Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-16T20:26:11.295Z Has data issue: false hasContentIssue false

Quitline in smoking cessation: A cost-effectiveness analysis

Published online by Cambridge University Press:  01 November 2004

Tanja Tomson
Affiliation:
Center for Tobacco Prevention
Ásgeir R. Helgason
Affiliation:
Center for Tobacco Prevention
Hans Gilljam
Affiliation:
Center for Tobacco Prevention

Abstract

Objectives: The cost-effectiveness of the Swedish quitline, a nation-wide, free of charge service, is assessed.

Methods: The study was based on data of a sample of 1,131 callers enrolled from February 1, 2000 to November 30, 2001. Outcome was measured as cost per quitter and cost per year of life saved. Cost per quitter was based on a calculation of the total cost of the quitline divided by the number of individuals who reported abstinence after 12 months. The cost per life year saved (LYS) was calculated by the use of data from the literature on average life expectancy for smokers versus quitters, the total cost of the quitline, and the cost of pharmacological treatment.

Results: The number of smokers who used the quitline and reported abstinence after 1 year was 354 (31 percent). The accumulated number of life years saved in the study population was 2,400. The cost per quitter was 1,052–1,360 USD, and the cost per life year saved was 311–401 USD. A sensitivity analysis showed that, for outcomes down to an abstinence rate of 20 percent, the cost per LYS rose modestly, from 311 to 482 USD. Discounting the cost per LYS showed the cost to be 135 USD for 3 percent and 283 USD for 5 percent.

Conclusions: The Swedish quitline is a cost-effective public health intervention compared with other smoking cessation interventions.

Type
GENERAL ESSAYS
Copyright
© 2004 Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brønnum-Hansen H, Juel K. 2001 Abstention from smoking extends life and compresses morbidity. A population based study of health expectancy among smokers and never smokers in Denmark. Tob Control. 10: 273278.Google Scholar
Caraballo RS, Giovino GA, Pechacek TF, Mowery PD. 2001 Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years and older. Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 153: 807814.Google Scholar
Crealey GE, McElmay JC, Maguire TA, O'Neill C. 1998 Costs and effects associated with a community pharmacy-based smoking cessation program. Pharmacoeconomics. 14: 323333.Google Scholar
Drummond MF, O'Brian B, Stoddart GL, Torrance GW. 1997. Methods for the economic evaluation of health care programs. 2nd ed. Oxford: Oxford University Press
El-Bastawissi AY, McAfee T, Zbikowski SM, et al. 2003 The uninsured and Medicaid Oregon tobacco user experience in a real world, phone based cessation programme. Tob Control. 12: 4551.Google Scholar
Fiore MC, Bailey WC, Cohen SJ, et al. 2000. Treating tobacco use and dependence. A clinical practice guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service
Helgason A, Tomson T, Lund KE, et al. 2004 Factors related to abstinence in a telephone helpline for smoking cessation. Eur J Public Health. 14: 306310.Google Scholar
Parrot S, Godfrey C, Raw M, et al. 1998 Guidance for commissioners on the cost effectiveness of smoking cessation interventions. Thorax. 53 (Suppl 5): 138.Google Scholar
Patrick DL, Cheadle A, Thompson DC, et al. 1994 The validity of self-reported smoking: A review and meta-analysis. Am J Public Health. 84: 10861093.Google Scholar
Peto R, Lopez AD, Boreham J, Thun M, Heath C. 1994. Mortality from tobacco in developed countries 1950-2000: Indirect estimates from national vital statistics. Oxford: Oxford University Press
Peto R. 1994 Smoking and death: The past 40 years and the next 40. BMJ. 309: 937939.Google Scholar
Pierce JP, Gilpin EA. 2003 A minimum 6-month prolonged abstinence should be required for evaluation smoking cessation trials. Nicotine Tob Res. 5: 151153.Google Scholar
Rapid and systematic review for NICE Bupropion SR and NRT for smoking cessation, 2002. Available at: www.nice.org.uk/pdf/Buproprionreview.pdf.
SBU—The Swedish Council on Technology Assessment in Health Care. 1998. Metoder för rökavvänjning. [Methods for smoking cessation]. Rapport nr 138, Stockholm: Swedish Council on Technology Assessment in Health Care
Shipley RH, Hartwell TD, Austin WD, Clayton AC, Stanley LC. 1995 Community stop-smoking contests in the COMMIT trial: Relationship of participation to costs. Prev Med. 24: 286292.Google Scholar
Statistics Sweden. SCB lifetables, 2001. Available at: www.scb.se.
Stead LH, Lancaster T, Perera R. 2003. Telephone counselling for smoking cessation. (Cochrane Review) In: The Cochrane Library, Volume 1. Oxford: Update Software
Taylor DH, Hasselblad V, Henley SJ, Thun MJ, Sloan FA. 2002 Benefits of smoking cessation for longevity. Am J Public Health. 92: 990996.Google Scholar
Tengs TO, Adams ME, Pliskin JS, et al. 1995 Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal. 15: 369390.Google Scholar
Tillgren P, Rosén M, Haglund BJ, et al. 1993 Cost-effectiveness of a tobacco ‘quit and win’ contest in Sweden. Health Policy. 26: 4353.Google Scholar
Tsevat J, Weinstein MC, Williams LW, Tosteson AN, Goldman L. 1991 Expected gains in life expectancy from various coronary heart disease risk factor modifications. Circulation. 83: 11941201.Google Scholar
Warner KE. 1997 Cost effectiveness of smoking cessation therapies. Interpretation of the evidence and implications for coverage. Pharmacoeconomics 11: 538549.Google Scholar
World Bank. 1999 Curbing the epidemic: Governments and the economics of tobacco control. Washington, DC: The World Bank 8: 196201.
Zhu SH, Anderson CM, Tedeschi GJ, et al. 2002 Evidence of real-world effectiveness of a telephone quitline for smokers. N Engl J Med. 347: 10871093.Google Scholar
Zhu SH, Melcer T, Sun J, et al. 2000 Smoking cessation with and without assistance a population-based analysis. Am J Prev Med. 18: 305311.Google Scholar
Mackay J, Eriksen M. 2002. The tobacco atlas. World Health Organisation. London: The Hanway Press