title: Cost-effectiveness of self-help smokeless tobacco cessation programs.
abstract: This study assessed the cost-effectiveness of two low-intensity programs for quitting smokeless tobacco, based on results of a randomized trial with 1,069 volunteer participants. Cost data were collected for two levels of intervention: manual only (a self-help manual) and assisted self-help (the manual plus a videotape and two supportive phone calls from tobacco cessation counselors). Incremental cost-effectiveness ratios were calculated for assisted self-help vs. quitting on one's own, using the manual-only quit rate and data from another study as alternative proxies for no intervention. A threshold analysis was conducted to determine the spontaneous quit rate at which the manual-only intervention becomes more cost-effective than assisted self-help. The cost to provide and receive the assisted self-help intervention averaged US $56 per participant vs. $20 for the manual-only intervention (societal perspective, Year 2000 dollars). Estimates for incremental cost per quit for the assisted self-help intervention ranged from $922 to $1,758, depending on the proxy used for no intervention. The manual-only intervention was more cost-effective than assisted self-help if quitting among motivated chewers who do not receive treatment does not exceed 3.4%. Support from a wife or partner added little cost to a quit attempt for male chewers ($3-$4). Providing a manual, video, and brief phone counseling to smokeless tobacco users who want to quit is a reasonable use of health care resources. The self-help quitting guide also may be a cost-effective treatment, but it remains to be demonstrated whether it is more effective than quitting on one's own.
authors.affiliation: Oregon Research Institute, Eugene, OR 97403, USA. lauraa@ori.org
authors.forename: Laura
authors.initials: L
authors.lastname: Akers
authors.forename: Herbert H
authors.initials: HH
authors.lastname: Severson
authors.forename: Judy A
authors.initials: JA
authors.lastname: Andrews
authors.forename: Edward
authors.initials: E
authors.lastname: Lichtenstein
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006266:Health Education / Q000191:economics* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000191:economics* / Q000379:methods; D012657:Self-Help Groups; D011795:Surveys and Questionnaires; D020340:Tobacco Use Cessation / Q000191:economics* / Q000379:methods; D014029:Tobacco Use Disorder / Q000188:drug therapy / Q000191:economics*; D014030:Tobacco, Smokeless / Q000191:economics*; D016896:Treatment Outcome; D014494:Unithiol
chemical_list: D014494:Unithiol