  
Cross Sectional Study ◽  
Intention To Quit ◽  
Sectional Study ◽  
Cross Sectional ◽  
Quit Smoking ◽  
To Receive

ObjectivesOur study aimed to evaluate the effectiveness of general practitioners’ (GPs’) smoking cessation support (SCS).Study designWe carried out a cross-sectional study between February and April 2016.Setting and participantA sample of 2904 regular smokers aged 18 years or older was selected randomly from 18 general medical practices involved in a national representative, general medical practice-based morbidity monitoring system. The GPs surveyed the selected adults and identified 708 regular smokers.Main outcome measuresMultivariate logistic regression models have been applied to evaluate the determinants (age, gender, education, smoking-related comorbidity, smoking intensity, intention to quit smoking and nicotine dependence) of provision of GP-mediated SCS such as brief intervention, pharmacological and non-pharmacological programmatic support.ResultsAccording to the survey, 24.4% of the adults were regular smokers, 30% of them showed high nicotine dependence and 38.2% willing to quit smoking. Most of the smokers were not participated in SCS by GPs: brief intervention, programmatic non-pharmacological support and pharmacotherapy were provided for 25%, 7% and 2% of smokers, respectively. Low-nicotine-dependence individuals were less (OR 0.30, 95% CI 0.12 to 0.75), patients with intention to quit were more (OR 1.49, 95% CI 1.00 to 2.22) likely to receive a brief intervention. Vocational (OR 1.71, 95% CI 1.13 to 2.59) and high school education (OR 2.08, 95% CI 1.31 to 3.31), chronic obstructive pulmonary disease and cardiovascular diseases (OR 3.34, 95% CI 1.04 to 10.68; OR 3.91, 95% CI 2.33 to 6.54) increased the probability to receive support by GP.ConclusionsAlthough there are differences among smokers’ subgroups, the SCS in Hungarian primary care is generally insufficient, compared with guidelines. Practically, the pharmacological support is not included in Hungarian GPs’ practice. GPs should increase substantially the working time devoted to SCS, and the organisation of primary healthcare should support GPs in improving SCS services.

Delivery of a smoking cessation induction intervention via virtual reality headset during a dental cleaning

2019 ◽  
Author(s):  
Belinda Borrelli ◽  
Nicolle Rueras ◽  
Marianne Jurasic
Keyword(s):  
Smoking Cessation ◽  
Virtual Reality ◽  
Positive Impact ◽  
Care Delivery ◽  
Dental Patients ◽  
Quit Smoking ◽  
Motivation To Quit ◽  
Promote Smoking Cessation ◽  
Patient Provider Communication

Abstract Smokers who are not motivated to quit are less likely to seek help or utilize medication for cessation, so it is critical to proactively reach them to motivate cessation. This study aims to determine feasibility and satisfaction of a smoking cessation induction intervention via a virtual reality (VR) headset worn during dental cleaning. Participants (n = 23) were adult dental patients who were current smokers. During their teeth cleaning, participants wore a VR headset to watch two 5-min smoking cessation videos, one targeted to smokers who are not ready to quit and one for those who are ready to quit. Questionnaires were administered pre- and postappointment, and 1 month later. Interviews were conducted immediately after the appointment. Implementation did not interfere with care delivery, including instrument manipulation and patient–provider communication. On a 1–7 scale, participants indicated satisfaction with the experience (M = 5.4, SD = 1.3), and a positive impact on their willingness to quit (15 of 22 rated ≥ 6) and their knowledge of the effects of smoking on their health (22 of 23 rated as ≥ 6). Participants were highly satisfied with the video content (M = 4.3; 1–5 scale). When prompted, 82.6% were able to recall three things from the video. One month later, four to five participants reported that they quit smoking (varied by measure) and 14 of 23 intentionally quit smoking ≥ 24 hr. Among nonquitters, motivation to quit increased from baseline to follow up. This study may help guide the integration of virtual reality headset use in the dental setting to promote smoking cessation regardless of motivation to quit.

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