scholarly journals Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment

2018 ◽  
Vol 28 (2) ◽  
pp. 168-175 ◽  
Author(s):  
John Buckell ◽  
Joachim Marti ◽  
Jody L Sindelar

ObjectivesTo provide the policy-relevant estimates of impacts of alternative flavour bans on preferences and demand for cigarettes and e-cigarettes in adult smokers and recent quitters.MethodsA best–best discrete choice experiment (DCE) is used to elicit smokers’ and recent quitters’ preferences for flavours, price, health impact and nicotine level in cigarettes and e-cigarettes. Choice of tobacco products and an opt-out option were examined. An efficient design yielded 36 choice sets. Exploded logit choice models were estimated. Flavour bans are modelled by restricting flavour coefficients in the estimated model.Setting and participantsA sample of 2031 adult smokers and recent quitters was recruited to complete an online survey and DCE.ResultsCurrent smokers and recent quitters, on average, prefer cigarettes and menthol cigarettes over flavoured e-cigarettes. However, there is substantial preference heterogeneity by younger adults (ages 18–25), race/ethnicity and respondents with higher education. Our predictions suggest that a ban on menthol cigarettes would produce the greatest reduction in the choice of cigarettes (−5.2%), but with an accompanying increase in e-cigarettes use (3.8%). In contrast, banning flavours in e-cigarettes, while allowing menthol in cigarettes would result in the greatest increase in the selection of cigarettes (8.3%), and a decline in the use of e-cigarettes (−11.1%). A ban on all flavours, but tobacco in both products would increase ‘opting-out’ the most (5.2%) but would also increase choice of cigarettes (2.7%) and decrease choice of e-cigarettes (−7.9%).ConclusionsA ban on flavoured e-cigarettes alone would likely increase the choice of cigarettes in smokers, arguably the more harmful way of obtaining nicotine, whereas a ban on menthol cigarettes alone would likely be more effective in reducing the choice of cigarettes. A ban on all flavours in both products would likely reduce the smoking/vaping rates, but the use of cigarettes would be higher than in the status quo. Policy-makers should use these results to guide the choice of flavour bans in light of their stance on the potential health impacts both products.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ping Liu ◽  
Shimeng Liu ◽  
Tiantian Gong ◽  
Quan Li ◽  
Gang Chen ◽  
...  

Abstract Background Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. Methods A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. Results In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. Conclusion The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e043477
Author(s):  
Mesfin G Genie ◽  
Luis Enrique Loría-Rebolledo ◽  
Shantini Paranjothy ◽  
Daniel Powell ◽  
Mandy Ryan ◽  
...  

IntroductionSocial distancing and lockdown measures are among the main government responses to the COVID-19 pandemic. These measures aim to limit the COVID-19 infection rate and reduce the mortality rate of COVID-19. Given we are likely to see local lockdowns until a treatment or vaccine for COVID-19 is available, and their effectiveness depends on public acceptability, it is important to understand public preference for government responses.Methods and analysisUsing a discrete choice experiment (DCE), this study will investigate the public’s preferences for pandemic responses in the UK. Attributes (and levels) are based on: (1) lockdown measures described in policy documents; (2) literature on preferences for lockdown measures and (3) a social media analysis. Attributes include: lockdown type; lockdown length; postponement of usual non-urgent medical care; number of excess deaths; number of infections; impact on household spending and job losses. We will prepilot the DCE using virtual think aloud interviews with respondents recruited via Facebook. We will collect preference data using an online survey of 4000 individuals from across the four UK countries (1000 per country). We will estimate the relative importance of the attributes, and the trade-offs individuals are willing to make between attributes. We will test if respondents’ preferences differ based on moral attitudes (using the Moral Foundation Questionnaire), socioeconomic circumstances (age, education, economic insecurity, health status), country of residence and experience of COVID-19.Ethics and disseminationThe University of Aberdeen’s College Ethics Research Board (CERB) has approved the study (reference: CERB/2020/6/1974). We will seek CERB approval for major changes from the developmental and pilot work. Peer-reviewed papers will be submitted, and results will be presented at public health and health economic conferences nationally and internationally. A lay summary will be published on the Health Economics Research Unit blog.


2021 ◽  
Author(s):  
Dorothy Szinay ◽  
Rory Cameron ◽  
Felix Naughton ◽  
Jennifer A. Whitty ◽  
Jamie Brown ◽  
...  

UNSTRUCTURED Understanding the preferences of potential users of digital health products is beneficial for digital health policy and planning. Stated preference methods could help elicit individuals’ preferences in the absence of observational data. A discrete choice experiment (DCE) is a commonly used stated preference method; a quantitative methodology that argues that individuals make trade-offs when engaging in a decision by choosing an alternative of a product or service that offers the greatest utility, or benefit. This methodology is widely used in health economics in situations where revealed preferences are difficult to collect but is much less used in the field of digital health. This article outlines the stages involved in developing a discrete choice experiment. As a case study, it uses the application of a DCE for revealing preferences in targeting the uptake of smoking cessation apps. It describes the establishment of attributes, the construction of choice tasks of two or more alternatives, and the development of the experimental design. This tutorial offers a guide for researchers with no prior knowledge of this research technique.


2020 ◽  
Author(s):  
Michael Danne ◽  
Saramena Meier-Sauthoff ◽  
Oliver Musshoff

Abstract Background: In order to achieve an environmentally friendly and sustainable energy supply, it is necessary that this goal is supported by society. In different countries worldwide it has been shown that one way consumers want to support the energy transition is by switching to green electricity. However, few people make the leap from their intention to a buying decision. This study explores parameters that influence whether German consumers would hypothetically decide to switch to a green electricity tariff.Methods: A quota-representative online survey including a discrete choice experiment with 371 German private households was conducted in 2016. For the econometric analysis, a generalized multinomial logit model in willingness to pay space was employed, enabling the estimation of WTP values to be as realistic as possible.Results: The results show that consumers’ decision whether or not to make the switch to green energy is mainly influenced by the source of green energy, whether a person can outsource the switching process, and a person’s attitude towards the renewable energy sources levy that currently exist in Germany.Conclusions: The findings indicate that politics should focus on supporting wind and solar energy as German consumers prefer these sources over biogas. As the results suggest, the EEG levy is a reason why consumers have lower WTP for switching to a green tariff. Therefore a switching bonus with a specifically “framed” bonus in the amount of the current EEG levy could be a promising strategy for the increase of green energy tariff acceptance. Furthermore, attention should be given to psychological and behavioral aspects, as the results indicate that these factors influence the consumer’s choice for a green electricity tariff.JEL classifications: C23, C25, Q40, Q50


BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006661 ◽  
Author(s):  
Shu Fen Wong ◽  
Richard Norman ◽  
Trisha L Dunning ◽  
David M Ashley ◽  
Paula K Lorgelly

IntroductionMedical decision-making in oncology is a complicated process and to date there are few studies examining how patients with cancer make choices with respect to different features of their care. It is also unknown whether patient choices vary by geographical location and how location could account for observed rural and metropolitan cancer differences. This paper describes an ongoing study that aims to (1) examine patient and healthcare-related factors that influence choices of patients with cancer; (2) measure and quantify preferences of patients with cancer towards cancer care using a discrete choice experiment (DCE) and (3) explore preference heterogeneity between metropolitan and rural locations.Methods and analysisA DCE is being conducted to understand how patients with cancer choose between two clinical scenarios accounting for different patient and healthcare-related factors (and levels). Preliminary qualitative research was undertaken to guide the development of an appropriate DCE design including characteristics that are important and relevant to patients with cancer. A fractional factorial design using the D-efficiency criteria was used to estimate interactions among attributes. Multinomial logistic regression will be used for the primary DCE analysis and to control for sociodemographic and clinical characteristics.Ethics and disseminationThe Barwon Health Human Research Ethics Committee approved the study. Findings from the study will be presented in national/international conferences and peer-reviewed journals. Our results will form the basis of a feasibility study to inform the development of a larger scale study into preferences of patients with cancer and their association with cancer outcomes.


2017 ◽  
Vol 67 (659) ◽  
pp. e388-e395 ◽  
Author(s):  
Katriina L Whitaker ◽  
Alex Ghanouni ◽  
Yin Zhou ◽  
Georgios Lyratzopoulos ◽  
Stephen Morris

BackgroundContacting a doctor for advice when experiencing a potential cancer symptom is an important step in early diagnosis, but barriers to consultation are commonly reported. Understanding barriers to consulting in primary care within the cancer context provides opportunities to improve earlier diagnosis of cancerAimTo investigate patients’ GP consultation preferences when presented with a potential cancer symptom, and to describe whether these preferences are mediated by variable levels of cancer risk.Design and settingA UK-wide online survey of adults ≥50 years old, using quota sampling to reflect general population characteristics.MethodA discrete choice experiment examined participants’ preferences for primary care consultation for three cancer symptom scenarios: risk level not mentioned, risk designated as ‘low’, or risk designated as ‘high’. Scenarios based on length of consultation, time to getting an appointment, convenience, choice of GP, and GP listening skills were presented in a self-completed online questionnaire.ResultsA total of 9616 observations were obtained from 601 participants. Participants expressed preferences for doctors with better listening skills, the ability to see a GP of their choice, and shorter waiting times. These findings were the same across risk conditions and demographic groups. Participants were willing to wait an extra 3.5 weeks for an appointment with a doctor with good/very good listening skills (versus very poor listening skills) and an extra week for an appointment with a GP of their choice (versus any GP).ConclusionPatient decisions about help seeking seem to be particularly influenced by the anticipated listening skills of doctors. Improving doctors’ communication skills may in the longer term encourage people to seek prompt medical help when they experience a cancer symptom.


2019 ◽  
Author(s):  
peipei Fu ◽  
Yi Wang ◽  
Shimeng Liu ◽  
Jiajia Li ◽  
qiufeng Gao ◽  
...  

Abstract Background: Preliminary evaluations have found that family doctor contract service has significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found uptake and utilization of these services to be limited. This study aimed to investigate rural resident preferences for FDCS from the public perspective in China. Methods : A discrete choice experiment (DCE) was performed to elicit respondent preferences towards FDCS among rural residents in China. Attributes and levels were established based on literature review and qualitative methods. Five attributes consisted of cost, medicine availability, reimbursement rate, competence of the family doctor, and attitude of the family doctor were evaluated using mixed logit model. Results: A total number of 609 residents were included in the main DCE analysis. Respondents valued high competence (coefficient 2.44, [SE 0.13]) and good attitude (coefficient 1.42, [SE 0.09]) of the family doctor most. Cost was negatively valued (coefficient -0.01, [SE 0.01]) as expected. The preference heterogeneity analysis was conducted after adjusting the interaction terms, we found that rural residents with lower educational attainment prefer good attitude than those with higher educational attainment counterparts. The estimated willingness to pay (WTP) for “high” relative to “low” competence was 441.13 RMB/year and WTP for a provider with a “good” relative to a “poor” attitude was 255.77 RMB/year. Conclusion: This present study suggested priorities should be given to strengthen and improve the quality of primary health care including family doctors’ competence and attitudes so as to increase the uptake of signing FDCS. The contract service package including annual cost, insurance reimbursement rate and individualized services should be redesigned and become congruent with residents with different health status and their stated preferences.


2019 ◽  
Vol 39 (4) ◽  
pp. 474-485 ◽  
Author(s):  
Jason J. Ong ◽  
Nyasule Neke ◽  
Mwita Wambura ◽  
Evodius Kuringe ◽  
Jonathan M. Grund ◽  
...  

Voluntary medical male circumcision (VMMC) is effective in reducing the risk of human immunodeficiency virus (HIV). However, countries like Tanzania have high HIV prevalence but low uptake of VMMC. We conducted a discrete-choice experiment to evaluate the preferences for VMMC service attributes in a random sample of 325 men aged 18 years or older from the general population in 2 Tanzanian districts, Njombe and Tabora. We examined the preference for financial incentives in the form of a lottery ticket or receiving a guaranteed transport voucher for attendance at a VMMC service. We created a random-parameters logit model to account for individual preference heterogeneity and a latent class analysis model for identifying groups of men with similar preferences to test the hypothesis that men who reported sexually risky behaviors (i.e., multiple partners and any condomless sex in the past 12 months) may have a preference for participation in a lottery-based incentive. Most men preferred a transport voucher (84%) over a lottery ticket. We also found that offering a lottery-based financial incentive may not differentially attract those with greater sexual risk. Our study highlights the importance of gathering local data to understand preference heterogeneity, particularly regarding assumptions around risk behaviors.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. Danne ◽  
S. Meier-Sauthoff ◽  
O. Musshoff

Abstract Background In order to achieve an environmentally friendly and sustainable energy supply, it is necessary that this goal is supported by society. In different countries worldwide it has been shown that one way consumers want to support the energy transition is by switching to green electricity. However, few people make the leap from their intention to a buying decision. This study explores parameters that influence whether German consumers would hypothetically decide to switch to a green electricity tariff. Methods A quota-representative online survey including a discrete choice experiment with 371 German private households was conducted in 2016. For the econometric analysis, a generalized multinomial logit model in willingness-to-pay space was employed, enabling the estimation of WTP values to be as realistic as possible. Results The results show that consumers’ decision whether or not to make the switch to green energy is mainly influenced by the source of green energy, whether a person can outsource the switching process, and a person’s attitude towards the renewable energy sources levy that currently exist in Germany. Conclusions The findings indicate that politics should focus on supporting wind and solar energy as German consumers prefer these sources over biogas. As the results suggest, the EEG levy is a reason why consumers have lower WTP for switching to a green tariff. Therefore, a switching bonus with a specifically “framed” bonus in the amount of the current EEG levy could be a promising strategy for the increase of green energy tariff acceptance. Furthermore, attention should be given to psychological and behavioral aspects, as the results indicate that these factors influence the consumer’s choice for a green electricity tariff.


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