Discrete Choice Experiment of Smoking Cessation Behaviour in Japan
Tobacco Control, Vol. 16, pp. 336-343, 2007
Posted: 14 Jun 2007
Background: In spite of gradual increases in tobacco price and the introduction of laws supporting various anti-tobacco measures, the proportion of smokers in Japan's population is still higher than in other developed nations.
Objective: To understand what information and individual characteristics drive smokers to attempt to quit smoking. These determinants will help to realize effective tobacco control policy as a base for understanding cessation behaviour.
Methods: We performed a discrete choice experiment on total of 616 respondents registered a consumer-monitoring investigative company. The respondents were classified into three types based on FTND (Fagerstrom Test for Nicotine Dependence). We deifined respondents scoring a total of zero to three as having low nicotine dependence (L-type), a total of four to six as middle nicotine dependence (M-type) and a total of seven and over as desplaying high nicotine dependence (H-type). After group discussions with clinicians and pre-tests undertaken for smokers in which we asked about factors associated with consideration of smoking cessation, five attributes were identified as the most important factors: the price of cigarettes, fines for smoking in public places, long-term health risks (mortality risk), short-term health risks (risk of upper respiratory infeciton), and health risks to others. For estimation, we used a mixed logit model that is flexible enough to obviate the limitations of conditional logit models by allowing for random taste variation.
Results: The effect of price is greater on smokers with lower nicotine dependence. The price elasticity of probability of continuing to smoke was caluculated: H-type, -0.926; M-type, -1.451; and L-type -1.612. For smokers of moderate and low dependency, short-term health risks and health risks caused by passive smoking hace a strong impact, though the existence of penalties and long-term health risks have little influence on smokers' decisions to quit. For highly dependent smokers, non-price attributes have little impact. Futhermore, the effects of age, gender, and knowledge are also not uniform in accouting for smoking cessation. In H-type smokers, JPY 706 (GBP 3.21) is needed for a 50% quitting rate and JPY 983 (GBP 4.47) for 90%. As for L-type smokers, JPY 467 (GBP 2.12) is needed to reach a 50% of qutting rate and JPY 696 (GBP 3.16) for 90%. Since M-type and L-type smokers account for arround 80% of smokers in total, a rapid increase to JPY 500 (GBP 2.27) would be necessatry to accompish a reduction of smokers smokers by half, which is a policy aim of the Healthy Japan 21 project.
Conclusions: Determinants of smoking cessation vary among levels of nicotine dependency. Therefore, how and what information is provided needs to be carefully considered when counselling smokers to help them quit.
Keywords: smoking cessation, discrete choice experiment, nicotine dependence
JEL Classification: I12, I18
Suggested Citation: Suggested Citation