Stop-smoking programs: More bang for the buck
Study confirms high cost-effectiveness
If you are looking for a wellness program that will add big bucks to your company's bottom line, a new study says smoking cessation programs are the way to go. A year after the Rockville, MD-based Agency for Health Care Policy and Research (AHCPR) issued its smoking cessation guideline, there is new evidence that getting smokers to quit smoking is not only good for their health but extremely cost-effective.
The report, released by the AHCPR and summarized in the Dec. 3 issue of the Journal of the American Medical Association (JAMA), finds that smoking cessation interventions have more payback for dollars spent than almost any other type of intervention program.
According to The Cost Effectiveness of the Clinical Practice Recommendations in the AHCPR Guideline for Smoking Cessation, while all types of smoking cessation treatments were found to be cost-effective, those involving more intensive counseling and the nicotine patch proved to be especially worthwhile.
Even better, you don't have to lay out a lot of money upfront to reap this dividend. Smoking cessation interventions are less costly than other preventive medical interventions, such as the treatment of high cholesterol. In fact, at an average cost of about $2,600 per year of life saved, smoking cessation treatment is especially cost-effective when compared with cholesterol treatment, a routine intervention that costs nearly forty times as much to treat a year.
These findings are based on an analysis of the first-year of implementing the clinical recommendations in AHCPR's Guideline for Smoking Cessation, released in April 1996. The guideline advises clinicians to screen all patients for tobacco use, urges smokers to quit, and provides proven interventions.
The report also found that if the interventions were provided to 75% of U.S. smokers aged 18 years and older, the cost would be $6.3 billion ($32.31 per capita) in the first year of implementation. As a result, society could expect to gain 1.7 million new quitters at an average cost of $3,779 per quitter, $2,587 per life-year saved (the cost to society to gain the extra life-years for smokers who quit through intervention: $6.3 billion/2.4 million total life-years saved), and $1,915 for every quality-adjusted life-year (QALY) saved. Costs per QALY saved ranged from $1,108 to $4,542, with more intensive interventions being more cost-effective. One finding of particular interest to wellness professionals: Group intensive cessation counseling exhibited the lowest cost per QALY saved, but only 5% of smokers appear willing to undertake this type of intervention. This may make a strong argument in favor of self-care.
The report's authors say that net medical costs over a person's lifetime are at least $6,239 higher for smokers during his or her remaining lifetime than for people who never smoked. Subtracting excess medical costs from the guideline's average cost per life-year saved would turn the ratio negative, implying that smoking cessation interventions actually save more in lifetime medical expenditures than they cost, initially.
Copies of the report can be obtained through the AHCPR Clearinghouse. Call (800) 358-9295. Or write to: AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907. The guidelines can be found on the agency's Web site at http://www.ahcpr.gov.
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