Sanders Anne E, Slade Gary D, Ranney Leah M, Jones Laura K, Goldstein Adam O
Department of Dental Ecology, School of Dentistry, University of North Carolina at Chapel Hill, Koury Oral Health Sciences Building, CB# 7450, Chapel Hill, NC 27599-7450, USA.
N C Med J. 2012 Nov-Dec;73(6):439-47.
After 40 years of continuous decline, smoking rates in the United States have stabilized signaling a challenge for tobacco control. Renewed decline may be guided by public opinion where support for tobacco control is strong. This study sought the public's preferences about tobacco control strategies.
This contingent valuation study investigated whether the public's valuations of 2 tobacco control policies outweighed their implementation costs. In a hypothetical referendum, a representative sample of North Carolinians aged 45-64 years (n = 644) was asked to indicate whether they would prefer a policy that would halve the youth smoking rate or one that would reduce smoking-related deaths by 10%, and to indicate how much additional tax they would be willing to pay to implement their preferred policy. This willingness-to-pay value formed the perceived "benefit" component in a cost-benefit analysis. Costs to halve youth smoking were calculated from evidence about the resources required to increase the state tobacco excise tax. Costs to reduce tobacco-related deaths were based on evidence about the resources required for a counseling quitline offering free nicotine replacement therapy.
The majority (85%) of respondents voted to halve the youth smoking rate. The mean maximum amount per person that voters were willing to pay in 1 year to do that was $14.90 (95% CI, $10.10-$19.60), and the maximum amount per person they were willing to pay in 1 year to reduce smoking-related deaths was $13.70 (95% CI, $2.10-$25.40). When aggregated to the North Carolina population aged 45-64 years (N = 2,400,144), the perceived benefit of halving youth smoking was $35.8 million. Implementation of a program to achieve this outcome would cost $109.8 million. Aggregating to the same population, the perceived benefit of a 10% reduction in tobacco-related deaths was $32.9 million, an amount that exceeds the $12.8 million estimated cost of achieving the outcome.
A counseling quitline with free nicotine replacement therapy would achieve a positive net benefit.
在美国，吸烟率在持续下降40年后趋于稳定，这对烟草控制构成了挑战。若公众对烟草控制的支持力度大，吸烟率可能会再度下降。本研究旨在探寻公众对烟草控制策略的偏好。
这项条件估值研究调查了公众对两项烟草控制政策的估值是否超过其实施成本。在一次假设的全民公投中，对年龄在45 - 64岁的北卡罗来纳州代表性样本（n = 644），询问他们更倾向于一项能使青少年吸烟率减半的政策，还是一项能将与吸烟相关的死亡人数减少10%的政策，并表明他们愿意为实施其偏好的政策额外支付多少税款。这一支付意愿值构成了成本效益分析中感知到的“效益”部分。使青少年吸烟率减半的成本是根据提高该州烟草消费税所需资源的证据计算得出的。减少与烟草相关死亡人数的成本是基于提供免费尼古丁替代疗法的咨询戒烟热线所需资源的证据。
大多数（85%）受访者投票支持使青少年吸烟率减半。选民愿意在1年内为此每人支付的平均最高金额为14.90美元（95%置信区间，10.10 - 19.60美元），而他们愿意在1年内为减少与吸烟相关的死亡人数每人支付的最高金额为13.70美元（95%置信区间，2.10 - 25.40美元）。将其汇总到北卡罗来纳州45 - 64岁的人口（N = 2,400,144）中，使青少年吸烟率减半的感知效益为3580万美元。实施一个实现这一结果的项目将花费1.098亿美元。汇总到相同人口中，将与烟草相关的死亡人数减少10%的感知效益为3290万美元，这一金额超过了实现该结果估计所需的1280万美元成本。
提供免费尼古丁替代疗法的咨询戒烟热线将产生正的净效益。
