Resources from BTS (Stop Smoking Champions and British Association of Stop Smoking Professionals) , PCRS-UK (opinion sheet) and IPCRG (desktop helper and slide sets).
August 2010: Long-term effectiveness and cost-effectiveness of smoking cessation interventions in patients with COPD
A very good new paper in Thorax 2010;65:711-718 The authors of this Dutch study sought to estimate the impact of smoking cessation interventions for patients with COPD on the future burden of their disease. They note that little is known about the cost-effectiveness of smoking cessation interventions offered to those who already have a smoking related disease such as COPD; and what is available relates to the short-term.
Key findings
The average 12-month continuous abstinence rates were estimated to be 1.4% for usual care (no counselling or pharmacotherapy, or any intervention for smoking cessation) 2.6% for minimal counselling (<90 minutes in total), 6.0% for intensive counselling (≥90 minutes without pharmacotherapy) and 12.3% for pharmacotherapy.
Compared with usual care, the costs per quality-adjusted life year (QALY) gained for minimal counselling, intensive counselling and pharmacotherapy were 16,900, 8200 and 2400 euro, respectively. The results were most sensitive to variations in the estimation of the abstinence rates and discount rates.
Conclusion
Compared with usual care, intensive counselling and pharmacotherapy resulted in low costs per QALY gained with ratios comparable to results for smoking cessation in the general population. Compared with intensive counselling, pharmacotherapy was cost saving and dominated the other interventions.
The authors conclude that their results “confirm the advice given in the guidelines that patients with COPD should be offered the most intensive smoking cessation intervention feasible, not only from a clinical but also from an economic perspective.”
A smokefree future: a comprehensive tobacco control strategy for England
was published by DH England 1 February 2010.
Key quotes from the document:
- Evidence suggests that tobacco use is the primary reason for the gap in healthy life expectancy between rich and poor.
- On average, each smoker who manages to stay off tobacco for the rest of their life gains 3.6 life years.
- Smoking cessation is the single most cost-effective lifesaving intervention provided by the NHS.
- Half of all quit attempts are "assisted quits" – they are made by people with support from NHS Stop Smoking Services or primary care, or using over-the-counter medication. This means that the other half are ‘unassisted (cold turkey) quits’, which have the lowest chance of success.
- The most effective way of stopping smoking is provided by NHS Stop Smoking Services. Quitting with support from NHS Stop Smoking Services is up to four times more likely to result in prolonged abstinence from smoking than quitting without any assistance.
NHS England 2020 aspirations
- Stopping the inflow of young people recruited as smokers: aspiring to reduce the 11–15-year-old smoking rate to 1% or less, and the rate among 16 and 17-year-olds to 8% by 2020.
- Motivating and assisting every smoker to quit: aspiring to reduce adult smoking rates to 10% or less, and halve smoking rates for routine and manual workers, among pregnant women and within the most disadvantaged areas by 2020.
- Protecting our families and communities from tobacco-related harm: aspiring to increase to two-thirds the proportion of homes where parents smoke but that are entirely smokefree indoors by 2020
.png)
With permission from A Smokefree Future