Use of national smoking cessation service program in Taiwan

Background Taiwan implemented a national smoking cessation service program (NSCSP) since 2004, which reimbursed the physicians counseling fee and partially subsidized the patients on the medication expense. Purpose To analyze the determinants of use of NSCSP and examine whether socio-economic status influenced the use of NSCSP among current smokers. Methods This study identified 3658 current smokers in the 2005 National Health Interview Survey and linked their National Health Insurance Research Database to identify use of NSCSP until 2007. We used survival analysis to analyze the time to use NSCSP. A multi-level logistic regression and a multi-level Poisson regression were used to analyze the difference of the influence of socio-economic status on using NSCSP across geographic areas. Results The multilevel logistic regression showed smokers with lower educational levels were less likely to use NSCSP than smokers of the highest educational level (elementary school or below: OR=0.55). People with chronic heart disease (OR=0.84) or diabetes (OR=2.37) tended to use NSCSP. The multilevel Poisson regression showed the similar associations. The survival analysis showed people with higher monthly household income tended delay the use of NSCSP; however, education levels didn't have significant effects on the time of NSCSP use. Conclusions Education level and health concerns played the most important roles on the initiation of using NSCSP. Meanwhile, monthly household income and health concerns played the important role on visits of NSCSP. Further efforts should be placed to reach the lower-educated smokers, who might need more information to increase their knowledge access to the NSCSP.