Time-discounting and tobacco smoking: a systematic review and network analysis.

Time-discounting and tobacco smoking: a systematic review and network analysis.
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DOI:
10.1093/ije/dyw233
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发表时间:
2017-06-01
影响因子:
7.7
通讯作者:
Stuckler D
Stuckler D
中科院分区:
医学1区
文献类型:
--
作者:
Barlow P;McKee M;Reeves A;Galea G;Stuckler D

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背景:吸烟危害健康,为什么人们吸烟却戒不掉?源于行为经济学的一种解释表明了时间折扣的作用,它描述了奖励的价值(例如更好的健康状况)如何随着收到的延迟而降低。大量研究测试了时间折扣与烟草结果的关系,但这种关系的时间模式及其根据测量方法的变化仍不清楚。我们回顾了时间折扣与吸烟之间的关联:(i) 从开始吸烟到戒烟的整个生命过程,以及 (ii) 各种折扣措施。 方法:我们在 Web of Science 和 PubMed 中确定了 69 项相关研究。我们综合了不同方法论的研究结果,并评估了折扣措施、研究质量和跨学科融合。 结果:在 54 项研究中的 44 项中,吸烟者比非吸烟者对未来的折扣更大,并且在纵向研究中,更高的折扣预测未来吸烟。时间折扣率较低的吸烟者戒烟率较高。使用假设的货币或香烟奖励情景衡量折扣率的研究结果一致。大多数研究的方法学质量被评为“中等”,同被引分析显示经济学期刊的孤立性和公共卫生研究的缺乏。 结论:有适度但一致的证据表明,高时间折扣是吸烟和戒烟不成功的危险因素。假设人口折扣率统一的政策情景可能无法充分反映吸烟者对成本和收益的看法。
Background: Tobacco smoking harms health, so why do people smoke and fail to quit? An explanation originating in behavioural economics suggests a role for time-discounting, which describes how the value of a reward, such as better health, decreases with delay to its receipt. A large number of studies test the relationship of time-discounting with tobacco outcomes but the temporal pattern of this relationship and its variation according to measurement methods remain unclear. We review the association between time-discounting and smoking across (i) the life course, from initiation to cessation, and (ii) diverse discount measures. Methods: We identified 69 relevant studies in Web of Science and PubMed. We synthesized findings across methodologies and evaluated discount measures, study quality and cross-disciplinary fertilization. Results: In 44 out of 54 studies, smokers more greatly discounted the future than non-smokers and, in longitudinal studies, higher discounting predicted future smoking. Smokers with lower time-discount rates achieved higher quit rates. Findings were consistent across studies measuring discount rates using hypothetical monetary or cigarette reward scenarios. The methodological quality of the majority of studies was rated as ‘moderate’ and co-citation analysis revealed an isolation of economics journals and a dearth of studies in public health. Conclusion: There is moderate yet consistent evidence that high time-discounting is a risk factor for smoking and unsuccessful cessation. Policy scenarios assuming a flat rate of population discounting may inadequately capture smokers’ perceptions of costs and benefits.
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