Time and risk preference parameters and the success of smoking cessation

Presenter: Rei Goto, Konan University

Abstract

Background: Time and risk preference parameters have been regarded as the key to analyse smoking behaviour. Theoretically, smokers who focus more on possible health damage in the future than on present enjoyment choose to quit smoking. There are few studies that have investigated the association of time and risk preference parameters related to the success of quitting behaviour.

Objective: To identify whether the time and risk parameters and the factors analysed in previous research predict the success of smoking cessation.

Methods: A longitudinal survey for smokers who recently started to quit. Time and preference parameters are individually estimated using a discrete choice experiment (DCE).

Participants: A total of 689 smokers who began quitting smoking within the last month.

Measurements: Time discount rate, coefficient of risk aversion, and duration of smoking cessation.

Findings: 321 (46.6%) smokers succeeded in quitting smoking at the time of the final survey that was conducted five months later. The number of failures decreased as the continuation time progressed. Within a proportional hazards regression model, the high time discount rate is associated with failure to quit (hazard ratio: 1.17, 95% confidence interval: 1.10 to 1.24, P < 0.001). The high coefficient of risk aversion improves the overall success of smoking cessation (0.20, 0.07 to 0.53, P = 0.001). Among the conventional variables analysed in previous research, the high self-efficacy of quitting (0.87, 0.79 to 0.95, P = 0.003), the use of nicotine replacement therapy (0.68, 0.49 to 0.96, P = 0.029) and high nicotine dependence are associated with successful cessation. Inexperienced quitters are significantly more likely to fail to quit (3.35, 1.61 to 7.00, P = 0.001). Age, gender, health status and mood variations have no significant effect.

Conclusions: Our study indicated that those who emphasize future rewards (time-patient preference) and those who give more importance to rewards that are certain (more risk-averted preference) were significantly more likely to continue to abstain from smoking. Time and risk preference parameters were good predictors of cessation.