Cost-effectiveness of extended cessation treatment for older smokers

Aims We examined the cost‐effectiveness of extended smoking cessation treatment in older smokers. Design Participants who completed a 12‐week smoking cessation program were factorial randomized to extended cognitive behavioral treatment and extended nicotine replacement therapy. Setting A free‐standing smoking cessation clinic. Participants A total of 402 smokers aged 50 years and older were recruited from the community. Measurements The trial measured biochemically verified abstinence from cigarettes after 2 years and the quantity of smoking cessation services utilized. Trial findings were combined with literature on changes in smoking status and the age‐ and gender‐adjusted effect of smoking on health‐care cost, mortality and quality of life over the long term in a Markov model of cost‐effectiveness over a lifetime horizon. Findings The addition of extended cognitive behavioral therapy added $83 in smoking cessation services cost [P = 0.012, confidence interval (CI) = $22–212]. At the end of follow‐up, cigarette abstinence rates were 50.0% with extended cognitive behavioral therapy and 37.2% without this therapy (P