https://doi.org/10.4081/monaldi.2024.3016
Willingness to pay for a tobacco-free life: a contingent valuation assessment
Submitted: April 4, 2024
Accepted: July 16, 2024
Published: August 30, 2024
Accepted: July 16, 2024
Abstract Views: 170
PDF_EARLY VIEW: 68
SUPPLEMENTARY MATERIAL: 13
SUPPLEMENTARY MATERIAL: 13
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
Tobacco, being an established risk factor for significant mortality and morbidity, causes over 7 million annual deaths globally. India is a country with over 270 million active tobacco users. On the one hand, although the willingness to quit amongst tobacco users is as high as 55.4%, the actual quit rates translate to less than 20%. Taking a cue from the economic principle of commitment and consistency, paying a nominal fee can serve as a form of public commitment and motivation to decrease the dropout rate amongst those committed to quitting. This study uses contingent valuation assessment to determine the willingness to pay (WTP) values for an effective tobacco cessation service across individuals with different socio-demographic characteristics. A cross-sectional observational study with multistage cluster sampling in Rajasthan was conducted to recruit 360 active tobacco users from 8 districts. Q-Q plots were used to determine the non-parametric distribution, and statistical differences between median WTP values were compared using Mann-Whitney U and Kruskal-Wallis H tests, considering a p-value less than 0.05 to be statistically significant. The majority of participants were males (57.78%) between the ages of 26 and 35 (40.28%), married (82.50%), and with children (65.83%), with an annual income between USD 7500-10,000 (23.61%) and graduate-level education (40.56%). Exclusive smokers formed the majority of the cohort (48.06%), and 50.83% were willing to quit as well as willing to pay for cessation. Median WTP values were maximum for males (USD 54.05; p<0.05), age group 26-35 years (USD 54.05; p<0.05), post-graduates (USD 81.08; p<0.05), and annual income above USD 20,000 (USD 121.62; p<0.05). Weak positive and significant correlations were observed between WTP and annual spending on tobacco, annual spending on health, and annual income. The study emphasizes the critical importance of early-age interventions for effective tobacco cessation prior to transitioning into dependency, resulting in reduced financial parity for availing health services. These are the first such WTP values from the Southeast Asian region, tailored for different population subsets, specifically for tobacco cessation. Our findings contribute to the growing body of evidence to support innovative approaches to enhance tobacco cessation efforts through financial commitments.
Centers for Disease Control and Prevention. Global tobacco control. Available from: https://www.cdc.gov/tobacco/global/index.htm. Accessed on: 23/04/2023.
World Health Organization. Tobacco control can save billions of dollars and millions of lives. 2017. Available from: https://www.who.int/news/item/10-01-2017-tobacco-control-can-save-billions-of-dollars-and-millions-of-lives.
Tata Institute of Social Sciences, Mumbai and Ministry of Health and Family Welfare, Government of India. Global Adult Tobacco Survey. India 2016-17 report. Available from: https://ntcp.mohfw.gov.in/assets/document/surveys-reports-publications/Global-Adult-Tobacco-Survey-Second-Round-India-2016-2017.pdf.
Reddy MM, Kanungo S, Naik BN, Kar SS. Willingness to quit tobacco smoking and its correlates among Indian smokers - findings from global adult tobacco survey India, 2009-2010. J Family Med Prim Care 2018;7:1353-60.
DOI: https://doi.org/10.4103/jfmpc.jfmpc_169_18
Kar SS, Sivanantham P, Rehman T, et al. Willingness to quit tobacco and its correlates among Indian tobacco users - findings from the global adult tobacco survey India, 2016-17. J Postgrad Med 2020;66:141-8.
DOI: https://doi.org/10.4103/jpgm.JPGM_408_19
Corsi DJ, Subramanian SV, Lear SA, et al. Tobacco use, smoking quit rates, and socioeconomic patterning among men and women: a cross-sectional survey in rural Andhra Pradesh, India. Eur J Prev Cardiol 2014;21:1308-18.
DOI: https://doi.org/10.1177/2047487313491356
Gupta R, Pednekar MS, Kumar R, Goel S. Tobacco cessation in India-Current status, challenges, barriers and solutions. Indian J Tuberc 2021;68S:S80-5.
DOI: https://doi.org/10.1016/j.ijtb.2021.08.027
Baca-Motes K, Brown A, Gneezy A, et al. Commitment and behavior change: evidence from the field. JCR 2013;39:1070-84.
DOI: https://doi.org/10.1086/667226
Achtypi E, Ashby NJS, Brown GDA, et al. The endowment effect and beliefs about the market. Decision 2021;8:16-35.
DOI: https://doi.org/10.1037/dec0000143
Whitehead JC, Haab TC. Contingent valuation method. In: Shogren JF, ed. Encyclopedia of energy, natural resource, and environmental economics. Amsterdam: Elsevier Science; 2013. pp 334-41.
DOI: https://doi.org/10.1016/B978-0-12-375067-9.00004-8
Frew EJ, Whynes DK, Wolstenholme JL. Eliciting willingness to pay: comparing closed-ended with open-ended and payment scale formats. Med Decis Making 2003;23:150-9.
DOI: https://doi.org/10.1177/0272989X03251245
Whynes DK, Frew EJ, Wolstenholme JL. Willingness-to-pay and demand curves: a comparison of results obtained using different elicitation formats. Int J Health Care Finance Econ 2005;5:369-86.
DOI: https://doi.org/10.1007/s10754-005-4014-2
Rai S, Joshi NK, Jain YK, et al. Compliance, enablers and barriers to implementation of the cigarette and other tobacco products act, in Jodhpur, Rajasthan. Int J Public Health Sci 2023;12:1422-9.
DOI: https://doi.org/10.11591/ijphs.v12i4.22933
ABC News. Study: nicotine addiction can be immediate. 2000. Available from: https://abcnews.go.com/Health/story?id=117976&page=1.
RajRAS. Physical Divisions of Rajasthan. 2023. Available from: https://www.rajras.in/rajasthan/geography/physical-divisions/. Accessed on: 4/04/2024.
Ayoub S, Raja R. Economic parameter of modified Kuppuswamy socioeconomic status scale for the year 2023. Indian J Forensic Community Med 2023;10:99-101.
DOI: https://doi.org/10.18231/j.ijfcm.2023.017
World Health Organization. Offer help to quit tobacco use. 2014. Available from: https://www.who.int/teams/health-promotion/tobacco-control/quitting/offer-help-to-quit-tobacco-use#:~:text=Treatment%20of%20tobacco%20dependence%20is,a%20smoker%20will%20quit%20successfully. Accessed on: 4/04/2024.
Steigenberger C, Flatscher-Thoeni M, Siebert U, Leiter AM. Determinants of willingness to pay for health services: a systematic review of contingent valuation studies. Eur J Health Econ 2022;23:1455-82.
DOI: https://doi.org/10.1007/s10198-022-01437-x
Wolff E, Larsson S, Svensson M. Willingness to pay for health improvements using stated preferences: prevention versus treatment. Value Health 2020;23:1384-90.
DOI: https://doi.org/10.1016/j.jval.2020.06.008
Hollis JF, McAfee TA, Fellows JL, et al. The effectiveness and cost effectiveness of telephone counselling and the nicotine patch in a state tobacco quitline. Tob Control 2007;16:i53-9.
DOI: https://doi.org/10.1136/tc.2006.019794
Onwuzo CN, Olukorode J, Sange W, et al. A review of smoking cessation interventions: efficacy, strategies for implementation, and future directions. Cureus 2024;16:e52102.
DOI: https://doi.org/10.7759/cureus.52102
Jain YK, Bhardwaj P, Joshi NK, et al. Death, disability, and premature life years lost due to cigarettes, bidis, and smokeless tobacco in India: a comparative assessment. Addict Health 2023;15:53-62.
DOI: https://doi.org/10.34172/ahj.2023.1420
Goyal M, Khokhar A, Lukhmana S, et al. Willingness to quit and associated factors among tobacco users attending outpatient departments of a tertiary care hospital in Delhi, India. Addict Health 2023;15:192-201.
DOI: https://doi.org/10.34172/ahj.2023.1444
World Health Organization. World no tobacco day 2019 awards - the winners. 2019. Available from: https://www.who.int/news/item/22-05-2019-world-no-tobacco-day-2019-awards---the-winners.
Hadaye RS, Thampi JG. Catastrophic health-care expenditure and willingness to pay for health insurance in a metropolitan city: a cross-sectional study. Indian J Community Med 2018;43:307-11.
DOI: https://doi.org/10.4103/ijcm.IJCM_252_18
Onwujekwe O, Okereke E, Onoka C, et al. Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?. Health Policy Plan 2010;25:155-61.
DOI: https://doi.org/10.1093/heapol/czp046
Conger RD, Conger KJ, Martin MJ. Socioeconomic status, family processes, and individual development. J Marriage Fam 2010;72:685-704.
DOI: https://doi.org/10.1111/j.1741-3737.2010.00725.x
Suls JM, Luger TM, Curry SJ, et al. Efficacy of smoking-cessation interventions for young adults: a meta-analysis. Am J Prev Med 2012;42:655-62.
DOI: https://doi.org/10.1016/j.amepre.2012.02.013
Levinson AH, Borrayo EA, Espinoza P, et al. An exploration of Latino smokers and the use of pharmaceutical aids. Am J Prev Med 2006;31:161-71.
DOI: https://doi.org/10.1016/j.amepre.2006.03.022
Xu X, Bishop EE, Kennedy SM, et al. Annual healthcare spending attributable to cigarette smoking: an update. Am J Prev Med 2015;48:326-33.
DOI: https://doi.org/10.1016/j.amepre.2014.10.012
Oberg M, Jaakkola MS, Woodward A, et al. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011;377:139-46.
DOI: https://doi.org/10.1016/S0140-6736(10)61388-8
Ali T, Ali J. Factors affecting the consumers’ willingness to pay for health and wellness food products. J Agric Food Res 2020;2:100076.
DOI: https://doi.org/10.1016/j.jafr.2020.100076
Kumar R, Saroj SK. Is tobacco quitline cost effective in India?. Monaldi Arch Chest Dis 2020;90:1381.
DOI: https://doi.org/10.4081/monaldi.2020.1381
Ethics Approval
Ethical clearance was obtained from the Institutional Ethical Committee of AIIMS Jodhpur (Certificate Reference Number: AIIMS/IEC/2022/4028).How to Cite
Jain, Yogesh Kumar, Pankaj Bhardwaj, Nitin Kumar Joshi, Manoj Kumar Gupta, Akhil Dhanesh Goel, and Prem Prakash Sharma. 2024. “Willingness to Pay for a Tobacco-Free Life: A Contingent Valuation Assessment”. Monaldi Archives for Chest Disease, August. https://doi.org/10.4081/monaldi.2024.3016.
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