Cost-effectiveness of Nicotine Gum as an Adjunct to Physician's Advice Against Cigarette Smoking

Abstract

A nicotine chewing gum has recently become available for use as an aid in giving up cigarette smoking. Although its efficacy has been demonstrated in clinic-based smoking cessation programs, its value in a primary care setting is uncertain. We examined the cost-effectiveness of nicotine gum as an adjunct to physician's advice and counseling against smoking during routine office visits. Our findings indicate that the cost per year of life saved with this intervention ranges from $4113 to $6465 for men and from $6880 to $9473 for women, depending on age. This compares favorably with other widely accepted medical practices, eg, treatment of hypertension or hyperlipidemia. Our study, therefore, suggests that nicotine gum is a cost-effective adjunct to physician's advice against cigarette smoking in a primary care setting.

Effectiveness and cost-effectiveness of computer and other electronic aids for smoking cessation: a systematic review and network meta-analysis.

“…The cost for each arm was divided by the number of quitters to give a cost per quitter. A value for the number of life-years gained by quitting was taken from Oster et al, 137 a study of nicotine gum published in 1986, which used the American Cancer Society Cancer Prevention Study to estimate the lifeyears (undiscounted and discounted at 5%) gained by quitters as a function of age and gender. Oster et al 137 calculated that the increase in life expectancy would be around 0.8-1.1 discounted life-years for men aged 35-64 years and 0.54-0.65 discounted life-years gained for women aged 35-64 years.…”

“…The cost-effectiveness ratio is given as £37 per quitter if mistargeted participants behaved similarly to the 846 included smokers, or £89 per quitter if none of the mistargeted participants benefitted from the letter in any way. Using the discounted life-years saved (LYS) from Oster et al, 137 the authors translate this into a LYS of between £50 and £122, although this implies the number of discounted LYS as 1.4. Further information on costs/ resource use is not given.…”

Long-term impact of smoking cessation on the incidence of coronary heart disease.

“…It is therefore not surprising that a variety of smoking interventions have been shown to be cost-effective. 11,36 Warner7 also stated that although the incidence of cardiovascular disease would decrease in a smoke free society, the age-unadjusted incidence might increase. Our results provide further evidence in support of this conjecture.…”

An evidence synthesis of qualitative and quantitative research on component intervention techniques, effectiveness, cost-effectiveness, equity and acceptability of different versions of health-related lifestyle advisor role in improving health.

“…Estimates of the effectiveness of brief advice vary, with American estimates being higher than those in the UK. 249,250,254,266,267 We apply an annual quit rate of 4% as assumed in the 2002 HTA assessment of the effectiveness of NRT and bupropion 268 and a cost of £47 based on data from Stapleton et al (£33 in '1998' GBP). 250 Pharmacy services also provide smoking cessation services; we apply the data collected by Boyd and Briggs 269 in a recent evaluation.…”