Assessing smoking cessation preferences in Germany: A discrete choice experiment

Area of Science:

• Public Health
• Behavioral Science
• Health Services Research

Background:

• Smoking prevalence in Germany remains high at 30%, with low uptake of cessation services.
• E-cigarettes are promoted for smoking cessation, but their preference over established methods is unclear.
• Understanding preferences for smoking cessation program characteristics is crucial for improving engagement.

Purpose of the Study:

• To estimate preferences and willingness-to-pay for smoking cessation program characteristics using a discrete choice experiment (DCE).
• To identify key attributes influencing German smokers' choices in cessation programs.

Main Methods:

• A discrete choice experiment (DCE) was conducted with 1052 German adult smokers (≥5 cigarettes/day).
• The DCE involved 12 choice tasks evaluating attributes: cessation aids (nicotine replacement, medication, e-cigarettes), counseling, professional referral, effectiveness, and cost.
• Mixed logit regression was used to analyze choices.

Main Results:

• Counseling, professional referrals, and program effectiveness significantly influenced choices (p<0.001).
• No specific cessation aids were significantly preferred overall, though e-cigarettes were preferred by prior users.
• Participants were willing to pay a significant amount (€91.48/month) for an effective program, with lower costs preferred by those new to cessation aids.

Conclusions:

• Smoking cessation programs in Germany should prioritize counseling and clearly communicate evidence of therapy effectiveness to increase engagement.
• Improving access through referrals and cost reduction can enhance cessation efforts.
• Health professionals should provide evidence-based guidance on all cessation methods, including e-cigarettes, to support informed decision-making.