A Review of Economic Evaluations of Tobacco Control Programs

Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA 30341, USA.
International Journal of Environmental Research and Public Health (Impact Factor: 2.06). 02/2009; 6(1):51-68. DOI: 10.3390/ijerph6010051
Source: PubMed


Each year, an estimated 443,000 people die of smoking-related diseases in the United States. Cigarette smoking results in more than $193 billion in medical costs and productivity losses annually. In an effort to reduce this burden, many states, the federal government, and several national organizations fund tobacco control programs and policies. For this report we reviewed existing literature on economic evaluations of tobacco control interventions. We found that smoking cessation therapies, including nicotine replacement therapy (NRT) and self-help are most commonly studied. There are far fewer studies on other important interventions, such as price and tax increases, media campaigns, smoke free air laws and workplace smoking interventions, quitlines, youth access enforcement, school-based programs, and community-based programs. Although there are obvious gaps in the literature, the existing studies show in almost every case that tobacco control programs and policies are either cost-saving or highly cost-effective.

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Available from: Bishwa Adhikari, May 07, 2014
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    • "Smoking cessation is one of the most cost effective interventions that can be achieved in primary care [29]. However many smokers are very reluctant to commit to a smoking cessation programme (precontemplative and contemplative) and about half of those that attend for smoking cessation intervention (action stage of change) are likely to drop out or give up trying. "
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    ABSTRACT: Background A gene-based estimate of lung cancer risk in smokers has been shown to act as a smoking cessation motivator in hospital recruited subjects. The objective of this trial is to determine if this motivator is as effective in subjects recruited from an NHS primary care unit. Method/Design Subjects will be recruited by mailings using smoking entries on the GP electronic data-base (total practice population = 32,048) to identify smokers who may want to quit. Smoking cessation clinics based on medical centre premises will run for eight weeks. Clinics will be randomised to have the gene-based test for estimation of lung cancer risk or to act as controls groups. The primary endpoint will be smoking cessation at eight weeks and six months. Secondary outcomes will include ranking of the gene-based test with other smoking cessation motivators. Discussion The results will inform as to whether the gene-based test is both effective as motivator and acceptable to subjects recruited from primary care. Trial registration Registered with Clinical Trials.gov, Registration number: NCT01176383.
    BMC Pulmonary Medicine 05/2014; 14(1):77. DOI:10.1186/1471-2466-14-77 · 2.40 Impact Factor
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    • "There is a vast literature on and strong evidence for the effectiveness of tobacco control programs [6], and a recent review concludes that interventions for tobacco cessation in the dental setting significantly can increase tobacco cessation rates [7]. It is also widely acknowledged that tobacco cessation programs are cost-effective, ranging from a few hundred to a few thousand dollars per Quality Adjusted Life Year (QALY) [6,8,9]. Behavioral support and medication, especially in combination, are effective and highly cost-effective as life-saving interventions [10]. "
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    ABSTRACT: Achieving lifelong tobacco abstinence is an important public health goal. Most studies use 1-year follow-ups, but little is known about how good these are as proxies for long-term and life-long abstinence. Also, intervention intensity is an important issue for development of efficient and cost-effective cessation treatment protocols. The study aims were to assess the long-term effectiveness of a high- and a low-intensity treatment (HIT and LIT) for smoking cessation and to analyze to what extent 12-month abstinence predicted long-term abstinence. 300 smokers attending dental or general health care were randomly assigned to HIT or LIT at the public dental clinic. Main outcome measures were self-reported point prevalence, continuous abstinence (≥6 months), and sustained abstinence. The study was a follow-up after 5–8 years of a previously performed 12-month follow-up, both by postal questionnaires. Response rate was 85% (n=241) of those still alive and living in Sweden. Abstinence rates were 8% higher in both programs at the long-term than at the 12-month follow-up. The difference of 7% between HIT and LIT had not change, being 31% vs. 24% for point prevalence and 26% vs. 19% for 6-month continuous abstinence, respectively. Significantly more participants in HIT (12%) than in LIT (5%) had been sustained abstinent (p=0.03). Logistic regression analyses showed that abstinence at 12-month follow-up was a strong predictor for abstinence at long-term follow-up. Abstinence at 12-month follow-up is a good predictor for long-term abstinence. The difference in outcome between HIT and LIT for smoking cessation remains at least 5–8 years after the intervention. Trial registration number NCT00670514
    BMC Public Health 06/2013; 13(1):592. DOI:10.1186/1471-2458-13-592 · 2.26 Impact Factor
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    ABSTRACT: Smoking cessation is the single most effective behavioral change for disease prevention. While almost 20% of the US population smokes, 70% of these smokers indicate they would like to quit. However, only approximately 3-5% of smokers quit without the aid of some intervention. Best practice suggests that every patient who smokes is offered brief behavioral counseling with pharmacotherapy support for smoking cessation. The past decade has presented new pharmacotherapies for tobacco cessation that allow the clinician more options for individualizing therapy to maximize each patient's chance for tobacco abstinence. Nicotine replacement therapy, bupropion sustained release and varenicline are discussed as monotherapies and in combination. As the understanding of neuropharmacology increases and new pharmacotherapies are developed, there will be the possibility of tailoring therapies for individual patients based on genetic predispositions and other individual characteristics.
    Expert Review of Respiratory Medicine 10/2009; 3(5):475-85. DOI:10.1586/ers.09.42
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