Eliciting patients' preferences for cigarette and alcohol cessation: an application of conjoint analysis

The strength and stability of preferences for quitting cigarettes versus alcohol in a population of dual users undergoing treatment was examined using conjoint analysis. Patients at a Veteran's Administration substance abuse treatment center ranked nine vignettes from most to least preferred at baseline and 4 weeks later. The vignettes, using a full factorial design, described health states associated with three levels of substance use. We regressed vignette rankings on the levels of smoking and drinking. A larger regression coefficient indicated a stronger preference for quitting. At baseline and follow-up, the group placed more preference on quitting alcohol than cigarettes (coefficients of 2.23 and 2.35 for alcohol cessation and.51 and.73 for smoking cessation). Some subjects preferred smoking to quitting at baseline (23.9%) and follow-up (23.5%). Over time, 29.4% and 35.3% increased their preference for tobacco and alcohol cessation, while 41.2% and 17.6% decreased their preference for cigarette and alcohol cessation. Preferences for stopping alcohol were stronger than for stopping cigarettes, and many preferences changed after a treatment program.