Cost effectiveness analysis of smoking cessation interventions.

OBJECTIVE: To identify which smoking cessation interventions provide the most efficient use of health care resources at a population level.
METHODS: Effectiveness data were obtained from a review of the international literature. Costs and effects of smoking cessation interventions were estimated from the perspective of the Australian Government. Treatment costs and effects were modelled using incremental cost-effectiveness ratios. Assumptions regarding effectiveness, resource use and costs were tested by sensitivity analysis.
RESULTS: From the population perspective, telephone counselling appeared to be the most cost-effective intervention. Adding proactive forms of telephone counselling increased the effectiveness of pharmacotherapies at a low incremental cost and, therefore, this could be a highly cost-effective strategy. Bupropion appeared to be more cost effective than nicotine replacement therapy (NRT). Combined bupropion and NRT did not appear to be cost effective.
CONCLUSIONS: General practitioners should be encouraged to refer patients to telephone quit lines and if prescribing pharmacotherapy consider the addition of telephone counselling. IMPLICATIONS: The results support greater investment in proactive forms of telephone counselling and more formal integration of pharmacotherapies with proactive telephone counselling services as cost-effective strategies for reducing population-level smoking rates.