Changes in Smokers' Attitudes Toward Intended Cessation Attempts in Japan

Background: Japan has the highest smoking prevalence among the G7 countries, and the Japanese government is expanding tobacco control measures, such as financial support for nicotine replacement therapy and cigarette price increases, to reduce smoking. In 2006, we examined intended quit attempts using hypothetical questions. Since then, a price increase for cigarettes has been proposed and has come closer to being realized. Objective: To examine attitude changes in intending to quit attempts according to the reinforcement of tobacco control policies and to clarify the attitudes toward the smoking policies under debate. Method: In July 2006, a discrete choice experiment was performed in 616 current smokers. In January 2010, we conducted the same discrete choice experiment in 600 current smokers. In addition, we investigated attitudes toward increased cigarette price and amendments to the laws regulating the tobacco industry. Results: In general, between 2006 and 2010, the discrete choice experiment indicated that the smoking continuation rate decreased for highly dependent smokers and increased for low and moderately dependent smokers. Regarding individual measures, increases in tobacco price consistently persuaded smokers of all dependence levels to attempt to quit smoking, whereas factors such as risk information and a smoking ban were effective only for low-dependence smokers. Current smokers show less support for a price increase and legislation of health promotion than nonsmokers. Of current smokers, those with greater nicotine dependence support these policies less. Conclusions: The shift of preference for intended attempts to quit is diverse according to nicotine dependence. These differences may be derived from the variations of their time and risk preference and their trust in the tobacco price policies.