Marlon P Mundt1, Timothy B Baker2, David L Fraser3, Stevens S Smith2, Megan E Piper2, Michael C Fiore2. 1. Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. Electronic address: marlon.mundt@fammed.wisc.edu. 2. Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 3. Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Abstract
OBJECTIVES: To determine the cost-effectiveness of an incentive-based stop-smoking intervention that paid Medicaid recipients who smoke to take calls from a tobacco quit line. METHODS: A cost-effectiveness analysis was conducted alongside a randomized controlled trial. The analysis was conducted from a health care systems perspective on the basis of costs and effectiveness over a 6-month follow-up. Participants (n = 1900) were recruited from May 2013 to June 2015 through quit line (n = 980), clinic-based (n = 444), or community-based (n = 476) referrals. Incentive group participants (n = 948) received $30 a call for taking up to five tobacco quit line calls and $40 for biochemically verified tobacco abstinence at 6 months. Control group participants (n = 952) did not receive financial incentives for taking quit line calls. Intervention resource costs included incentive payments to participants, counselor and administrative staff time, and smoking cessation medications. Smoking status at baseline and 6 months was determined for all study participants via carbon monoxide (CO) breath tests (abstinence: CO < 7 ppm). Cost-effectiveness analysis calculated the incremental cost-effectiveness ratio (ICER). RESULTS: Incentive treatment produced higher 6-month CO-confirmed 7-day point-prevalence abstinence than did the control treatment (21.6 vs. 13.8%; P < 0.001). The ICER of the financial incentives intervention was $2316 (95% confidence interval $1582-$4270) per additional person who quit. The study ICER compares favorably with other smoking treatments, such as varenicline combined with proactive telephone counseling, whose ICER has been estimated at $2600 per additional smoker who quits. CONCLUSIONS: Use of financial incentives to engage with tobacco quit line treatment is a cost-effective option to enhance smoking cessation rates for low-income smokers.
RCT Entities:
OBJECTIVES: To determine the cost-effectiveness of an incentive-based stop-smoking intervention that paid Medicaid recipients who smoke to take calls from a tobacco quit line. METHODS: A cost-effectiveness analysis was conducted alongside a randomized controlled trial. The analysis was conducted from a health care systems perspective on the basis of costs and effectiveness over a 6-month follow-up. Participants (n = 1900) were recruited from May 2013 to June 2015 through quit line (n = 980), clinic-based (n = 444), or community-based (n = 476) referrals. Incentive group participants (n = 948) received $30 a call for taking up to five tobacco quit line calls and $40 for biochemically verified tobacco abstinence at 6 months. Control group participants (n = 952) did not receive financial incentives for taking quit line calls. Intervention resource costs included incentive payments to participants, counselor and administrative staff time, and smoking cessation medications. Smoking status at baseline and 6 months was determined for all study participants via carbon monoxide (CO) breath tests (abstinence: CO < 7 ppm). Cost-effectiveness analysis calculated the incremental cost-effectiveness ratio (ICER). RESULTS: Incentive treatment produced higher 6-month CO-confirmed 7-day point-prevalence abstinence than did the control treatment (21.6 vs. 13.8%; P < 0.001). The ICER of the financial incentives intervention was $2316 (95% confidence interval $1582-$4270) per additional person who quit. The study ICER compares favorably with other smoking treatments, such as varenicline combined with proactive telephone counseling, whose ICER has been estimated at $2600 per additional smoker who quits. CONCLUSIONS: Use of financial incentives to engage with tobacco quit line treatment is a cost-effective option to enhance smoking cessation rates for low-income smokers.
Authors: Kevin G Volpp; Andrea B Troxel; Mark V Pauly; Henry A Glick; Andrea Puig; David A Asch; Robert Galvin; Jingsan Zhu; Fei Wan; Jill DeGuzman; Elizabeth Corbett; Janet Weiner; Janet Audrain-McGovern Journal: N Engl J Med Date: 2009-02-12 Impact factor: 91.245
Authors: Beth C Bock; George D Papandonatos; Marcel A de Dios; David B Abrams; Munawar M Azam; Mark Fagan; Patrick J Sweeney; Michael D Stein; Raymond Niaura Journal: Nicotine Tob Res Date: 2013-10-30 Impact factor: 4.244
Authors: Prabhat Jha; Chinthanie Ramasundarahettige; Victoria Landsman; Brian Rostron; Michael Thun; Robert N Anderson; Tim McAfee; Richard Peto Journal: N Engl J Med Date: 2013-01-24 Impact factor: 91.245
Authors: Marlon P Mundt; Timothy B Baker; Megan E Piper; Stevens S Smith; David L Fraser; Michael C Fiore Journal: Tob Control Date: 2019-05-30 Impact factor: 7.552
Authors: Douglas E Levy; Susan Regan; Giselle K Perez; Alona Muzikansky; Emily R Friedman; Julia Rabin; Nancy A Rigotti; Jamie S Ostroff; Elyse R Park Journal: JAMA Netw Open Date: 2022-06-01
Authors: Olivier Drouin; Ryoko Sato; Jeremy E Drehmer; Emara Nabi-Burza; Bethany Hipple Walters; Jonathan P Winickoff; Douglas E Levy Journal: JAMA Netw Open Date: 2021-04-01
Authors: Charlotta Pisinger; Cecilie Goltermann Toxværd; Mette Rasmussen Journal: Int J Environ Res Public Health Date: 2022-08-31 Impact factor: 4.614
Authors: Darla E Kendzor; Michael S Businelle; Joseph J C Waring; Ashley J Mathews; Daryl W Geller; Jocelyn M Barton; Adam C Alexander; Emily T Hébert; Chaelin K Ra; Damon J Vidrine Journal: JMIR Mhealth Uhealth Date: 2020-04-15 Impact factor: 4.773