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Nordic Studies on Alcohol and Drugs

The Journal of Nordic Centre for Welfare and Social Issues


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Does screening participation affect cigarette smokers’ decision to quit? A long-horizon panel data analysis

1Senior researcher Norwegian Institute for Alcohol and Drug Research (SIRUS)

2Professor Department of Economics University of Oslo, Norway

3Norwegian Institute of Public Health Division of Epidemiology

© by Anne Line Bretteville-Jensen. This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY-NC-ND 3.0)

Citation Information: Nordic Studies on Alcohol and Drugs. Volume 31, Issue 2, Pages 141–160, ISSN (Online) 1458-6126, ISSN (Print) 1455-0725, DOI: 10.2478/nsad-2014-0012, April 2014

Publication History

Received:
2013-10-28
Accepted:
2014-03-19
Published Online:
2014-04-25

ABSTRACT

BACKGROUND - Despite decades of intensive anti-tobacco initiatives, millions of people are still smoking. The health authorities are seeking new tools and extended knowledge. Screening programs may, in addition to the potential health benefits from early detection of smoking related diseases, also increase smoking cessation among participants. This study examines the effect of screening participation by comparing the smokers’ cessation hazard in screening years to nonscreening years. METHODS - All smokers (n=10,471) participated in a three-wave cardiovascular screening and were followed up over a maximum of 14 years. The panel was merged with administrative registers. We used a flexible discrete-time duration model to investigate the effect of the screening program while simultaneously accounting for the possible influence of personal characteristics, addiction indicators, economic factors, health status and health changes. Specifically, we examined and compared long-term smokers (LT; smoked ≥25 years) with short-term (ST; smoked ≤ 5 years) and medium-term (MT; smoked 10-20 years) smokers. RESULTS - We found that 29% of LT smokers quitted smoking during the follow-up whereas 32% of MT and 48% of ST smokers reported the same. The screening participation years stood out as especially important for all groups. The impact of the first screening was particularly high, and for the first two screenings, the effect was higher for long-term smokers than for the smokers with shorter smoking careers. Receiving an abnormal test result was not associated with a significant increase in cessation hazard for any group of smokers. CONCLUSIONS - The substantial effect of being invited to and participating in a screening appears robust, and may prove useful when discussing future policies for smoking cessation. This paper suggests that further initiatives for consultations with health personnel, in this case through a screening program, could increase the quitting hazard

KEYWORDS: cigarette cessation; duration model; quitting hazard; screening; long-term smokers; health status and shocks; policy intervention

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