Nagelhout Gera E, Willemsen Marc C, van den Putte Bas, de Vries Hein, Willems Roy A, Segaar Dewi
Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands Alliance Smokefree Holland, The Hague, The Netherlands.
Department of Communication, University of Amsterdam (ASCoR), Amsterdam, The Netherlands Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands.
Tob Control. 2015 Sep;24(5):455-61. doi: 10.1136/tobaccocontrol-2013-051430. Epub 2014 May 18.
In 2011, the Netherlands implemented a national policy that ensured that health insurance companies reimbursed behavioural counselling for smoking cessation or the combination of behavioural counselling with pharmacological therapy.
To examine the real-world impact of a national reimbursement policy and accompanying media attention on use of cessation treatment and on smoking cessation.
We used a four-wave longitudinal survey among 2763 adult smokers that started in September 2010 and was repeated at approximately 3 month intervals until June 2011. Two survey waves were conducted before the implementation of the policy and two survey waves after.
There were significant increases in quit attempts (among moderate-to-heavy smokers) and in quit success (among all smokers) following the implementation of the reimbursement policy and the media attention. Use of behavioural counselling did not increase, while use of pharmacological therapy without behavioural counselling (unreimbursed treatment) increased among moderate-to-heavy smokers. Attention to media about the reimbursement was significantly associated with more quit attempts and more quit success. Awareness of the policy was significantly associated with more use of reimbursed treatment among all smokers, while attention to the media coverage was only significantly associated with more use of reimbursed treatment among moderate-to-heavy smokers. Awareness/attention variables were not significantly associated with use of unreimbursed treatment.
It seems that a national reimbursement policy for smoking cessation treatment that is accompanied by media attention can increase cessation. Our findings suggest that this increase can (partly) be ascribed to the media attention that accompanied the policy implementation.
2011年,荷兰实施了一项国家政策,确保健康保险公司为戒烟行为咨询或行为咨询与药物治疗相结合的方式提供报销。
研究国家报销政策及随之而来的媒体关注对戒烟治疗使用情况和戒烟的实际影响。
我们对2763名成年吸烟者进行了一项四波纵向调查,该调查于2010年9月开始,每隔约3个月重复一次,直至2011年6月。在政策实施前进行了两波调查,实施后进行了两波调查。
报销政策实施及媒体关注后,(中度至重度吸烟者中的)戒烟尝试和(所有吸烟者中的)戒烟成功率均显著提高。行为咨询的使用没有增加,而在中度至重度吸烟者中,未进行行为咨询的药物治疗(未报销治疗)的使用有所增加。对报销政策的媒体关注度与更多的戒烟尝试和更高的戒烟成功率显著相关。政策知晓度与所有吸烟者更多地使用报销治疗显著相关,而对媒体报道的关注度仅与中度至重度吸烟者更多地使用报销治疗显著相关。知晓度/关注度变量与未报销治疗的使用无显著关联。
一项伴有媒体关注的国家戒烟治疗报销政策似乎可以提高戒烟率。我们的研究结果表明,这种提高(部分)可归因于政策实施时伴随的媒体关注。