‘Real-world’ effectiveness of smoking cessation treatments: a population study

Kotz, Daniel; Brown, Jamie; West, Robert

doi:10.1111/add.12429

Cited by 166 publications

(176 citation statements)

References 42 publications

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“…In contrast to standard NRT, where effectiveness increases with age, varenicline seems equally effective in younger and older people 47. Moreover, in a real‐world setting, varenicline together with specialist behavioural support was very effective 24, 48 and thus offers potential for transferring this evidence outside study environments.…”

Section: Discussionmentioning

confidence: 97%

“…Varenicline has been shown to be more cost‐effective than bupropion 22 for smoking cessation. However, in Germany, over‐the‐counter nicotine replacement therapies (NRT) such as nicotine patches and gums are used significantly more frequently for smoking cessation than prescription drugs (approximately 20 versus 1%) 15, although they are less effective 23, 24.…”

Section: Methodsmentioning

confidence: 99%

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Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

Huber¹,

Präger²,

Coyle

et al. 2017

Addiction

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AimsTo evaluate costs, effects and cost‐effectiveness of increased reach of specific smoking cessation interventions in Germany.DesignA Markov‐based state transition return on investment model (EQUIPTMOD) was used to evaluate current smoking cessation interventions as well as two prospective investment scenarios. A health‐care perspective (extended to include out‐of‐pocket payments) with life‐time horizon was considered. A probabilistic analysis was used to assess uncertainty concerning predicted estimates.SettingGermany.ParticipantsCohort of current smoking population (18+ years) in Germany.InterventionsInterventions included group‐based behavioural support, financial incentive programmes and varenicline. For prospective scenario 1 the reach of group‐based behavioral support, financial incentive programme and varenicline was increased by 1% of yearly quit attempts (= 57 915 quit attempts), while prospective scenario 2 represented a higher reach, mirroring the levels observed in England.MeasurementsEQUIPTMOD considered reach, intervention cost, number of quitters, quality‐of‐life years (QALYs) gained, cost‐effectiveness and return on investment.FindingsThe highest returns through reduction in smoking‐related health‐care costs were seen for the financial incentive programme (€2.71 per €1 invested), followed by that of group‐based behavioural support (€1.63 per €1 invested), compared with no interventions. Varenicline had lower returns (€1.02 per €1 invested) than the other two interventions. At the population level, prospective scenario 1 led to 15 034 QALYs gained and €27 million cost‐savings, compared with current investment. Intervention effects and reach contributed most to the uncertainty around the return‐on‐investment estimates. At a hypothetical willingness‐to‐pay threshold of only €5000, the probability of being cost‐effective is approximately 75% for prospective scenario 1.ConclusionsIncreasing the reach of group‐based behavioural support, financial incentives and varenicline for smoking cessation by just 1% of current annual quit attempts provides a strategy to German policymakers that improves the population's health outcomes and that may be considered cost‐effective.

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Section: Discussionmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

Huber¹,

Präger²,

Coyle

et al. 2017

Addiction

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“…nicotine gum). When used as a stand-alone treatment, it is not more effective than stopping smoking without any aids (Stead and Lancaster, 2012;Kotz et al, 2014). Effectiveness problems are also anticipated for NV as a stand-alone treatment:…”

Section: From Testing Conditions To the Real Worldmentioning

confidence: 99%

Lifestyle Vaccines and Public Health: Exploring Policy Options for a Vaccine to Stop Smoking

Wolters

Wert

Schayck

et al. 2016

Public Health Ethics

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“…This programme has established a method of assessing realworld effectiveness of aids to cessation by comparing the success rates of smokers trying to quit with different methods and adjusting statistically for a wide range of factors that could bias the results, such as nicotine dependence [31]. The method has been able to detect effects of behavioural support and prescription medications to aid cessation and found a higher rate of success when using varenicline than prescription nicotine replacement therapy (NRT) [32,33], supporting findings from randomized controlled trials and clinical observation studies [34][35][36][37]. This method cannot achieve the same level of internal validity as a randomized controlled trial, but clearly has greater external validity, so both are important in determining the potential public health contribution of devices hypothesized to aid cessation, such as e-cigarettes.…”

Section: Introductionmentioning

confidence: 99%

Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study

2014

Br Dent J

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Background and Aims Electronic cigarettes (e-cigarettes) are rapidly increasing in popularity. Two randomized controlled trials have suggested that e-cigarettes can aid smoking cessation, but there are many factors that could influence their real-world effectiveness. This study aimed to assess, using an established methodology, the effectiveness of e-cigarettes when used to aid smoking cessation compared with nicotine replacement therapy (NRT) bought overthe-counter and with unaided quitting in the general population. Design and Setting A large cross-sectional survey of a representative sample of the English population. Participants The study included 5863 adults who had smoked within the previous 12 months and made at least one quit attempt during that period with either an e-cigarette only (n = 464), NRT bought over-the-counter only (n = 1922) or no aid in their most recent quit attempt (n = 3477). Measurements The primary outcome was self-reported abstinence up to the time of the survey, adjusted for key potential confounders including nicotine dependence. Findings E-cigarette users were more likely to report abstinence than either those who used NRT bought over-the-counter [odds ratio (OR) = 2.23, 95% confidence interval (CI) = 1.70-2.93, 20.0 versus 10.1%] or no aid (OR = 1.38, 95% CI = 1.08-1.76, 20.0 versus 15.4%). The adjusted odds of non-smoking in users of e-cigarettes were 1.63 (95% CI = 1.17-2.27) times higher compared with users of NRT bought over-the-counter and 1.61 (95% CI = 1.19-2.18) times higher compared with those using no aid. Conclusions Among smokers who have attempted to stop without professional support, those who use e-cigarettes are more likely to report continued abstinence than those who used a licensed NRT product bought over-the-counter or no aid to cessation. This difference persists after adjusting for a range of smoker characteristics such as nicotine dependence.

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‘Real-world’ effectiveness of smoking cessation treatments: a population study

Cited by 166 publications

References 42 publications

Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

Lifestyle Vaccines and Public Health: Exploring Policy Options for a Vaccine to Stop Smoking

Real-world effectiveness of e-cigarettes when used to aid smoking cessation: a cross-sectional population study

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