Cost effectiveness of a community based research project to help women quit smoking

Abstract

Objective: To estimate the cost effectiveness of a four year, multifaceted, community based research project shown previously to help women quit smoking. Design: A quasi-experimental matched control design. Setting: Two counties in Vermont and two in New Hampshire, USA. Subjects: Women aged 18-64 years. Methods: Costs were the grant related expenditures converted to 2002 US$. Survey results at the end of the intervention were used to estimate the numbers of never smokers, former smokers, light smokers, and heavy smokers in the intervention and comparison counties, and 1986 life tables for populations of US women categorised by smoking status to estimate the gain in life expectancy. Main outcome measures: Cost effectiveness ratios, as dollars per life-year saved, for the intervention only and for total grant costs (intervention, evaluation and indirect costs). Results: The cost effectiveness ratio for the intervention, in 2002 US$ per life-year saved, discounted at 3%, was $1156 (90% confidence interval (CI) $567 to '), and for the total grant, $4022 (90% CI $1973 to '). When discounted at 5%, these ratios were $1922 (90% CI $1024 to $15 647), and $6683 (90% CI $3555 to $54 422), respectively. Conclusion: The cost effectiveness ratios of this research project are economically attractive, and are comparable with other smoking cessation interventions for women. These observations should encourage further research and dissemination of community based interventions to reduce smoking.

Measuring the benefits of health promotion programmes: Application of the contingent valuation method

“…Health outcomes are reported where evidence exists or where they can be derived through modelling [22,23]. Life years gained or quality adjusted life years (QALYs) are also sometimes estimated [24][25][26][27][28][29][30][31]. However, even these generic measures of outcome can fail to capture the full range of intervention benefits.…”

The Hitchhiker's Guide to Tobacco Control: A Global Assessment of Harms, Remedies, and Controversies

“…The cost-effectiveness of English smoking treatment services [£684 per quality-adjusted life-year (QALY) on average] is well below the U.K. benchmark of £20,000 per QALY (53). Less is known about the cost-effectiveness of community interventions, but they may be comparable (115). Even in middle-income countries, cessation pharmacotherapy can be highly cost-effective compared with other medical interventions (50).…”

Establishing the economics of engaging communities in health promotion: what is desirable, what is feasible?

“…The quit-and-win contests for smoking cessation did not directly assess benefits, but found that the per-participant cost of the 26 contests, which ranged from US$28 to $154, was directly related to participation rates (Segal et al 1998). Only one of the included studies found that community engagement might not be cost-effective for health promotion: Secker-Walker's evaluation of 'Breathe Easy', a multifaceted smoking cessation intervention for women, reported wide confidence intervals around the estimates of cost-effectiveness, meaning that the intervention was not statistically significantly more effective than not intervening (Secker-Walker et al 2005).…”

“…Interventions were complex and no study was designed to evaluate the cost-effectiveness of a 'community-engagement' component per se. Interventions were designed to reduce HIV infections (Broadhead et al 1998, Pinkerton et al 1998, prevent non-insulin dependent diabetes mellitus (NIDDM) (Segal et al 1998), and reduce smoking prevalence (Shipley et al 1995, Baxter et al 1997, Ratcliffe et al 1997, Ong and Glantz 2005, Secker-Walker et al 2005. The study by Baxter promoted smoking cessation alongside other healthy-heart behaviours such as healthy eating, exercise and weight loss (Baxter et al 1997).…”

“…Using a broad definition of community engagement , eight studies met the inclusion criteria for the review (Shipley et al 1995, Baxter et al 1997, Ratcliffe et al 1997, Broadhead et al 1998, Pinkerton et al 1998, Segal et al 1998, Ong and Glantz 2005, Secker-Walker et al 2005. With the exception of one study (Baxter et al 1997) that was identified by checking the bibliography of a review (Parrott et al 1998), all studies were identified on the NHS EED database, and two were again identified by the mapping review search strategy.…”