Estimation of the break-even point for smoking cessation programs in pregnancy.
BACKGROUND
Successful programs to help pregnant women quit smoking have been developed and evaluated, but formal smoking cessation programs are not a part of care at most prenatal sites. The cost of such programs may be an issue. Considering the costs of adverse maternal and infant outcomes resulting from smoking, we estimated there would be an amount of money a prenatal program could invest in smoking cessation and still "break even" economically.


METHODS
A model was developed and published data, along with 1989 hospital charge data, were used to arrive at a break-even point for smoking cessation programs in pregnancy.


RESULTS
Using overall United States data, we arrived at a break-even cost of $32 per pregnant woman. When these data were varied to fit specific US populations, the break-even costs varied from $10 to $237, with the incidence of preterm low birth weight having the most impact on the cost.


CONCLUSIONS
It may be advisable to invest greater amounts of money in a prenatal smoking cessation program for some populations. However, for every population there is an amount that can be invested while still breaking even.
Shipp
M
M
School of Medicine, University of California, San Francisco 94143-0900.
Croughan-Minihane
M S
MS
Petitti
D B
DB
Washington
A E
AE
D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D003663:Decision Trees; D005260:Female; D017048:Health Care Costs; D006302:Health Services Research; D006760:Hospitalization / Q000191:economics; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000191:economics / Q000592:standards*; D015995:Prevalence; D012907:Smoking / Q000191:economics / Q000453:epidemiology; D016540:Smoking Cessation / Q000191:economics*; D000074606:Smoking Prevention; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology