title: Are there income differences in the impact of a national reimbursement policy for smoking cessation treatment and accompanying media attention? Findings from the International Tobacco Control (ITC) Netherlands Survey.
abstract: BACKGROUND
  This study examined possible income differences in the impact of a national reimbursement policy for smoking cessation treatment and accompanying media attention in the Netherlands in 2011.
  
  
  METHODS
  We used three waves of the International Tobacco Control (ITC) Netherlands Survey, a nationally representative longitudinal sample of smokers aged 15 years and older (n=1912). The main analyses tested trends and income differences in outcome measures (smokers' quit attempt rates, use of behavioral counseling, use of cessation medications, and quit success) and awareness variables (awareness of reimbursement possibilities, the media campaign, medications advertisements and other media attention) with generalized estimating equations analyses.
  
  
  RESULTS
  In the first half of 2011, there was a significant increase in quit attempts (odds ratio (OR)=2.02, p<0.001) and quit success (OR=1.47, p<0.001). Use of counseling and medications remained stable at 3% of all smokers in this period. Awareness of reimbursement possibilities increased from 11% to 42% (OR=6.38, p<0.001). Only awareness of the media campaign was associated with more quit attempts at the follow-up survey (OR=1.95, p<0.001). Results were not different according to smokers' income level.
  
  
  CONCLUSIONS
  The Dutch reimbursement policy with accompanying media attention was followed by an increase in quit attempts and quit success, but use of cessation treatment remained stable. The impact of the policy and media attention did not seem to have decreased or increased socioeconomic inequalities in quit attempts, use of cessation treatment, or quit success.
authors.affiliation: Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands; Alliance Smokefree Holland, The Hague, the Netherlands. Electronic address: Gera.Nagelhout@alliantieNR.nl.
authors.forename: Gera E
authors.initials: GE
authors.lastname: Nagelhout
authors.affiliation: Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands.
authors.forename: Karin
authors.initials: K
authors.lastname: Hummel
authors.affiliation: Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands; Alliance Smokefree Holland, The Hague, the Netherlands.
authors.forename: Marc C
authors.initials: MC
authors.lastname: Willemsen
authors.affiliation: Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, United States.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Siahpush
authors.affiliation: Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands.
authors.forename: Anton E
authors.initials: AE
authors.lastname: Kunst
authors.affiliation: Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, the Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: de Vries
authors.affiliation: Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada; Ontario Institute for Cancer Research, Toronto, Ontario, Canada.
authors.forename: Geoffrey T
authors.initials: GT
authors.lastname: Fong
authors.affiliation: Department of Communication, University of Amsterdam (ASCoR), Amsterdam, the Netherlands; Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, the Netherlands.
authors.forename: Bas
authors.initials: B
authors.lastname: van den Putte
mesh_terms: D000293:Adolescent; D000328:Adult; D003146:Communications Media; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000191:economics* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012907:Smoking / Q000188:drug therapy / Q000628:therapy*; D016540:Smoking Cessation / Q000191:economics*; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Netherlands; Public policy; Reimbursement; Smoking cessation; Social class