Healthcare financing systems for increasing the use of tobacco dependence treatment

Brand, Floor van den; Nagelhout, Gera E.; Reda, Ayalu A.; Winkens, Björn; Evers, Silvia M. A. A.; Kotz, Daniel; Schayck, Onno Cp van

doi:10.1002/14651858.cd004305.pub5

Cited by 102 publications

(50 citation statements)

References 99 publications

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“…Previous research has also found that covering the cost of smoking cessation therapy increases its use. 24 Finally, the interviewed employees appreciated the employers’ initiative to offer a smoking cessation training programme, because it was seen as an expression of caring for the employees’ health. Employees viewed the training programme as an opportunity and considered it an appropriate addition to the current company health plan.…”

Section: Discussionmentioning

confidence: 99%

‘Secretly, it’s a competition’: a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives

et al. 2018

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ObjectivesSmoking cessation programmes in combination with financial incentives have shown to increase quit rates in smokers, but it is not clear which elements of this intervention help smokers to succeed in their quit attempt. The aim of this study was to explore the view of successful and unsuccessful quitters about which factors had affected their ability to quit smoking.DesignSemistructured qualitative interviews were conducted and analysed using the Framework method.SettingInterviews were conducted in 2017 with employees from nine different Dutch companies.Participants24 successful and unsuccessful quitters from the intervention group of a cluster randomised controlled trial (RCT) who participated in a workplace smoking cessation group training programme in which smoking abstinence was rewarded with financial incentives.ResultsThemes that emerged were the workplace setting, quitting with colleagues, motivation, family support, strategies and the financial incentives. The interviewees reported that the smoking cessation programme was appreciated in general, was convenient, lowered the threshold to sign up, stimulated peer support and competition and provided strategies to resist smoking. Personal motivation and a mind set to never smoke again were regarded as important factors for quit success. The financial incentives were not considered as a main motivator to quit smoking, which contradicts the results from the RCT. The financial incentives were considered as more attractive to smokers with a low income.ConclusionsAccording to participants, contributors to quitting smoking were the workplace cessation programme, personal motivation and peer support, but not the incentives. More research is needed on the contradiction between the perceived effects of financial incentives on quit success and the actual difference in quit rates.Trial registration numberNTR5657.

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Section: Discussionmentioning

confidence: 99%

‘Secretly, it’s a competition’: a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives

et al. 2018

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“… 9 Full financial coverage of the costs of smoking cessation treatment had an effect size of 1.77 on abstinence when compared with no incentive in a healthcare setting. 12 We conservatively estimate an effect size of 1.25 for a small financial incentive to use smoking cessation services combined with CBR in a community-based trial. Validated abstinence at 6 months is therefore expected to be 11.0% in the intervention group and 5% in the control group.…”

Section: Methods and Analysismentioning

confidence: 99%

“… 11 12 Financial incentives increased service enrolment 13 and use of tobacco-dependent treatment (medications, nicotine replacement therapies and counselling) 14–17 and service providers have offered them effective treatments to increase abstinence. 12 Our previous trial revealed that time constraints and low interest are the main barriers to use smoking cessation services. 9 Although smoking cessation services in Hong Kong are mostly free or charge minimal fees, proactive models that offer referral assistance with a small financial incentive may increase smokers’ motivation to overcome perceived barriers.…”

Section: Introductionmentioning

confidence: 99%

Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

et al. 2020

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IntroductionEvidence-based smoking cessation treatments are effective but underutilised, accentuating the need for novel approaches to increase use. This trial investigates the effects of active referral combined with a financial incentive to use smoking cessation services on smoking abstinence among community smokers.Methods and analysisThis ongoing study is a two-arm, assessor-blinded, pragmatic, cluster randomised controlled trial with follow‐ups at 1, 2, 3 and 6 months after randomisation. We aim to enrol 1134 daily smokers from 70 community sites (clusters) in Hong Kong. All participants receive Ask, Warn, Advise, Refer, Do-it-again (AWARD) guided advice and a self-help booklet at baseline. Additionally, participants in the intervention group receive an offer of referral to smoking cessation services at baseline and a small financial incentive (HK$300≈US$38) contingent on using any of such services within 3 months. The primary outcomes are bioverified abstinence (exhaled carbon monoxide <4 ppm and salivary cotinine <10 ng/mL) at 3 and 6 months. Secondary outcomes include self-reported 7-day point prevalence of abstinence, smoking reduction rate, quit attempts and the use of smoking cessation services at 3 and 6 months. Intention-to-treat approach and regression models will be used in primary analyses.Ethics and disseminationThis protocol has been approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (IRB reference number: UW 18-318). The results of this trial will be submitted for publication in peer-reviewed journals, and the key findings will be presented at national and international conferences.Trial registration numberClinicalTrials.gov Registry NCT03565796.

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“…89 The provision of prompts and reminders, 90 decision support tools embedded into medical software, 91 the establishment of referral services and pathways, 92,93 and systems of financial reimbursement of care were effective in improving the management of tobacco addiction by health services. 94,95 Such strategies are also likely to be required to support improvements in the delivery of health services to prevent and treat obesity. World Obesity, a federation of member organisations in more than 50 countries, offers e-learning platforms, internationally accredited certification in obesity management, and a range of resources to treat patients with obesity.…”

Section: Provider Capacity and Implementation Supportsmentioning

confidence: 99%

The challenge for global health systems in preventing and managing obesity

et al. 2019

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Summary Few health crises have been as predictable as the unfolding obesity pandemic. Clinical and public health services remain the front line of efforts to reduce the burden of obesity. While a range of clinical practice guidelines exist, the need for clinical interventions exceeds the capacity of health systems to provide care for those affected with obesity, and routine clinical practices fall far short of guidelines recommendations even in high‐income countries. In this manuscript, we discuss current recommendations regarding obesity interventions and key challenges facing global health systems in managing the health needs of people with obesity. Improving the provision of obesity‐related health care is a considerable challenge and will require changing existing perceptions of obesity as a matter of personal failure to its recognition as a disease, innovative approaches to health system reform, clinician capacity building and implementation support, a focus on prevention, and wise resource allocation. Leadership from governments, the medical profession, and patient and community groups to address the issues raised in this manuscript is urgently needed to address the growing health concern.

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Healthcare financing systems for increasing the use of tobacco dependence treatment

Cited by 102 publications

References 99 publications

‘Secretly, it’s a competition’: a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives

‘Secretly, it’s a competition’: a qualitative study investigating what helped employees quit smoking during a workplace smoking cessation group training programme with incentives

Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

The challenge for global health systems in preventing and managing obesity

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