Smokers’ willingness to pay for smoking cessation services and its determinants: evidence from China

Smoking remains a leading cause of preventable disease, and smoking cessation services (SCS) are crucial for reducing tobacco-related burdens. However, little is known about Chinese smokers’ willingness to pay (WTP) for SCS and its determinants. This study assessed WTP for SCS and examined predisposing, enabling, and need factors guided by the Andersen model. A stratified multi-stage random household survey was conducted among 1,354 current smokers in Sichuan Province, China, between 2022 and 2023. Logistic regression was used to examine factors associated with the likelihood of expressing any WTP. Among smokers willing to pay, linear regression and Tobit models were applied to analyze determinants of payment levels for cessation benefits and incremental WTP associated with individual and third-party health benefits. Overall, 29.84% of smokers expressed a WTP for SCS. Among those willing to pay, the mean WTP was CNY 2,238.90 (USD 332.67) for smoking cessation, with additional mean WTP of CNY 1,011.77 (USD 150.34) for individual health benefits and CNY 907.22 (USD 134.80) for third-party health benefits. The likelihood of expressing any WTP was primarily associated with enabling resources and need factors, whereas payment levels were shaped by a broader combination of predisposing characteristics, enabling resources, as well as perceived and evaluated need. WTP for SCS among Chinese smokers is limited in prevalence, but among those who are willing to pay, the payment amounts are substantial. Different combinations of predisposing, enabling, and need-related factors shape whether smokers are willing to pay and how much they are willing to pay. Policies that emphasize affordable pricing, targeted subsidies, and strengthened public education may help expand SCS utilization and mitigate tobacco-related health burdens in China.