Reimbursement for smoking cessation treatment may double the abstinence rate: results of a randomized trial.
OBJECTIVE
Few smokers who try to quit smoking use smoking cessation treatment (SCT), and cost could be one factor. To increase the number of successful quitters, we assessed whether financial reimbursement for SCT would encourage the use of SCT and would as a result increase the 6-month point abstinence rate.


METHODS
We recruited smokers aged over 18 years from a random sample of Dutch inhabitants insured by one health insurance company. INTERVENTION AND DESIGN: The smokers were assigned randomly to the intervention group (n = 632) or control group (n = 634). Respondents in the intervention group received an offer of reimbursement for nicotine replacement therapy, bupropion and behavioural counselling. No reimbursement was offered to the control group. To preclude a change of behaviour due to disappointment in the control group, we used a randomized consent design.


RESULTS
During the reimbursement period, 10.8% smokers in the intervention group reported having used SCT compared with 4.1% in the control group (OR = 2.9, 95% CI 1.8-4.7). In the intervention group, 23.4% smokers tried to stop compared with 20.8% in the control group (OR = 1.2, 95% CI 0.9-2.4). After 6 months, the biochemically validated 7-day point prevalence abstinence rate was 5.5% in the intervention group and 2.8% in the control group (OR = 2.3, 95% CI 1.2-4.1).


CONCLUSIONS
Reimbursement for SCT seems efficacious in increasing the use of SCT and may double the number of successful quitters.
Kaper
J
J
Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, 3200 MD Maastricht, the Netherlands. janneke.kaper@hag.unimaas.nl
Wagena
E J
EJ
Willemsen
M C
MC
van Schayck
C P
CP
D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009426:Netherlands; D012051:Reimbursement Mechanisms / Q000191:economics / Q000706:statistics & numerical data*; D016540:Smoking Cessation / Q000191:economics*; D011795:Surveys and Questionnaires