title: A randomized controlled trial to assess the effects of reimbursing the costs of smoking cessation therapy on sustained abstinence.
abstract: OBJECTIVE
  We studied whether reimbursement for smoking cessation treatment (SCT) can increase prolonged abstinence from smoking up to 2 years. SETTING, PARTICIPANTS AND DESIGN: From the general population, we recruited smokers and assigned them randomly to a control group (n = 634) or an intervention group (n = 632). For 6 months, participants in the intervention group could apply for reimbursement and received information regarding the reimbursed SCT. Participants in the control group received no reimbursement or information.
  
  
  METHODS
  In this follow-up study, prolonged abstinence from smoking was defined as reported being abstinent from at least 7 days before the end of reimbursement until the follow-up assessment 6 months or 2 years later.
  
  
  RESULTS
  At 6 months after the end of reimbursement, 18 participants in the control group (2.8%) and 35 participants (5.5%) in the intervention group reported sustained abstinence for at least 6 months [odds ratio (OR) = 2.0, 95% confidence interval (CI) 1.1-3.6]. Two years after the reimbursement period, 10 participants in the control group (1.6%) and 27 participants in the intervention group (4.3%) still reported sustained abstinence (OR = 4.1, 95% CI 1.7-10.2). The overall effectiveness of SCT increased with reimbursement and was 22% in the intervention group and 8% in the control group after 2 years.
  
  
  CONCLUSIONS
  Reimbursement may be an effective strategy to increase the prolonged abstinence rate even after 2 years.
authors.affiliation: Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands. janneke.kaper@hag.unimaas.nl
authors.forename: J
authors.initials: J
authors.lastname: Kaper
authors.forename: E J
authors.initials: EJ
authors.lastname: Wagena
authors.forename: M C
authors.initials: MC
authors.lastname: Willemsen
authors.forename: C P
authors.initials: CP
authors.lastname: van Schayck
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D012907:Smoking / Q000191:economics*; D016540:Smoking Cessation / Q000191:economics* / Q000379:methods; D000074606:Smoking Prevention; D013997:Time Factors; D016896:Treatment Outcome