Cost-effectiveness analysis of smoking cessation interventions using cell phones in a low-income population. Issue 1 (9th June 2018)

• Record Type: Journal Article
• Authors: Daly, Allan T; Deshmukh, Ashish A; Vidrine, Damon J; Prokhorov, Alexander V; Frank, Summer G; Tahay, Patricia D; Houchen, Maggie E; Cantor, Scott B
• Is Part Of: Tobacco control. Volume 28:Issue 1(2019)
• Page Start: 88
• Page End: 94
• Publication Date: 2018-06-09
• Subjects: smoking cessation -- cost and cost analysis -- decision making -- underserved populations -- community outreach -- mobile clinic; Tobacco use -- Prevention -- Periodicals; Tobacco use -- Periodicals; Smoking -- Law and legislation -- Periodicals; Smoking -- prevention & control -- Periodicals; Tobacco Use Disorder -- prevention & control -- Periodicals; Tobacco -- Periodicals; Electronic journals; 613.85
• DOI: 10.1136/tobaccocontrol-2017-054229
• Languages: English
• ISSNs: 0964-4563

Abstract

Abstract : Background: The prevalence of cigarette smoking is significantly higher among those living at or below the federal poverty level. Cell phone-based interventions among such populations have the potential to reduce smoking rates and be cost-effective. Methods: We performed a cost-effectiveness analysis of three smoking cessation interventions: Standard Care (SC) (brief advice to quit, nicotine replacement therapy and self-help written materials), Enhanced Care (EC) (SC plus cell phone-delivered messaging) and Intensive Care (IC) (EC plus cell phone-delivered counselling). Quit rates were obtained from Project ACTION (Adult smoking Cessation Treatment through Innovative Outreach to Neighborhoods). We evaluated shorter-term outcomes of cost per quit and long-term outcomes using cost per quality-adjusted life year (QALY). Results: For men, EC cost an additional $541 per quit vs SC; however, IC cost an additional $5232 per quit vs EC. For women, EC was weakly dominated by IC—IC cost an additional $1092 per quit vs SC. Similarly, for men, EC had incremental cost-effectiveness ratio (ICER) of $426 per QALY gained vs SC; however, IC resulted in ICER of $4127 per QALY gained vs EC. For women, EC was weakly dominated; the ICER of IC vs SC was $1251 per QALY gained. The ICER was below maximum acceptable willingness-to-pay threshold of $50 000 per QALY under all alternative modelling assumptions. Discussion: Cell phone interventions for low socioeconomic groups are a cost-effective use of healthcare resources. Intensive Care was the most cost-effective strategy both for men and women. Trial registration number: NCT00948129 ; Results.