Stakeholder preferences for smoking cessation support in Queensland, Australia: a mixed methods study to develop attributes and levels for a discrete choice experiment

Background and objective Engagement with smoking cessation services, such as Quitline, supports successful attempts at smoking cessation. Nevertheless, very few Australians engage with services when initiating a quit attempt. We sought to understand important attributes for smoking cessation support from stakeholders of smoking cessation services in Queensland, Australia. This paper describes the iterative process of attribute development for a prospective discrete choice experiment (DCE) on preferences for smoking cessation support. Methods We identified important attributes for smoking cessation support through individual qualitative interviews with stakeholders. We then conducted a quantitative prioritisation exercise in which stakeholders ranked these attributes in order of perceived importance. An expert panel debated the validity and feasibility of these attributes for use in a planned DCE. Stakeholders in our study included adults who currently or previously smoked tobacco-based cigarettes, and professionals working in smoking cessation services. Results The process of attribute development incorporated service-user and -provider perspectives, alongside service-level, and methodological considerations. We developed a final list of seven attributes, each with between two and 10 levels for use in a DCE survey to elicit preferences for smoking cessation support. The final attributes comprised pharmacotherapy options, “medications”; options for contact methods by which support is delivered, “support”; total travel distance to and from the service if delivered in person, “distance”; proactive or ad-hoc contact options, “contact”; advice and support for other topics in addition to smoking cessation counselling, “additional”; self-directed mobile-based supports, “tools”; and out-of-pocket costs for the program, “cost”. Conclusions We describe the process of extensive stakeholder engagement to develop and refine attributes and levels for smoking cessation for use in a future DCE. The results of this paper could be applicable to attribute development in services and contexts beyond smoking cessation services in Queensland.