Effectiveness of a national reimbursement policy and accompanying media attention on use of cessation treatment and on smoking cessation: a real-world study in the Netherlands

Background
In 2011, the Netherlands implemented a national policy that ensured that health insurance companies reimbursed behavioural counselling for smoking cessation or the combination of behavioural counselling with pharmacological therapy.

Objective
To examine the real-world impact of a national reimbursement policy and accompanying media attention on use of cessation treatment and on smoking cessation.

Methods
We used a four-wave longitudinal survey among 2763 adult smokers that started in September 2010 and was repeated at approximately 3 month intervals until June 2011. Two survey waves were conducted before the implementation of the policy and two survey waves after.

Findings
There were significant increases in quit attempts (among moderate-to-heavy smokers) and in quit success (among all smokers) following the implementation of the reimbursement policy and the media attention. Use of behavioural counselling did not increase, while use of pharmacological therapy without behavioural counselling (unreimbursed treatment) increased among moderate-to-heavy smokers. Attention to media about the reimbursement was significantly associated with more quit attempts and more quit success. Awareness of the policy was significantly associated with more use of reimbursed treatment among all smokers, while attention to the media coverage was only significantly associated with more use of reimbursed treatment among moderate-to-heavy smokers. Awareness/attention variables were not significantly associated with use of unreimbursed treatment.

Conclusions
It seems that a national reimbursement policy for smoking cessation treatment that is accompanied by media attention can increase cessation. Our findings suggest that this increase can (partly) be ascribed to the media attention that accompanied the policy implementation.