[Efficacy and cost-effectiveness of smoking cessation courses in the statutory health insurance: a review].
BACKGROUND
Most of German health insurance funds provide and reimburse cognitive-behavioural group-based courses for smoking cessation according to section sign 20 Abs. 1 SGB V or section sign 20 a SGB V. The main goal of this study is to conduct a review of the efficacy and cost-effectiveness of these smoking cessation courses and their methodical approaches.


METHODS
A literature search for available systematic reviews, meta-analyses, health technology assessments (HTA), and guidelines was conducted in relevant databases.


RESULTS
Overall, six publications were included. Two sources confirm the long-term efficacy of group-based smoking cessation approach [OR (odds ratio)=1.3 and OR=2.17] with meta-analyses. The majority of available reviews or national guidelines are based on the results of these two researches. Two further reviews estimate the behaviour-based group therapy as effective. The efficacy estimation of single behavioural intervention components (skill training, problem solv-ing, relapse prevention) varies from OR=0.91 to OR=1.5. The evidence is insufficient for the internationally widespread course "Allen Carr's Easyway". No relevant publications on economic issues could be included for the courses currently made available by the statutory health insurance.


CONCLUSIONS
The methodical approaches of smoking cessation courses offered by health insurance funds are effective and recommendable according to the available secondary literature. The efficacy of these interventions is not very high and solely covers general methodical approaches or programme components. Evaluations of current smoking cessation courses are rare and do not meet internationally accepted standards. Further research should be aimed to evaluate the established programmes with high-quality health economic studies.
Rasch
A
A
Fakultät für Gesundheitswissenschaften, Gesundheitsökonomie und Gesundheitsmanagement (AG5), Universität Bielefeld. andrej.rasch@uni-bielefeld.de
Greiner
W
W
D003362:Cost-Benefit Analysis; D005858:Germany / Q000453:epidemiology; D017048:Health Care Costs / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006801:Humans; D009313:National Health Programs / Q000331:legislation & jurisprudence*; D010353:Patient Education as Topic / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D012907:Smoking / Q000191:economics* / Q000453:epidemiology*; D016540:Smoking Cessation / Q000191:economics* / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data