Effect of the first federally funded US antismoking national media campaign

Abstract

EVAR and open repair. In the current study, the authors sought to analyze the cost-effectiveness and cost-utility of EVAR compared with a standard open repair in the treatment of rAAA, with costs per 30-day and 6-month survival as outcome parameters. Resource use was determined from the Amsterdam Acute Aneurysm trial data. Analysis was performed from a provider perspective. All costs were calculated as if patients had been treated in the same teaching hospital (Onze Lieve Vrouwe Gasthuis). The study randomized 116 patients. The 30-day mortality was 21% after EVAR and 25% after open repair, for an absolute risk reduction of 4.4% (95% confidence interval [CI], À11.0% to 19.7%). At 6 months, the total mortality rate for EVAR was 28% compared with 31% for those assigned to open repair (absolute risk reduction, 2.4%; 95% CI, À14.2% to 19.0%). The mean cost difference between EVAR and OR was €5306 (95% CI, À€1854 to €12,659) at 30 days and €10,189 (95% CI, e€2477 to €24,506) at 6 months. The incremental cost-effectiveness ratio per prevented death was €120,591 at 30 days and €424,542 at 6 months. There was no significant difference in quality of life between EVAR and OR. EVAR was not superior regarding cost-utility, either. In this study, the mean costs of the EVAR group were substantially raised by eight patients who required conversion to open repair. At 6 months, the mean difference between the converted and nonconverted groups was €19,981. The total costs required to save one person's life with EVAR was €120,446. At 6 months, this leads to a number needed to treat of 41.7 patients at €424,881 per life saved.Comment: Overall, the Amsterdam Ruptured Aneurysm Study has indicated that EVAR for treatment of rAAA is associated with a slightly lower mortality rate but a considerably higher cost. The paper raises the interesting point: At what point are advances in medical technology affordable, and at what point do they become cost-prohibitive?

How Graphic Visual Health Warnings Affect Young Smokers’ Thoughts of Quitting

“…One immediate research question to consider is whether graphic images on cigarette packages act as a deterrent for adolescents and young adults who are not current smokers when they are offered a cigarette. A recent evaluation of those exposed (vs. not exposed) to graphic images from the CDC's "Tips from Former Smokers" antismoking media campaign showed positive effects not only on smoker quit attempts and abstinence but also on nonsmoker recommendations for smokers to quit (McAfee et al 2013). Thus, clearly, more research examining the potential preventive nature of the graphic warnings is needed.…”

“…These attempts include antitobacco ad campaigns (Andrews et al 2004;Farrelly et al 2005;McAfee et al 2013;Pechmann and Reibling 2000;Pechmann et al 2003), comprehensive school-based programs (Flynn et al 1994), restriction of promotion at retail stores (Slater et al 2007), and increased excise taxes to limit usage for more advanced adolescent smokers (Emery, White, and Pierce 2001). Although many of these efforts have shown some success in reducing smoking intentions and/or behavior, the most prominent countermarketing tool that has been employed in more than 43 countries worldwide today (though not in the United States) is the use of graphic visual health warnings on cigarette packages (Myers 2012).…”

“…Although some research exists on understanding how adult smokers process graphic visual health warnings (e.g., Hammond et al 2003; Kees et al 2006Kees et al , 2010McAfee et al 2013;Romer et al 2013), it is uncertain exactly how adolescent smokers will react to such warnings, especially those evaluated as "highly graphic." Will they express stronger thoughts of quitting after exposure to graphic pictures?…”

Recall of Anti-Tobacco Advertisements and Effects on Quitting Behavior: Results From the California Smokers Cohort

“…The majority of evidence indicates that these mass media campaigns are effective in motivating individuals to think about quitting, try to quit, get help for quitting and stay quit (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). At the population level, advertisements are also associated with decreases in cigarette consumption and smoking prevalence (13,15,16,19,(30)(31)(32)(33)(34)(35). Although the magnitude of the effect of media campaigns on cessation is estimated to be fairly small, when this small effect is applied over an entire population the reductions can be very meaningful.…”

“…Although the magnitude of the effect of media campaigns on cessation is estimated to be fairly small, when this small effect is applied over an entire population the reductions can be very meaningful. The United States Center for Disease Control (CDC), for example, recently estimated that their national ad-campaign called "Tips From Former Smokers (TIPS)" led to 1.64 million quit attempts and more than 100 000 American's quitting smoking (19).…”