Kaper J, Wagena E J, Willemsen M C, van Schayck C P
Department of General Practice, Care and Public Health Research Institute (CAPHRI), Maastricht University, 3200 MD Maastricht, the Netherlands.
Addiction. 2005 Jul;100(7):1012-20. doi: 10.1111/j.1360-0443.2005.01097.x.
Few smokers who try to quit smoking use smoking cessation treatment (SCT), and cost could be one factor. To increase the number of successful quitters, we assessed whether financial reimbursement for SCT would encourage the use of SCT and would as a result increase the 6-month point abstinence rate.
We recruited smokers aged over 18 years from a random sample of Dutch inhabitants insured by one health insurance company. INTERVENTION AND DESIGN: The smokers were assigned randomly to the intervention group (n = 632) or control group (n = 634). Respondents in the intervention group received an offer of reimbursement for nicotine replacement therapy, bupropion and behavioural counselling. No reimbursement was offered to the control group. To preclude a change of behaviour due to disappointment in the control group, we used a randomized consent design.
During the reimbursement period, 10.8% smokers in the intervention group reported having used SCT compared with 4.1% in the control group (OR = 2.9, 95% CI 1.8-4.7). In the intervention group, 23.4% smokers tried to stop compared with 20.8% in the control group (OR = 1.2, 95% CI 0.9-2.4). After 6 months, the biochemically validated 7-day point prevalence abstinence rate was 5.5% in the intervention group and 2.8% in the control group (OR = 2.3, 95% CI 1.2-4.1).
Reimbursement for SCT seems efficacious in increasing the use of SCT and may double the number of successful quitters.
尝试戒烟的吸烟者中很少有人使用戒烟治疗（SCT），费用可能是一个因素。为了增加成功戒烟者的数量，我们评估了SCT的费用报销是否会鼓励人们使用SCT，从而提高6个月时的戒烟率。
我们从一家健康保险公司承保的荷兰居民随机样本中招募了18岁以上的吸烟者。
吸烟者被随机分配到干预组（n = 632）或对照组（n = 634）。干预组的受访者可获得尼古丁替代疗法、安非他酮和行为咨询的费用报销。对照组则不提供报销。为了避免对照组因失望而改变行为，我们采用了随机同意设计。
在报销期间，干预组中有10.8%的吸烟者报告使用了SCT，而对照组为4.1%（比值比=2.9，95%置信区间1.8 - 4.7）。干预组中有23.4%的吸烟者尝试戒烟，而对照组为20.8%（比值比=1.2，95%置信区间0.9 - 2.4）。6个月后，经生化验证的7天点患病率戒烟率在干预组为5.5%，在对照组为2.8%（比值比=2.3，95%置信区间1.2 - 4.1）。
SCT费用报销似乎能有效增加SCT的使用，并可能使成功戒烟者的数量翻倍。
