Quit smoking advice from health professionals in Taiwan: the role of funding policy and smoker socioeconomic status

Abstract

ObjectivesIn 2002, Taiwan launched a program to encourage doctors to provide brief cessation counselling to their patients during routine outpatient visits. This study is to compare and analyse the annual prevalence rate of receiving advice to quit smoking from health professionals before (2004) and after (2005, 2006) the increase in funding and the withdrawal of additional funding (2007).MethodsWe analysed pooled data from 2004 to 2007 Taiwan Adult Tobacco Survey, an annual random digit dialling telephone survey, to estimate the prevalence of receiving quit advice among ever smokers across these years. Smoking characteristics and the socioeconomic factors of smokers associated with receipt of advice to quit smoking were also examined.ResultsThe prevalence rate of receiving quit advice increased from 21.1% in 2004 to 28.2% in 2006, and then decreased slightly to 27.6% in 2007 after the funds were cut. Multivariate analyses results indicated that increasing financing for smoking cessation services in 2005, being male, older, a daily cigarette user, having previously attempted to quit, perceiving oneself as having poor health and being aware of the benefits of smoking cessation services were significantly positively associated with receiving quit advice from health professionals. In contrast, smokers who were younger, female and occasional cigarette users were less likely to receive quit advice. Also, smokers with socioeconomic disadvantages were not less likely to receive quit advice.ConclusionsDuring the period of increased funding for smoking cessation services, the rates of receiving quit advice increased among all smokers and across different socioeconomic groups.

The impact of smoke-free legislation on reducing exposure to secondhand smoke: differences across gender and socioeconomic groups

“…In each sampled household, a representative adult was randomly selected. The yearly response rates were about 60% 15. From year 2005 to 2011, the annual sample of survey was about 16 200 to 16 900 (see table 1).…”

Effectiveness of providing financial incentives to healthcare professionals for smoking cessation activities: systematic review

“…Roski et al 36 and Coleman et al 32 found no difference between control and financial intervention groups. Otherwise the improvement ranged from an increase of 2.25% in Chang et al 's patient database study (0.50% in 2004, 2.75% in 2005, OR 5.05, 95% CI 4.98 to 5.12)35 to 5.7% in the study by Chang et al using the Taiwan Tobacco survey (21.1% in 2004, 26.8% in 2005, adjusted OR 1.26, 95% CI 1.11 to 1.42) 31…”

“…They included two randomised controlled trials,19 30 one cluster randomised controlled trial,36 two serial cross-sectional studies comparing health maintenance organisations (HMO)s with and without financial incentives for smoking cessation activities,33 34 and three before and after designs 31 32 35. The designs of the before and after studies did not take account of secular changes in smoking prevalence.…”

“…Four studies examined the effect of financial incentives on individual doctors 19 30 31 35. In one study it was unclear whether the incentive payment was to individual doctors or to groups of doctors in the organisation 34.…”

“…For Roski et al 36 the incentive was US$5000–US$10 000 if ≥75% of patients at participating clinics had their smoking status recorded and if ≥65% of smokers had been given smoking cessation advice. For the studies by Chang et al 31 35 the bonus was paid per smoker advised and was of the order of US$24. In two of the papers the payment was paid per smoker who stopped smoking, varying from US$2432 to US$152 19.…”