Cost-effectiveness of a hospital-based smoking cessation intervention.
OBJECTIVE
This study evaluated the cost-effectiveness of a smoking cessation and relapse-prevention program for hospitalized adult smokers from the perspective of an implementing hospital. It is an economic analysis of a two-group, controlled clinical trial in two acute care hospitals owned by a large group-model health maintenance organization. The intervention included a 20-minute bedside counseling session with an experienced health counselor, a 12-minute video, self-help materials, and one or two follow-up calls.


METHODS
Outcome measures were incremental cost (above usual care) per quit attributable to the intervention and incremental cost per discounted life-year saved attributable to the intervention.


RESULTS
Cost of the research intervention was $159 per smoker, and incremental cost per incremental quit was $3,697. Incremental cost per incremental discounted life-year saved ranged between $1,691 and $7,444, much less than most other routine medical procedures. Replication scenarios suggest that, with realistic implementation assumptions, total intervention costs would decline significantly and incremental cost per incremental discounted life-year saved would be reduced by more than 90%, to approximately $380.


CONCLUSIONS
Providing brief smoking cessation advice to hospitalized smokers is relatively inexpensive, cost-effective, and should become a part of the standard of inpatient care.
Meenan
R T
RT
Kaiser Permanente Center for Health Research, Portland, Oregon 97227-1098, USA. meenanri@chr.mts.kpnw.org
Stevens
V J
VJ
Hornbrook
M C
MC
La Chance
P A
PA
Glasgow
R E
RE
Hollis
J F
JF
Lichtenstein
E
E
Vogt
T M
TM
D000328:Adult; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009922:Oregon; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011634:Public Health; D055502:Secondary Prevention; D016540:Smoking Cessation / Q000191:economics*; D026712:Value of Life; D014861:Washington