title: Effectiveness of pharmacotherapy in behavioural therapeutic smoking cessation programmes.
abstract: BACKGROUND
  In 2011, pharmacotherapy as a part of smoking cessation treatment was reimbursed through the basic health insurance in the Netherlands. We examine the (cost)-effectiveness of pharmacotherapy added to behavioural therapy.
  
  
  METHODS
  An observational study was conducted using data from the suppliers of the smoking cessation programmes together with information on costs from health insurance company Achmea. National suppliers, general practitioners and healthcare centres offered four different programmes. (i) Behavioural support (=therapy); (ii) Behavioural support combined with nicotine replacement therapy (NRT); (iii) Behavioural support combined with smoking cessation aids (=medication) (SCA); (iv) Behavioural support combined with NRT and SCA. The primary independent variable was the programme type, and the primary outcome was whether someone quitted smoking. To examine the effectiveness of the different programmes logistic regression and logistic multilevel analyses were performed. Bootstrapping was used to evaluate cost-effectiveness.
  
  
  RESULTS
  The results indicate that behavioural support combined with SCA has more quitters than the reference programme of behavioural support alone, and it also seems the most cost-effective programme for general practitioners and healthcare centres. Behavioural therapy combined with NRT had also more quitters, although the difference with the reference programme was smaller.
  
  
  CONCLUSIONS
  Behavioural support combined with SCA seems the most successful programme. However, as we performed an observational study, firm conclusions about the differences in effectiveness between the programme types cannot be made. Future research should consider the type of smoker (smoking history, amount of cigarettes per day).
authors.affiliation: 1 Achmea, Care and Health division, knowledge and expertise centre, Zeist, The Netherlands rosan.oostveen@achmea.nl.
authors.forename: Rosan
authors.initials: R
authors.lastname: Oostveen
authors.affiliation: 1 Achmea, Care and Health division, knowledge and expertise centre, Zeist, The Netherlands.
authors.forename: Onno P
authors.initials: OP
authors.lastname: van der Galiën
authors.affiliation: 1 Achmea, Care and Health division, knowledge and expertise centre, Zeist, The Netherlands 2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hugo M
authors.initials: HM
authors.lastname: Smeets
authors.affiliation: 1 Achmea, Care and Health division, knowledge and expertise centre, Zeist, The Netherlands.
authors.forename: Anne P D
authors.initials: AP
authors.lastname: Hollinga
authors.affiliation: 3 Faculty of Earth and Life Science, VU University Amsterdam, Amsterdam, The Netherlands.
authors.forename: Judith E
authors.initials: JE
authors.lastname: Bosmans
mesh_terms: D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D018722:Nicotinic Agonists / Q000191:economics* / Q000627:therapeutic use*; D015397:Program Evaluation / Q000191:economics*; D016540:Smoking Cessation / Q000191:economics* / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D018722:Nicotinic Agonists