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Areas for further research

  • Given the fast-changing landscape of tobacco control interventions affecting the tobacco market as well as the ever-growing supply of smoking cessation interventions, it is imperative to study the economic aspects of smoking cessation globally, and especially in low- and middle-income countries where the majority of smokers live and where the evidence is still scarce.
  • Investigators should study what motivates quit attempts and their frequency, and how this motivation changes over time, across different socio-economics group and across smokers with different levels of nicotine dependence. For example, little is known about the impact of tobacco excise tax structure and the resulting degree of tobacco price variation on the motivation for cessation and successful quitting. The level of tobacco excise tax is related to tobacco products' price points that could escalate the demand for cessation. Establishing that price point and reaching it by implementing a systematic tobacco tax policy could result in a real breakthrough in escalating smoking cessation rates.
  • Higher health insurance premiums for smokers can also motivate smoking cessation, yet there is little evidence to demonstrate this relationship.
  • Very little is still known about the determinants of successful cessation. Is the level of nicotine dependence a factor? Are there type of smokers who would benefit from the extended duration of pharmacotherapy to achieve abstinence and prevent relapse?
  • The relationship between the motivation to quit and the demand for cessation services and cessation pharmacotherapies should be investigated. Assessing price and income elasticities of demand for these products are important for evaluating the cost-effectiveness of cessation interventions.
  • Researchers should study effectiveness, costs and cost-effectiveness by frequency and intensity of tobacco use and by socio-economic status. There is a gap in the literature with respect to the cost-effectiveness of school-based cessation programs and youth smoking cessation programs using novel methods such as Internet and mobile-based cessation interventions. What is the role of peer and family on the demand for smoking cessation among young smokers? It is also important to evaluate the effectiveness and the cost-effectiveness of tailor-made cessation approaches for high prevalence/hard to reach populations (e.g. low income groups, the less educated, aboriginals, those with a history of mental illness). In addition, we know very little about access to and the demand for cessation services in low- and middle-income countries and the role these can play in achieving lower smoking prevalence targets.
  • Future research should also address the effect of e-cigarette uptake on smoking cessation and examine the nature of the relationship between physical exercise and smoking cessation. logo
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