A Cost-Effectiveness Analysis of Comprehensive Smoking-Cessation Interventions Based on the Community and Hospital Collaboration

Abstract

BackgroundThe prevalence of cigarette smoking in China is high and the utilization of smoking cessation clinics is very low. Multicomponent smoking cessation interventions involving community and hospital collaboration have the potential to increase the smoking cessation rate. However, the cost-effectiveness of this intervention model is unknown.MethodsWe conducted a smoking cessation intervention trial in 19 community health service centers in Beijing, China. A cost-effectiveness analysis was performed from a societal perspective to compare three strategies of smoking cessation: no intervention (NI), pharmacological intervention (PI), and comprehensive intervention (CI) (PI plus online health promotion). A Markov model, with a time horizon of 20 years, was used to simulate the natural progression of estimated 10,000 male smokers. A cross-sectional survey was conducted to obtain data on costs and quality-adjusted life years (QALYs) by using the five-level EuroQol-5-dimension (EQ-5D-5L) questionnaire. Probabilistic sensitivity analysis was performed to explore parameters of uncertainty in the model.ResultsA total of 680 participants were included in this study, including 283 in the PI group and 397 in the CI group. After 6 months of follow-up, the smoking cessation rate reached 30.0% in the CI group and 21.2% in the PI group. Using the Markov model, compared with the NI group, the intervention strategies of the PI group and the CI group were found to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of $535.62/QALY and $366.19/QALY, respectively. The probabilistic sensitivity analysis indicated that the CI strategy was always the most cost-effective intervention.ConclusionCI for smoking cessation, based in hospital and community in China, is more cost-effective than PI alone. Therefore, this smoking cessation model should be considered to be implemented in healthcare settings.

Environment and social support for smoking cessation among community smokers in Beijing, China

“…There was no significant difference in the effect of tobacco control intervention between those who had quit and those who did not quit (p>0.05). The specific intervention plan is described elsewhere 15 , 18 . The community smoking cessation intervention group comparisons are shown in Tables 2 and 3 .…”

“…Using convenience sampling, we selected 19 community health service centers with stable population and chronic disease management as the survey objects in Beijing. Data were collected from December 2018 to December 2019 15 . Community doctors and community managers were responsible for recruiting smokers who were willing to participate in the smoking cessation programs and face-to-face interviews by trained investigators were used to obtain data for 683 participants 15 .…”

“…Data were collected from December 2018 to December 2019 15 . Community doctors and community managers were responsible for recruiting smokers who were willing to participate in the smoking cessation programs and face-to-face interviews by trained investigators were used to obtain data for 683 participants 15 .…”

“…Those who were included 15 were smokers who: 1) had smoked for ≥6 months and had smoked within 30 days prior to the survey, 2) had not currently used other methods to quit smoking, 3) could verbally communicate fluently, and 4) were willing to take part in the follow-up.…”

“…Those who were excluded 15 were: 1) non-smokers, 2) smokers who had participated in another smoking cessation program, 3) reluctant to participate in smoking cessation programs, 4) pregnant or breast feeding, and 5) suffering from a serious illness that prevented them from being able to participate physically or mentally.…”