Reach, Efficacy, and Cost-effectiveness of Free Nicotine Medication Giveaway Programs

Cummings, K. Michael; Fix, Brian V.; Celestino, Paula; Carlin-Menter, Shannon; O’Connor, Richard J.; Hyland, Andrew

doi:10.1097/00124784-200601000-00009

Cited by 135 publications

(123 citation statements)

References 13 publications

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“…One intervention that appears promising is free distribution of nicotine replacement therapy (NRT) through state Quitline programs (26). A CEA calculated that an NRT program could be costeffective, with a cost of less than $5000 per QALY (94).…”

Section: Tobacco Controlmentioning

confidence: 99%

Lessons from Cost-Effectiveness Research for United States Public Health Policy

Grosse

Teutsch

Haddix

2007

Annu. Rev. Public Health

111

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The application of cost-effectiveness analysis to health care has been the subject of previous reviews. We address the use of economic evaluation methods in public health, including case studies of population-level policies, e.g., environmental regulations, injury prevention, tobacco control, folic acid fortification, and blood product safety, and the public health promotion of clinical preventive services, e.g., newborn screening, cancer screening, and childhood immunizations. We review the methods used in cost-effectiveness analysis, the implications for cost-effectiveness findings, and the extent to which economic studies have influenced policy and program decisions. We discuss reasons for the relatively limited impact to date of economic evaluation in public health. Finally, we address the vexing question of how to decide which interventions are cost effective and worthy of funding. Policy makers have funded certain interventions with rather high cost-effectiveness ratios, notably nucleic acid testing for blood product safety. Cost-effectiveness estimates are a decision aid, not a decision rule. 365

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Section: Tobacco Controlmentioning

confidence: 99%

Lessons from Cost-Effectiveness Research for United States Public Health Policy

Grosse

Teutsch

Haddix

2007

Annu. Rev. Public Health

111

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“…On the other hand, telephone quitlines are effective 5,8 and offer convenience as well as high costeffectiveness relative to most other interventions for smoking cessation. [9][10][11][12][13] Quitlines currently exist in all US states and throughout the world, reaching a large proportion of smokers annually.…”

mentioning

confidence: 99%

Relapse-Prevention Booklets as an Adjunct to a Tobacco Quitline: A Randomized Controlled Effectiveness Trial

Unrod

Simmons

Sutton

et al. 2015

NICTOB

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IntroductionLong-term smoking cessation is related to decreased mortality and morbidity, 1-3 yet most smokers who achieve short-term abstinence eventually relapse to smoking. Among self-quitting smokers, the relapse rate may be as high as 95%. 4 Among smokers receiving cessation treatment, 70% relapse. 5 Even among smokers who successfully abstain for one full year, 10% eventually return to regular smoking. 6 Consequently, effective interventions aimed at relapse prevention (RP) are essential for long-term cessation and decrease in smoking-related illness.Cognitive behavioral counseling combined with pharmacotherapy is the most effective evidence-based approach to smoking AbstractIntroduction: Relapse prevention (RP) remains a major challenge to smoking cessation. Previous research found that a set of self-help RP booklets significantly reduced smoking relapse. This study tested the effectiveness of RP booklets when added to the existing services of a telephone quitline. Methods: Quitline callers (N = 3458) were enrolled after their 2-week quitline follow-up call and randomized to one of three interventions: (1) Usual Care: standard intervention provided by the quitline, including brief counseling and nicotine replacement therapy; (2) Repeated Mailings (RM): eight Forever Free RP booklets sent to participants over 12 months; and (3) Massed Mailings: all eight Forever Free RP booklets sent upon enrollment. Follow-ups were conducted at 6-month intervals, through 24 months. The primary outcome measure was 7-day-point-prevalence-abstinence. Results: Overall abstinence rates were 61.0% at baseline, and 41.9%, 42.7%, 44.0%, and 45.9% at the 6-, 12-, 18-and 24-month follow-ups, respectively. Although RM produced higher abstinence rates, the differences did not reach significance for the full sample. Post-hoc analyses of at-risk subgroups revealed that among participants with high nicotine dependence (n = 1593), the addition of RM materials increased the abstinence rate at 12 months (42.2% vs. 35.2%; OR = 1.38; 95% CI = 1.03% to 1.85%; P = .031) and 24 months (45% vs. 38.8%; OR = 1.31; 95% CI = 1.01% to 1.73%; P = .046). Conclusions: Sending self-help RP materials to all quitline callers appears to provide little benefit to deterring relapse. However, selectively sending RP booklets to callers explicitly seeking assistance for RP and those identified as highly dependent on nicotine might still prove to be worthwhile.

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“…Recent studies of free NRT distribution programs operated via smoking quitlines demonstrate short-term and long-term effectiveness on smoking cessation among large populations of smokers [6][7][8][9]. Such programs often provide minimal behavioral counseling over the phone; however, research also suggests that cessation outcomes can be improved if smokers are provided with brief behavioral counseling face-to-face from a health professional [10,11].…”

mentioning

confidence: 99%