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Longitudinal patterns and sociodemographic profiles of health-related behaviour clustering among middle-aged and older adults in China and Japan. AGEING & SOCIETY 2023. [DOI: 10.1017/s0144686x2200143x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Abstract
Given inevitable age-related decreases in physical or mental capacity, studies on health-related behaviour (HRB) clustering in older people provide an opportunity to reduce health-care costs and promote healthy ageing. This study explores the clustering of HRBs and transition probabilities of cluster memberships over time, and compares sociodemographic characteristics of these clusters among Chinese and Japanese middle-aged and older adults. Using the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2015 (N = 19614) and the Japanese Study of Ageing and Retirement (JSTAR) from 2007 to 2011 (N = 7,080), Latent Transition Analysis was applied to investigate the clustering and change in clustering memberships of smoking, alcohol consumption, physical activity and body mass index. Multivariate logistic regression was used to explore the sociodemographic characteristics of these longitudinal HRB cluster members. We identified four common clusters in CHARLS and JSTAR: ‘smoking’, ‘overweight or obese’, ‘healthy lifestyle’ and ‘current smoking with drinking’, and an additional cluster named ‘ex-smoking with drinking’ in JSTAR. Although HRB cluster members were largely stable in both cohorts, participants in China tended to move towards an unhealthy lifestyle, while participants in Japan did the opposite. We also found that participants who smoked and drank were more likely to be male, younger, less educated and unmarried in both cohorts, but the overweight or obese participants were female, urban and higher income in CHARLS but not JSTAR. Our study not only contributes to the knowledge of longitudinal changes in health-related behavioural clustering patterns in an Asian elderly population, but may also facilitate the design of targeted multi-behavioural interventions to promote healthy lifestyles among older people in both countries.
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Lee C, Gao M, Ryff CD. Conscientiousness and Smoking: Do Cultural Context and Gender Matter? Front Psychol 2020; 11:1593. [PMID: 32733344 PMCID: PMC7358448 DOI: 10.3389/fpsyg.2020.01593] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/15/2020] [Indexed: 01/26/2023] Open
Abstract
Prior studies have found that conscientiousness has a protective effect against smoking, but evidence for this relationship mostly comes from Western contexts. In societies where smoking is pervasive and less stigmatized, the protective effect of conscientiousness on smoking may be less evident. Moreover, whether smoking is viewed as normal or deviant also may vary by gender norms attached to smoking. Using surveys of Midlife Development in the United States (MIDUS) and Japan (MIDJA), we examined patterns in the association between conscientiousness and smoking status (never, former, current) for men and women. We found that in the United States, where the social unacceptability of smoking has dramatically increased, there is an inverse association between conscientiousness and smoking status for both genders. In Japan, where the stigma attached to smoking operates for women but not men, the association between conscientiousness and smoking status varies by gender. For Japanese men, levels of conscientiousness do not differ across smoking statuses. For Japanese women, those who formerly smoked show lower levels of conscientiousness than those who never smoked and those who currently smoke. We interpret these findings in light of differing cultural and historical backgrounds of smoking for men and women.
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Affiliation(s)
- Chioun Lee
- Department of Sociology, University of California, Riverside, Riverside, CA, United States,*Correspondence: Chioun Lee,
| | - Manjing Gao
- Department of Sociology, University of California, Riverside, Riverside, CA, United States
| | - Carol D. Ryff
- Institute on Aging and Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States
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Thompson ME, Boudreau C, Quah AC, Ouimet J, Li G, Yan M, Mochizuki Y, Yoshimi I, Fong GT. Survey Methods of the 2018 International Tobacco Control (ITC) Japan Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2598. [PMID: 32290304 PMCID: PMC7177252 DOI: 10.3390/ijerph17072598] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/02/2020] [Accepted: 04/07/2020] [Indexed: 11/24/2022]
Abstract
This paper describes the methods of the Wave 1 (2018) International Tobacco Control (ITC) Japan Survey. The respondents were adults aged 20 years and older in one of four user groups: (1) cigarette-only smokers who smoked at least monthly and used heated tobacco products (HTPs) not at all or less than weekly, (2) HTP-only users who used HTPs at least weekly and smoked cigarettes not at all or less than monthly, (3) cigarette-HTP dual users who smoked at least monthly and used HTPs at least weekly, and (4) non-users who had never smoked or who smoked less than monthly and used HTPs less than weekly. Eligible respondents were recruited by a commercial survey firm from its online panel. Respondents were allocated proportionally to sample strata based on demographic, geographic, and user type specifications benchmarked to a national reference. Survey weights, accounting for smoking/HTP use status, sex, age, education, and geography, were calibrated to benchmarks from a nationally representative survey in Japan. Response rate was 45.1% and cooperation rate was 96.3%. The total sample size was 4615 (3288 cigarette smokers, 164 exclusive HTP users, 549 cigarette-HTP dual users, and 614 non-users). The 2018 ITC Japan Survey sampling design and survey data collection methods will allow analyses to examine prospectively the use of cigarettes and HTPs in Japan and factors associated with the use of both products and of transitions between them.
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Affiliation(s)
- Mary E. Thompson
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Christian Boudreau
- Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Anne C.K. Quah
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (A.C.K.Q.); (J.O.); (G.L.); (M.Y.); (G.T.F.)
| | - Janine Ouimet
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (A.C.K.Q.); (J.O.); (G.L.); (M.Y.); (G.T.F.)
| | - Grace Li
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (A.C.K.Q.); (J.O.); (G.L.); (M.Y.); (G.T.F.)
| | - Mi Yan
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (A.C.K.Q.); (J.O.); (G.L.); (M.Y.); (G.T.F.)
| | - Yumiko Mochizuki
- Division of Tobacco Policy Research, National Cancer Center Japan, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Itsuro Yoshimi
- Japan Cancer Society, 13th Floor, Yurakucho Center Bldg. 2-5-1, Yurakucho, Chiyoda-ku, Tokyo 100-0006, Japan;
| | - Geoffrey T. Fong
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada; (A.C.K.Q.); (J.O.); (G.L.); (M.Y.); (G.T.F.)
- School of Public Health and Health Systems, University of Waterloo, 200 University Ave W., Waterloo, ON N2L 3G1, Canada
- Ontario Institute for Cancer Research, 661 University Ave Suite 510, Toronto, ON M5G 0A3, Canada
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Kistler CE, Ranney LM, Sutfin EL, Chrzan K, Wretman CJ, Enyioha C, Meernik C, Berman M, Zarkin GA, Goldstein AO. Product attributes important to US adult consumers' use of electronic nicotine delivery systems: a discrete choice experiment. BMJ Open 2019; 9:e027247. [PMID: 31420386 PMCID: PMC6701580 DOI: 10.1136/bmjopen-2018-027247] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To understand the importance of electronic nicotine delivery systems (ENDS) product attributes to adult consumers in the USA by age and gender. DESIGN Cross-sectional survey with a discrete choice experiment (best-worst, case 2, scaling) of 19 choice tasks in which participants answered what would make them most want to use and least want to use an ENDS product. SETTING AND PARTICIPANTS A national sample of adults (aged 18+ years) in the USA who had tried an ENDS product at least once. MEASURES We included 9 ENDS attributes with levels that varied across 19 choice tasks. We performed a multinomial logistic regression to obtain overall importance scores, attribute-level part-worth utilities and most important attribute. RESULTS Of 660 participants, 81% were white, 51% women and 37% had at least a 4-year college degree with an average age of 42.0 years (SD ±19.4). The attributes had the following importance: harms of use 17.6%; general effects 14.1%; cessation aid 12.6%; purchase price 12.1%; monthly cost 12.0%; nicotine content 11.4%; flavour availability 8.4%; device design 7.2%; modifiability 4.6%. Harms of use was the most important attribute for all ages and genders (p<0.05); variation in other important attributes existed by age though not by gender. CONCLUSION This study identified the importance of nine ENDS attributes. Perceived harms of use of ENDS use appeared most important, and modifiability was least important. Variation by consumer group existed, which may allow for targeted interventions to modify ENDS use.
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Affiliation(s)
- Christine E Kistler
- Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Leah M Ranney
- Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Erin L Sutfin
- Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Keith Chrzan
- Sawtooth Analytics, Sawtooth Software, Inc., Provo, Utah, USA
| | - Christopher J Wretman
- Cecil G. Sheps Center for Health Services Research, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Chineme Enyioha
- Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Clare Meernik
- Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Micah Berman
- Health Services Management and Policy, Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Gary A Zarkin
- RTI International, Research Triangle Park, North Carolina, USA
| | - Adam O Goldstein
- Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
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Buckell J, Sindelar JL. The impact of flavors, health risks, secondhand smoke and prices on young adults' cigarette and e-cigarette choices: a discrete choice experiment. Addiction 2019; 114:1427-1435. [PMID: 30866132 PMCID: PMC6639008 DOI: 10.1111/add.14610] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/08/2018] [Accepted: 03/04/2019] [Indexed: 12/22/2022]
Abstract
AIMS To estimate young adults' preferences for cigarettes and e-cigarettes, and how preferences vary by policy-relevant factors. A related aim was to provide information on potential substitution/complementarity across cigarettes and e-cigarettes ahead of policy selection. DESIGN An online discrete choice experiment (DCE) in which respondents chose their preferred option among cigarettes, two types of e-cigarettes (disposable/reusable) and 'none'. Each cigarette-type was characterized by policy-relevant attributes: flavors, short-term health risks to self, secondhand smoke risks and price. A latent class model identified smoking types that respond differently to these. SETTING US tobacco market. PARTICIPANTS A total of 2003 young adults (aged 18-22 years) who ever tried either cigarettes or e-cigarettes, recruited via the survey platform Qualtrics, matched to the 2015 National Health Interview Survey by age, gender, education and census region. MEASUREMENTS Respondents' DCE choices. FINDINGS Young adults fell into two broad categories. One latent group, termed 'prefer smoking group', preferred cigarettes and another, 'prefer vaping group', preferred e-cigarettes. The 'prefer smoking group' preferred lower prices and lower health harms more than other attributes. The 'prefer vaping group' valued these, although price less intensely, and valued health and fruit/candy flavors more. CONCLUSION Banning all flavors in cigarettes and e-cigarettes might improve the health of young adults who ever tried either cigarettes or e-cigarettes. Young adult ever-triers might be deterred from smoking by increasing cigarette prices and encouraged to switch to e-cigarettes by reducing the health harms of e-cigarettes. Reducing health harms of e-cigarettes could also make the 'prefer vaping group' less likely to quit, resulting in increased health harm.
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Affiliation(s)
- John Buckell
- School of Public HealthYale University New Haven CT USA
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Challenges and opportunities for greater tobacco control in Japan. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 70:78-86. [PMID: 31121458 DOI: 10.1016/j.drugpo.2019.05.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 03/26/2019] [Accepted: 05/03/2019] [Indexed: 11/21/2022]
Abstract
Japan is a high tobacco burden country with over 20 million smokers in 2017. Tobacco control measures in Japan has been criticised as largely inadequate and ineffective despite ratifying the World Health Organization's Framework Convention on Tobacco Control in 2004. Numerous factors such as pro-tobacco legislators, regulatory oversight of the primary Japanese tobacco company from the Ministry of Finance and industry interference on the policy-making process in Japan have prevented aggressive tobacco control efforts. Given the intricate challenges in Japan, it is important to develop feasible and effective smoking cessation strategies. In this paper, we have analysed the trends in tobacco prices, sale and smoking prevalence, major tobacco/smoking policies and some of the industry-related challenges that have prevented the development of effective tobacco control measures in Japan. We have emphasised the need for stronger implementation of the World Health Organization's Framework Convention on Tobacco Control and its MPOWER policy package and to separate the tobacco industry from the tobacco control policymaking process to promote cessation and abstinence from smoking and better sensitisation against exposure to second-hand smoke.
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Regmi K, Kaphle D, Timilsina S, Tuha NAA. Application of Discrete-Choice Experiment Methods in Tobacco Control: A Systematic Review. PHARMACOECONOMICS - OPEN 2018; 2:5-17. [PMID: 29464666 PMCID: PMC5820233 DOI: 10.1007/s41669-017-0025-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND Economic evidence relating to tobacco control is generally derived from the cost effectiveness of smoking-cessation programs or the economic impact of tobacco-induced disease, based on revealed-preference data. However, empirical estimates from stated-preference data on tobacco users' preferences, smoking behaviour and smoking cessation aids using analytical techniques such as discrete-choice experiments (DCEs) could be important for policy decision making in tobacco control. OBJECTIVES Our objective was to review the practice and utility of DCE methodology across nicotine- and tobacco-related issues, particularly smoking and smoking-cessation behaviour, anti-smoking policies and preferences for smoking-cessation aids. METHODS We searched the PubMed, MEDLINE and ECONLIT databases for full-text original research articles on tobacco-related issues published between January 2000 and April 2016 that used a DCE method. We summarised the evidence and methodological characteristics of DCEs according to Lancsar and Louviere, 2008. RESULTS Our review of the 12 eligible studies showed that DCE methodology was used to elicit smoker preferences and to evaluate tobacco-control policies. The majority of the studies were published in the last 5 years. The areas of application were smoking cessation, smoking behaviour, electronic cigarette use, water-pipe smoking and tobacco packaging. Monetary attributes were the most influential attributes in all studies. The design of the DCEs varied. CONCLUSION DCE studies of tobacco-related issues were methodologically consistent with guidelines proposed for conducting health-related DCEs.
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Affiliation(s)
- Kabindra Regmi
- Faculty of Health Science, PAPRSB Institute of Health Science, University Brunei Darussalam, Gadong, BE1410 Brunei Darussalam
- Centre for Innovative Research in Public Health, Pokhara, Nepal
| | - Dinesh Kaphle
- School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Sabina Timilsina
- Centre for Innovative Research in Public Health, Pokhara, Nepal
- Faculty of Medicine, Center for Tropical Medicine, Gadjah Mada University, Gedung PAU UGM, Yogyakarta, 55281 Indonesia
| | - Nik Annie Afiqah Tuha
- Faculty of Health Science, PAPRSB Institute of Health Science, University Brunei Darussalam, Gadong, BE1410 Brunei Darussalam
- Department of Primary Care and Public Health, Faculty of Public Health, Imperial College London, London, UK
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Morgan H, Hoddinott P, Thomson G, Crossland N, Farrar S, Yi D, Hislop J, Moran VH, MacLennan G, Dombrowski SU, Rothnie K, Stewart F, Bauld L, Ludbrook A, Dykes F, Sniehotta FF, Tappin D, Campbell M. Benefits of Incentives for Breastfeeding and Smoking cessation in pregnancy (BIBS): a mixed-methods study to inform trial design. Health Technol Assess 2016; 19:1-522, vii-viii. [PMID: 25897655 DOI: 10.3310/hta19300] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Smoking in pregnancy and/or not breastfeeding have considerable negative health outcomes for mother and baby. AIM To understand incentive mechanisms of action for smoking cessation in pregnancy and breastfeeding, develop a taxonomy and identify promising, acceptable and feasible interventions to inform trial design. DESIGN Evidence syntheses, primary qualitative survey, and discrete choice experiment (DCE) research using multidisciplinary, mixed methods. Two mother-and-baby groups in disadvantaged areas collaborated throughout. SETTING UK. PARTICIPANTS The qualitative study included 88 pregnant women/recent mothers/partners, 53 service providers, 24 experts/decision-makers and 63 conference attendees. The surveys included 1144 members of the general public and 497 health professionals. The DCE study included 320 women with a history of smoking. METHODS (1) Evidence syntheses: incentive effectiveness (including meta-analysis and effect size estimates), delivery processes, barriers to and facilitators of smoking cessation in pregnancy and/or breastfeeding, scoping review of incentives for lifestyle behaviours; (2) qualitative research: grounded theory to understand incentive mechanisms of action and a framework approach for trial design; (3) survey: multivariable ordered logit models; (4) DCE: conditional logit regression and the log-likelihood ratio test. RESULTS Out of 1469 smoking cessation and 5408 breastfeeding multicomponent studies identified, 23 smoking cessation and 19 breastfeeding studies were included in the review. Vouchers contingent on biochemically proven smoking cessation in pregnancy were effective, with a relative risk of 2.58 (95% confidence interval 1.63 to 4.07) compared with non-contingent incentives for participation (four studies, 344 participants). Effects continued until 3 months post partum. Inconclusive effects were found for breastfeeding incentives compared with no/smaller incentives (13 studies) but provider commitment contracts for breastfeeding show promise. Intervention intensity is a possible confounder. The acceptability of seven promising incentives was mixed. Women (for vouchers) and those with a lower level of education (except for breastfeeding incentives) were more likely to disagree. Those aged ≤ 44 years and ethnic minority groups were more likely to agree. Agreement was greatest for a free breast pump and least for vouchers for breastfeeding. Universal incentives were preferred to those targeting low-income women. Initial daily text/telephone support, a quitting pal, vouchers for > £20.00 per month and values up to £80.00 increase the likelihood of smoking cessation. Doctors disagreed with provider incentives. A 'ladder' logic model emerged through data synthesis and had face validity with service users. It combined an incentive typology and behaviour change taxonomy. Autonomy and well-being matter. Personal difficulties, emotions, socialising and attitudes of others are challenges to climbing a metaphorical 'ladder' towards smoking cessation and breastfeeding. Incentive interventions provide opportunity 'rungs' to help, including regular skilled flexible support, a pal, setting goals, monitoring and outcome verification. Individually tailored and non-judgemental continuity of care can bolster women's capabilities to succeed. Rigid, prescriptive interventions placing the onus on women to behave 'healthily' risk them feeling pressurised and failing. To avoid 'losing face', women may disengage. LIMITATIONS Included studies were heterogeneous and of variable quality, limiting the assessment of incentive effectiveness. No cost-effectiveness data were reported. In surveys, selection bias and confounding are possible. The validity and utility of the ladder logic model requires evaluation with more diverse samples of the target population. CONCLUSIONS Incentives provided with other tailored components show promise but reach is a concern. Formal evaluation is recommended. Collaborative service-user involvement is important. STUDY REGISTRATION This study is registered as PROSPERO CRD42012001980. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Heather Morgan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Pat Hoddinott
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Nicola Crossland
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Shelley Farrar
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Deokhee Yi
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Jenni Hislop
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Victoria Hall Moran
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Kieran Rothnie
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Fiona Stewart
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Linda Bauld
- The Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Anne Ludbrook
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - Fiona Dykes
- Maternal and Infant Nutrition and Nurture Unit, University of Central Lancashire, Preston, UK
| | - Falko F Sniehotta
- Institute of Health and Society, University of Newcastle, Newcastle, UK
| | - David Tappin
- Perinatal Epidemiology and Child Health Unit, School of Medicine, University of Glasgow, Glasgow, UK
| | - Marion Campbell
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
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Tanihara S, Momose Y. Reasons for smoking cessation attempts among Japanese male smokers vary by nicotine dependence level: a cross-sectional study after the 2010 tobacco tax increase. BMJ Open 2015; 5:e006658. [PMID: 25795690 PMCID: PMC4368926 DOI: 10.1136/bmjopen-2014-006658] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 02/14/2015] [Accepted: 02/16/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To examine the association between smoking cessation attempts during the previous 12 months, motivators to quit smoking and nicotine dependence levels among current male smokers after Japan's massive 2010 tobacco tax increase. DESIGN Cross-sectional study. SETTING A self-reported questionnaire about smoking habits, nicotine dependence levels and factors identified as motivators to quit smoking was administered to 9378 employees working at a company located in Fukuoka Prefecture in Japan (as of 1 October 2011). PARTICIPANTS A total of 2251 male current smokers 20-69 years old. PRIMARY AND SECONDARY OUTCOME MEASURES Nicotine dependence level assessed by Fagerström Test for Cigarette Dependence (FTCD), smoking cessation attempts during the previous 12 months and motivators for smoking cessation. RESULTS The proportion of current smokers who had attempted to quit smoking within the previous 12 months was 40.6%. Nicotine dependence level of current smokers was negatively associated with cessation attempts during the previous 12 months. Motivators for smoking cessation differed by nicotine dependence levels. 'The rise in cigarette prices since October 2010' as a smoking cessation motivator increased significantly at the medium nicotine dependence level (OR 1.44, 95% CI 1.09 to 1.90); however, this association was not statistically significant for individuals with high nicotine dependence (OR 1.24, 95% CI 0.80 to 1.92). 'Feeling unhealthy' was significantly negatively associated for medium (OR 0.42, 95% CI 0.27 to 0.65) and high (OR 0.31, 95% CI 0.14 to 0.71) nicotine dependence levels. Trend associations assessed by assigning ordinal numbers to total FTCD score for those two motivators were statistically significant. CONCLUSIONS The efficacy of smoking cessation strategies can be improved by considering the target group's nicotine dependence level. For smokers with medium and high nicotine dependence levels, more effective strategies aimed at encouraging smoking cessation, such as policy interventions including increasing tobacco taxes, are needed.
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Affiliation(s)
- Shinichi Tanihara
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yoshito Momose
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Clark MD, Determann D, Petrou S, Moro D, de Bekker-Grob EW. Discrete choice experiments in health economics: a review of the literature. PHARMACOECONOMICS 2014; 32:883-902. [PMID: 25005924 DOI: 10.1007/s40273-014-0170-x] [Citation(s) in RCA: 508] [Impact Index Per Article: 50.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
BACKGROUND Discrete choice experiments (DCEs) are increasingly used in health economics to address a wide range of health policy-related concerns. OBJECTIVE Broadly adopting the methodology of an earlier systematic review of health-related DCEs, which covered the period 2001-2008, we report whether earlier trends continued during 2009-2012. METHODS This paper systematically reviews health-related DCEs published between 2009 and 2012, using the same database as the earlier published review (PubMed) to obtain citations, and the same range of search terms. RESULTS A total of 179 health-related DCEs for 2009-2012 met the inclusion criteria for the review. We found a continuing trend towards conducting DCEs across a broader range of countries. However, the trend towards including fewer attributes was reversed, whilst the trend towards interview-based DCEs reversed because of increased computer administration. The trend towards using more flexible econometric models, including mixed logit and latent class, has also continued. Reporting of monetary values has fallen compared with earlier periods, but the proportion of studies estimating trade-offs between health outcomes and experience factors, or valuing outcomes in terms of utility scores, has increased, although use of odds ratios and probabilities has declined. The reassuring trend towards the use of more flexible and appropriate DCE designs and econometric methods has been reinforced by the increased use of qualitative methods to inform DCE processes and results. However, qualitative research methods are being used less often to inform attribute selection, which may make DCEs more susceptible to omitted variable bias if the decision framework is not known prior to the research project. CONCLUSIONS The use of DCEs in healthcare continues to grow dramatically, as does the scope of applications across an expanding range of countries. There is increasing evidence that more sophisticated approaches to DCE design and analytical techniques are improving the quality of final outputs. That said, recent evidence that the use of qualitative methods to inform attribute selection has declined is of concern.
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Affiliation(s)
- Michael D Clark
- Department of Economics, University of Warwick, Coventry, CV4 7AL, UK,
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Harrison M, Rigby D, Vass C, Flynn T, Louviere J, Payne K. Risk as an Attribute in Discrete Choice Experiments: A Systematic Review of the Literature. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2014; 7:151-70. [DOI: 10.1007/s40271-014-0048-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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12
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Das S, Rajalingham S. Smoking bans and the reduction in heart diseases: The emerging scenario. Regul Toxicol Pharmacol 2012; 62:571. [DOI: 10.1016/j.yrtph.2011.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Revised: 11/09/2011] [Accepted: 11/09/2011] [Indexed: 11/26/2022]
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