Population impact of reimbursement for smoking cessation: a natural experiment in The Netherlands

Abstract

Aims: To report on the impact of financial reimbursement of pharmacotherapy for smoking cessation in combination with behavioural support on the number of enrollees to proactive counselling in the Dutch national quitline.

Design: Descriptive time-series analysis was used to compare quitline enrolment in 2010 and 2012 (no reimbursement) with 2011 (reimbursement).

Settings: National smoking cessation quitline.

Participants: Smokers signing up for proactive counselling.

Measurements: Treatment enrolment data recorded by the quitline as part of usual care from 2010, 2011 and 2012 (until May).

Findings: In 2010, a total of 848 smokers started treatment. In 2011, 9091 smokers enrolled. In 2012, the number of enrollees dropped dramatically, even below the 2010 level. In addition, the proportion of smokers in the population dropped from 27.2% in 2010 to 24.7% in 2011.

Conclusions: The introduction of a national reimbursement system in the Netherlands was associated with a more than 10-fold increase in telephone counselling for smoking cessation and suggests that reimbursement for smoking cessation contributed to improvements in public health.