Premium
The cost‐effectiveness of a smoking cessation program for out‐patients in treatment for depression
Author(s) -
Barnett Paul G.,
Wong Wynnie,
Hall Sharon
Publication year - 2008
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/j.1360-0443.2008.02167.x
Subject(s) - smoking cessation , medicine , nicotine replacement therapy , mental health , abstinence , depression (economics) , cost effectiveness , psychiatry , bupropion , randomized controlled trial , quality of life (healthcare) , intervention (counseling) , nursing , risk analysis (engineering) , pathology , economics , macroeconomics
Aims Smoking cessation programs are highly cost‐effective. The cost‐effectiveness of programs for psychiatric patients may be affected by differences in cost, efficacy, survival and quality of life. We evaluated cost‐effectiveness of a program for smokers being treated for depression. Design A randomized trial compared brief contact to a stepped smoking cessation program in 322 cigarette smoking mental health out‐patients. We determined the intervention's direct cost. Because smoking cessation may affect short‐term use of mental health care, we used administrative databases and self‐report to find mental health‐care cost. Findings The 163 individuals randomized to stepped care received an average of $346 of smoking cessation services, including $221 for computer‐mediated assessments of readiness to quit, and $124 for counseling, nicotine replacement therapy and bupropion. The cessation program was used by 53 participants. Total cost of smoking cessation and mental health services was $4805 in the stepped care group and $4173 in the brief‐contact care group (not significantly different). After 18 months of follow‐up, the stepped care group had 5.5% greater abstinence from smoking. Smoking cessation services cost $6204 per successful quit. Cessation services and mental health care cost was $11 496 per successful quit. Conclusion If smoking cessation yields 1.2 years additional life, the cessation services cost $5170 per life‐year, and cessation services and mental health care cost $9580 per life‐year. Even if quitting does not increase survival of depressed individuals as well as in other smokers, the stepped care intervention is likely to be regarded as cost‐effective.