A model for cost-effectiveness analyses of smoking cessation interventions applied to a Quit-and-Win contest for mothers of small children

Johansson, Pia; Tillgren, Per; Guldbrandsson, Karin; Lindholm, Lars

doi:10.1080/14034940510005789

Cited by 23 publications

(9 citation statements)

References 35 publications

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“…For example, the cost per life year saved via tobacco dependence treatment has been estimated at $3,539 (Cromwell et al, 1997), which compares favorably to hypertension screening for men, ages 45–54 ($5,200), and annual cervical screening for women, ages 34–39 ($4,100; Tengs et al, 1995). In addition, tobacco dependence treatment compares quite favorably, on the basis of quality adjusted life years saved, with other treatments such as those for hypertension and hypercholesterolemia as well as with preventive screening (e.g., mammography, Pap smears; Brandon et al, 2004; Chirikos, Herzog, Meade, Webb, & Brandon, 2004; Croghan et al, 1997; Feenstra, Hamberg-van Reenen, Hoogenveen, & Rutten-van Molken, 2005; Johansson, Tillgren, Guldbrandsson, & Lindholm, 2005; Parrott&Godfrey, 2004; Raw, McNeill,&Coleman, 2005; Solberg et al, 2006; Stapleton, Lowin, & Russell, 1999). …”

Section: Merits Of Psychosocial Interventions and Future Prospects Ofmentioning

confidence: 99%

Current Status and Future Prospects of Clinical Psychology

Baker

McFall

Shoham

2008

Psychol Sci Public Interest

281

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SUMMARYThe escalating costs of health care and other recent trends have made health care decisions of great societal import, with decision-making responsibility often being transferred from practitioners to health economists, health plans, and insurers. Health care decision making increasingly is guided by evidence that a treatment is efficacious, effective-disseminable, cost-effective, and scientifically plausible. Under these conditions of heightened cost concerns and institutional-economic decision making, psychologists are losing the opportunity to play a leadership role in mental and behavioral health care: Other types of practitioners are providing an increasing proportion of delivered treatment, and the use of psychiatric medication has increased dramatically relative to the provision of psychological interventions.Research has shown that numerous psychological interventions are efficacious, effective, and costeffective. However, these interventions are used infrequently with patients who would benefit from them, in part because clinical psychologists have not made a convincing case for the use of these interventions (e.g., by supplying the data that decision makers need to support implementation of such interventions) and because clinical psychologists do not themselves use these interventions even when given the opportunity to do so.Clinical psychologists' failure to achieve a more significant impact on clinical and public health may be traced to their deep ambivalence about the role of science and their lack of adequate science training, which leads them to value personal clinical experience over research evidence, use assessment practices that have dubious psychometric support, and not use the interventions for which there is the strongest evidence of efficacy. Clinical psychology resembles medicine at a point in its history when practitioners were operating in a largely prescientific manner. Prior to the scientific reform of medicine in the early 1900s, physicians typically shared the attitudes of many of today's clinical psychologists, such as valuing personal experience over scientific research. Medicine was reformed, in large part, by a principled effort by the American Medical Association to increase the science base of medical school education. Substantial evidence shows that many clinical psychology doctoral training programs, especially PsyD and for-profit programs, do not uphold high standards for graduate admission, have high student-faculty ratios, deemphasize science in their training, and produce students who fail to apply or generate scientific knowledge.A promising strategy for improving the quality and clinical and public health impact of clinical psychology is through a new accreditation system that demands highquality science training as a central feature of doctoral training in clinical psychology. Just as strengthening training standards in NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript medicine markedly enhanced the quality of health care, improved tra...

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Section: Merits Of Psychosocial Interventions and Future Prospects Ofmentioning

confidence: 99%

Current Status and Future Prospects of Clinical Psychology

Baker

McFall

Shoham

2008

Psychol Sci Public Interest

281

View full text Add to dashboard Cite

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“…These researchers intended that the HECOS model would be widely accessible and modifiable for application to other countries, but the version we sourced could not be adapted to provide the analyses we needed. Johansson and colleagues developed a similar model to predict the health and economic consequences of smoking cessation in Sweden, [7] but it is not available for adaptation to other settings.…”

Section: Introductionmentioning

confidence: 99%

Untitled

Hurley

Matthews²

2007

Cost Eff Resour Alloc

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“…5 Unlike for all pharmacologic therapies for COPD, the cost-effectiveness of smoking cessation on a population basis has been rigorously evaluated and found to be cost-effective to costsaving over time. [6][7][8][9] We examined whether smoking status and the duration of abstinence from tobacco smoke were associated with a decreased risk of COPD exacerbations.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Smoking Cessation on the Risk of Chronic Obstructive Pulmonary Disease Exacerbations

et al. 2009

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BACKGROUND:Smoking cessation has been demonstrated to reduce the rate of loss of lung function and mortality among patients with mild to moderate chronic obstructive pulmonary disease (COPD). There is a paucity of evidence about the effects of smoking cessation on the risk of COPD exacerbations. OBJECTIVE:We sought to examine whether smoking status and the duration of abstinence from tobacco smoke is associated with a decreased risk of COPD exacerbations. DESIGN:We assessed current smoking status and duration of smoking abstinence by self-report. Our primary outcome was either an inpatient or outpatient COPD exacerbation. We used Cox regression to estimate the risk of COPD exacerbation associated with smoking status and duration of smoking cessation. PARTICIPANTS:We performed a cohort study of 23,971 veterans who were current and past smokers and had been seen in one of seven Department of Veterans Affairs (VA) primary care clinics throughout the US. MEASUREMENTS AND MAIN RESULTS:In comparison to current smokers, ex-smokers had a significantly reduced risk of COPD exacerbation after adjusting for age, comorbidity, markers of COPD severity and socioeconomic status (adjusted HR 0.78, 95% CI 0.75-0.87). The magnitude of the reduced risk was dependent on the duration of smoking abstinence (adjusted HR: quit<1 year, 1.04; 95% CI 0.87-1.26; 1-5 years 0.93, 95% CI 0.79-1.08; 5-10 years 0.84, 95% CI 0.70-1.00; ≥10 years 0.65, 95% CI 0.58-0.74; linear trend<0.001). CONCLUSIONS:Smoking cessation is associated with a reduced risk of COPD exacerbations, and the described reduction is dependent upon the duration of abstinence.

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A model for cost-effectiveness analyses of smoking cessation interventions applied to a Quit-and-Win contest for mothers of small children

Cited by 23 publications

References 35 publications

Current Status and Future Prospects of Clinical Psychology

Current Status and Future Prospects of Clinical Psychology

Untitled

The Effects of Smoking Cessation on the Risk of Chronic Obstructive Pulmonary Disease Exacerbations

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