Cost-effectiveness of smoking cessation programs for hospitalized patients: a systematic review
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This systematic review examined the characteristics of published cost-effectiveness analyses of inpatient smoking cessation programs and assessed the methodological quality of the selected studies, to provide policymakers with economic evidence for this type of program.
A literature search was undertaken using a relevant database by three investigators. Only full economic evaluations with results in the form of the incremental cost-effectiveness ratio (ICER) were included. Costs were adjusted to 2016 US dollars using the Gross Domestic Product deflator and purchasing power parities. The British Medical Journal checklist was utilized to appraise the methodological quality of the included studies.
Nine articles were ultimately selected. The inpatient smoking cessation programs appeared to be a highly cost-effective intervention according to the recommended cost-effectiveness thresholds by the World Health Organization or individual studies. The highest ICERs among the selected studies were $5593 per additional quit, $10,550 per life year gained, and $5680 per quality-adjusted life year gained.
This study provides robust evidence supporting the cost-effectiveness of smoking cessation programs for hospitalized patients. In addition, the results indicated that the degree of cost-effectiveness of the inpatient smoking cessation program might not be related to either the components of the program or methodological variations in the cost-effectiveness analysis. Policymakers should provide hospitals with resources and strong incentives to promote wider implementation of the smoking cessation program.
KeywordsSmoking cessation Hospitalized patients Cost-effectiveness analysis Systematic review
We are grateful to two anonymous reviewers for helpful comments on an earlier version of this article. This research was partially supported by a grant from the Korean Health Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (Grant No. HI 13C0729).
- 1.National Center for Chronic Disease Prevention and Health Promotion (US), Office on Smoking and Health: The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Centers for Disease Control and Prevention, Atlanta (2014)Google Scholar
- 2.Gronkjaer, M., Eliasen, M., Skov-Ettrup, L.S., Tolstrup, J.S., Christiansen, A.H., Mikkelsen, S.S., Becker, U., Flensborg-Madsen, T.: Preoperative smoking status and postoperative complications: a systematic review and meta-analysis. Ann. Surg. 259, 52–71 (2014). https://doi.org/10.1097/SLA.0b013e3182911913 CrossRefPubMedGoogle Scholar
- 8.National Institute for Health and Care Excellence: Smoking cessation in secondary care: cost-effectiveness review. https://www.nice.org.uk/guidance/ph48/evidence/review-of-cost-effectiveness-pdf-430365277. Accessed 10 Oct 2018
- 10.Liberati, A., Altman, D.G., Tetzlaff, J., Mulrow, C., Gøtzsche, P.C., Ioannidis, J.P.A., Clarke, M., Devereaux, P.J., Kleijnen, J., Moher, D.: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339, b2700 (2009). https://doi.org/10.1136/bmj.b2700 CrossRefPubMedPubMedCentralGoogle Scholar
- 11.Centre for Reviews and Dissemination: Systematic Reviews: CRD’s Guidance for Undertaking Reviews in Health Care. CRD University of York, York (2008)Google Scholar
- 12.Glanville, J., Fleetwood, K., Yellowlees, A., Kaunelis, D., Mensinkai, S.: Development and Testing of Search Filters to Identify Economic Evaluations in MEDLINE and EMBASE. Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa (2009)Google Scholar
- 15.The World Bank: Inflation, GDP deflator (annual %). https://data.worldbank.org/indicator/NY.GDP.DEFL.KD.ZG. Accessed 14 Feb 2018
- 16.Organisation for Economic Co-operation and Development (OECD): Purchasing power parities for GDP and related indicators. https://data.oecd.org/conversion/purchasing-power-parities-ppp.htm. Accessed 14 Feb 2018
- 17.Chiou, C.-F., Hay, J.W., Wallace, J.F., Bloom, B.S., Neumann, P.J., Sullivan, S.D., Yu, H.T., Keeler, E.B., Henning, J.M., Ofman, J.J.: Development and validation of a grading system for the quality of cost-effectiveness studies. Med. Care 41(1), 32–44 (2003). https://doi.org/10.1097/01.MLR.0000039824.73620.E5 CrossRefPubMedGoogle Scholar
- 18.Husereau, D., Drummond, M., Petrou, S., Carswell, C., Moher, D., Greenberg, D., Augustovski, F., Briggs, A.H., Mauskopf, J., Loder, E., ISPOR Health Economic Evaluation Publication Guidelines-CHEERS Good Reporting Practices Task Force: Consolidated Health Economic Evaluation Reporting Standards (CHEERS)–explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health 16(2), 231–250 (2013). https://doi.org/10.1016/j.jval.2013.02.002 CrossRefPubMedGoogle Scholar
- 27.Mullen, K.-A., Coyle, D., Manuel, D., Nguyen, H.V., Pham, B., Pipe, A.L., Reid, R.D.: Economic evaluation of a hospital-initiated intervention for smokers with chronic disease, in Ontario, Canada. Tob. Control 24(5), 489–496 (2015). https://doi.org/10.1136/tobaccocontrol-2013-051483 CrossRefPubMedGoogle Scholar
- 28.Barnett, P.G., Wong, W., Jeffers, A., Hall, S.M., Prochaska, J.J.: Cost-effectiveness of smoking cessation treatment initiated during psychiatric hospitalization: analysis from a randomized, controlled trial. J. Clin. Psychiatry 76(10), e1285–e1291 (2015). https://doi.org/10.4088/JCP.14m09016 CrossRefPubMedPubMedCentralGoogle Scholar
- 29.Berndt, N., Bolman, C., Lechner, L., Max, W., Mudde, A., de Vries, H., Evers, S.: Economic evaluation of a telephone- and face-to-face-delivered counseling intervention for smoking cessation in patients with coronary heart disease. Eur. J. Health Econ. 17(3), 269–285 (2016). https://doi.org/10.1007/s10198-015-0677-x CrossRefPubMedGoogle Scholar
- 34.Hurt, R.D., Dale, L.C., Fredrickson, P.A., Caldwell, C.C., Lee, G.A., Offord, K.P., Lauger, G.G., Marŭsić, Z., Neese, L.W., Lundberg, T.G.: Nicotine patch therapy for smoking cessation combined with physician advice and nurse follow-up. One-year outcome and percentage of nicotine replacement. JAMA. 271(8), 595–600 (1994)CrossRefGoogle Scholar
- 40.Reid, R.D., Mullen, K.A., Slovinec D’Angelo, M.E., Aitken, D.A., Papadakis, S., Haley, P.M., McLaughlin, C.A., Pipe, A.L.: Smoking cessation for hospitalized smokers: an evaluation of the “Ottawa Model”. Nicotine Tob. Res. 12(1), 11–18 (2010). https://doi.org/10.1093/ntr/ntp165 CrossRefPubMedGoogle Scholar
- 41.World Health Organization: Macroeconomics and Health: Investing in Health for Economic Development: Report of the Commission on Macroeconomics and Health. WHO, Geneva (2001)Google Scholar
- 42.Schwarzer, R., Rochau, U., Saverno, K., Jahn, B., Bornschein, B., Muehlberger, N., Flatscher-Thoeni, M., Schnell-Inderst, P., Sroczynski, G., Lackner, M., Schall, I.: Systematic overview of cost-effectiveness thresholds in ten countries across four continents. J. Comput. Eff. Res. 4, 485–504 (2015)CrossRefGoogle Scholar
- 47.Barua, R.S., Rigotti, N.A., Benowitz, N.L., Cummings, K.M., Jazayeri, M.A., Morris, P.B., Ratchford, E.V., Sarna, L., Stecker, E.C., Wiggins, B.S.: 2018 ACC expert consensus decision pathway on tobacco cessation treatment: A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J. Am. Coll. Cardiol. 72, 3332–3365 (2018)CrossRefGoogle Scholar