A cost-benefit analysis of smoking cessation programs during the first trimester of pregnancy for the prevention of low birthweight.
BACKGROUND
The frequency of low birthweight decreases when women quit smoking in the first trimester of pregnancy. This analysis examines the cost-effectiveness of smoking-cessation programs during pregnancy for the prevention of low birthweight.


METHODS
Using data from the 1988 National Health Interview Survey and estimated costs of care for low birthweight and normal birthweight infants, a decision tree was constructed to estimate break-even costs for smoking-cessation programs, assuming a success rate of 18%. Sensitivity analyses were performed to determine how program effectiveness and changes in the population affected the break-even costs.


RESULTS
For a population similar to that which participated in the 1988 National Health Interview Survey, smoking-cessation programs would be cost-effective if the program cost $80 or less. In general, to be cost-effective, a smoking-cessation program has to decrease smoking rates by 2.15% to justify every $10 in program costs. Sensitivity analyses showed that as the baseline spontaneous quit rate in the smoking population decreases, smoking-cessation programs of higher cost become more cost-effective.


CONCLUSIONS
Smoking cessation programs during pregnancy may be cost-effective for preventing low birthweight if their cost is $80 or less and they achieve success rates of at least 18%.
Hueston
W J
WJ
Eau Claire Family Practice Residency Program, Wisconsin 54701.
Mainous
A G
AG
Farrell
J B
JB
D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011322:Primary Prevention / Q000191:economics; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation / Q000191:economics*