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‐stand...
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| Veröffentlicht in: | Addiction (Abingdon, England) England), 2014-02, Vol.109 (2), p.314-322 |
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| creator | Barnett, Paul G. Wong, Wynnie Jeffers, Abra Munoz, Ricardo Humfleet, Gary Hall, Sharon |
| description | 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 |
| doi_str_mv | 10.1111/add.12404 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4020783</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1531929765</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5774-fc389e0c6f20e19d01403d29154562d3601243d082ddbc391f95c2132d8d87c13</originalsourceid><addsrcrecordid>eNqFkdtrFDEUxoModq0--A_IgAj6MG3umbwUym5dL1VfvDyGNDnRaWcmNcn28t-butv1AmIIBJLf-c538iH0mOA9Ute-9X6PUI75HTQjTOIWc87uohnWUrSUcLyDHuR8ijFWneb30Q7ljGqt6Awt5jGXFkIAV_oLmCDnJoYGrgpMHnzj6oUtfZyaksCWEabShJiaOHhITR7jGaT8EN0LdsjwaHPuok8vjz7OX7XHH5av54fHrRNK8TY41mnATgaKgWiPqzPmqSaCC0l9NV6HYB531PsTxzQJWjhKGPWd75QjbBcdrHXPVycjeFfNJDuY89SPNl2baHvz58vUfzNf44XhmNbRWRV4vhFI8fsKcjFjnx0Mg50grrIhghFNtZLi_yjXUgsh8Y3q07_Q07hKU_2JSilFad20Ui_WlEsx5wRh65tgcxOjqTGanzFW9snvg27J29wq8GwD2OzsEJKdXJ9_cR2hshO4cvtr7rIf4PrfHc3hYnHbul1X9LnA1bbCpjMjFVPCfHm_NJ_fiHd4OX9rJPsBYdvBDw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1477227222</pqid></control><display><type>article</type><title>Cost-effectiveness of extended cessation treatment for older smokers</title><source>MEDLINE</source><source>Wiley Journals</source><source>Sociological Abstracts</source><creator>Barnett, Paul G. ; Wong, Wynnie ; Jeffers, Abra ; Munoz, Ricardo ; Humfleet, Gary ; Hall, Sharon</creator><creatorcontrib>Barnett, Paul G. ; Wong, Wynnie ; Jeffers, Abra ; Munoz, Ricardo ; Humfleet, Gary ; Hall, Sharon</creatorcontrib><description>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 < 0.05, odds ratio 1.69, CI 1.18–2.54). The model‐based incremental cost‐effectiveness ratio was $6324 per quality‐adjusted life year (QALY). Probabilistic sensitivity analysis found that the additional $947 in lifetime cost of the intervention had a 95% confidence interval of −$331 to 2081; the 0.15 additional QALYs had a confidence interval of 0.035–0.280, and that the intervention was cost‐effective against a $50 000/QALY acceptance criterion in 99.6% of the replicates. Extended nicotine replacement therapy was not cost‐effective.
Conclusions
Adding extended cognitive behavior therapy to standard cessation treatment was cost‐effective. Further intensification of treatment may be warranted.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/add.12404</identifier><identifier>PMID: 24329972</identifier><identifier>CODEN: ADICE5</identifier><language>eng</language><publisher>Oxford: Blackwell Publishing Ltd</publisher><subject>Abstinence ; Addictive behaviors ; Adult and adolescent clinical studies ; Age ; Aged ; Aged, 80 and over ; Behavior Modification ; Benefit cost analysis ; Biological and medical sciences ; Clinical trial ; Cognition ; cognitive behaviorial treatment ; Cognitive therapy ; Cognitive Therapy - economics ; Cognitive Therapy - methods ; Cost-Benefit Analysis ; cost-effectiveness analysis ; Costs ; Counseling ; Desintoxication. Drug withdrawal ; extended smoking cessation ; Factor analysis ; Female ; Health care ; Humans ; incremental cost-effectiveness ratio ; Intervention ; Male ; Markov model ; Medical sciences ; Middle Aged ; Mortality Rates ; Older people ; Patient Acceptance of Health Care - statistics & numerical data ; Probability ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health ; Quality of Life ; Quality-Adjusted Life Years ; Secondary Prevention ; Smoking ; Smoking cessation ; Smoking Cessation - economics ; Smoking Cessation - methods ; Studies ; Tobacco smoking ; tobacco use cessation ; Tobacco Use Cessation Products - economics ; Tobacco Use Disorder - economics ; Tobacco Use Disorder - therapy ; Tobacco, tobacco smoking ; Toxicology ; Treatment Outcome ; Treatments ; Trials</subject><ispartof>Addiction (Abingdon, England), 2014-02, Vol.109 (2), p.314-322</ispartof><rights>2013 Society for the Study of Addiction</rights><rights>2015 INIST-CNRS</rights><rights>2013 Society for the Study of Addiction.</rights><rights>2014 Society for the Study of Addiction</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5774-fc389e0c6f20e19d01403d29154562d3601243d082ddbc391f95c2132d8d87c13</citedby><cites>FETCH-LOGICAL-c5774-fc389e0c6f20e19d01403d29154562d3601243d082ddbc391f95c2132d8d87c13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fadd.12404$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fadd.12404$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1417,27924,27925,33775,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28126850$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24329972$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Barnett, Paul G.</creatorcontrib><creatorcontrib>Wong, Wynnie</creatorcontrib><creatorcontrib>Jeffers, Abra</creatorcontrib><creatorcontrib>Munoz, Ricardo</creatorcontrib><creatorcontrib>Humfleet, Gary</creatorcontrib><creatorcontrib>Hall, Sharon</creatorcontrib><title>Cost-effectiveness of extended cessation treatment for older smokers</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>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 < 0.05, odds ratio 1.69, CI 1.18–2.54). The model‐based incremental cost‐effectiveness ratio was $6324 per quality‐adjusted life year (QALY). Probabilistic sensitivity analysis found that the additional $947 in lifetime cost of the intervention had a 95% confidence interval of −$331 to 2081; the 0.15 additional QALYs had a confidence interval of 0.035–0.280, and that the intervention was cost‐effective against a $50 000/QALY acceptance criterion in 99.6% of the replicates. Extended nicotine replacement therapy was not cost‐effective.
Conclusions
Adding extended cognitive behavior therapy to standard cessation treatment was cost‐effective. Further intensification of treatment may be warranted.</description><subject>Abstinence</subject><subject>Addictive behaviors</subject><subject>Adult and adolescent clinical studies</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Behavior Modification</subject><subject>Benefit cost analysis</subject><subject>Biological and medical sciences</subject><subject>Clinical trial</subject><subject>Cognition</subject><subject>cognitive behaviorial treatment</subject><subject>Cognitive therapy</subject><subject>Cognitive Therapy - economics</subject><subject>Cognitive Therapy - methods</subject><subject>Cost-Benefit Analysis</subject><subject>cost-effectiveness analysis</subject><subject>Costs</subject><subject>Counseling</subject><subject>Desintoxication. Drug withdrawal</subject><subject>extended smoking cessation</subject><subject>Factor analysis</subject><subject>Female</subject><subject>Health care</subject><subject>Humans</subject><subject>incremental cost-effectiveness ratio</subject><subject>Intervention</subject><subject>Male</subject><subject>Markov model</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality Rates</subject><subject>Older people</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Probability</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health</subject><subject>Quality of Life</subject><subject>Quality-Adjusted Life Years</subject><subject>Secondary Prevention</subject><subject>Smoking</subject><subject>Smoking cessation</subject><subject>Smoking Cessation - economics</subject><subject>Smoking Cessation - methods</subject><subject>Studies</subject><subject>Tobacco smoking</subject><subject>tobacco use cessation</subject><subject>Tobacco Use Cessation Products - economics</subject><subject>Tobacco Use Disorder - economics</subject><subject>Tobacco Use Disorder - therapy</subject><subject>Tobacco, tobacco smoking</subject><subject>Toxicology</subject><subject>Treatment Outcome</subject><subject>Treatments</subject><subject>Trials</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BHHNA</sourceid><recordid>eNqFkdtrFDEUxoModq0--A_IgAj6MG3umbwUym5dL1VfvDyGNDnRaWcmNcn28t-butv1AmIIBJLf-c538iH0mOA9Ute-9X6PUI75HTQjTOIWc87uohnWUrSUcLyDHuR8ijFWneb30Q7ljGqt6Awt5jGXFkIAV_oLmCDnJoYGrgpMHnzj6oUtfZyaksCWEabShJiaOHhITR7jGaT8EN0LdsjwaHPuok8vjz7OX7XHH5av54fHrRNK8TY41mnATgaKgWiPqzPmqSaCC0l9NV6HYB531PsTxzQJWjhKGPWd75QjbBcdrHXPVycjeFfNJDuY89SPNl2baHvz58vUfzNf44XhmNbRWRV4vhFI8fsKcjFjnx0Mg50grrIhghFNtZLi_yjXUgsh8Y3q07_Q07hKU_2JSilFad20Ui_WlEsx5wRh65tgcxOjqTGanzFW9snvg27J29wq8GwD2OzsEJKdXJ9_cR2hshO4cvtr7rIf4PrfHc3hYnHbul1X9LnA1bbCpjMjFVPCfHm_NJ_fiHd4OX9rJPsBYdvBDw</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Barnett, Paul G.</creator><creator>Wong, Wynnie</creator><creator>Jeffers, Abra</creator><creator>Munoz, Ricardo</creator><creator>Humfleet, Gary</creator><creator>Hall, Sharon</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7U4</scope><scope>BHHNA</scope><scope>DWI</scope><scope>WZK</scope><scope>5PM</scope></search><sort><creationdate>201402</creationdate><title>Cost-effectiveness of extended cessation treatment for older smokers</title><author>Barnett, Paul G. ; Wong, Wynnie ; Jeffers, Abra ; Munoz, Ricardo ; Humfleet, Gary ; Hall, Sharon</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5774-fc389e0c6f20e19d01403d29154562d3601243d082ddbc391f95c2132d8d87c13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Abstinence</topic><topic>Addictive behaviors</topic><topic>Adult and adolescent clinical studies</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Behavior Modification</topic><topic>Benefit cost analysis</topic><topic>Biological and medical sciences</topic><topic>Clinical trial</topic><topic>Cognition</topic><topic>cognitive behaviorial treatment</topic><topic>Cognitive therapy</topic><topic>Cognitive Therapy - economics</topic><topic>Cognitive Therapy - methods</topic><topic>Cost-Benefit Analysis</topic><topic>cost-effectiveness analysis</topic><topic>Costs</topic><topic>Counseling</topic><topic>Desintoxication. Drug withdrawal</topic><topic>extended smoking cessation</topic><topic>Factor analysis</topic><topic>Female</topic><topic>Health care</topic><topic>Humans</topic><topic>incremental cost-effectiveness ratio</topic><topic>Intervention</topic><topic>Male</topic><topic>Markov model</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality Rates</topic><topic>Older people</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Probability</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Public health</topic><topic>Quality of Life</topic><topic>Quality-Adjusted Life Years</topic><topic>Secondary Prevention</topic><topic>Smoking</topic><topic>Smoking cessation</topic><topic>Smoking Cessation - economics</topic><topic>Smoking Cessation - methods</topic><topic>Studies</topic><topic>Tobacco smoking</topic><topic>tobacco use cessation</topic><topic>Tobacco Use Cessation Products - economics</topic><topic>Tobacco Use Disorder - economics</topic><topic>Tobacco Use Disorder - therapy</topic><topic>Tobacco, tobacco smoking</topic><topic>Toxicology</topic><topic>Treatment Outcome</topic><topic>Treatments</topic><topic>Trials</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Barnett, Paul G.</creatorcontrib><creatorcontrib>Wong, Wynnie</creatorcontrib><creatorcontrib>Jeffers, Abra</creatorcontrib><creatorcontrib>Munoz, Ricardo</creatorcontrib><creatorcontrib>Humfleet, Gary</creatorcontrib><creatorcontrib>Hall, Sharon</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Sociological Abstracts (pre-2017)</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts</collection><collection>Sociological Abstracts (Ovid)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Barnett, Paul G.</au><au>Wong, Wynnie</au><au>Jeffers, Abra</au><au>Munoz, Ricardo</au><au>Humfleet, Gary</au><au>Hall, Sharon</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of extended cessation treatment for older smokers</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2014-02</date><risdate>2014</risdate><volume>109</volume><issue>2</issue><spage>314</spage><epage>322</epage><pages>314-322</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><coden>ADICE5</coden><abstract>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 < 0.05, odds ratio 1.69, CI 1.18–2.54). The model‐based incremental cost‐effectiveness ratio was $6324 per quality‐adjusted life year (QALY). Probabilistic sensitivity analysis found that the additional $947 in lifetime cost of the intervention had a 95% confidence interval of −$331 to 2081; the 0.15 additional QALYs had a confidence interval of 0.035–0.280, and that the intervention was cost‐effective against a $50 000/QALY acceptance criterion in 99.6% of the replicates. Extended nicotine replacement therapy was not cost‐effective.
Conclusions
Adding extended cognitive behavior therapy to standard cessation treatment was cost‐effective. Further intensification of treatment may be warranted.</abstract><cop>Oxford</cop><pub>Blackwell Publishing Ltd</pub><pmid>24329972</pmid><doi>10.1111/add.12404</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0965-2140 |
| ispartof | Addiction (Abingdon, England), 2014-02, Vol.109 (2), p.314-322 |
| issn | 0965-2140 1360-0443 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4020783 |
| source | MEDLINE; Wiley Journals; Sociological Abstracts |
| subjects | Abstinence Addictive behaviors Adult and adolescent clinical studies Age Aged Aged, 80 and over Behavior Modification Benefit cost analysis Biological and medical sciences Clinical trial Cognition cognitive behaviorial treatment Cognitive therapy Cognitive Therapy - economics Cognitive Therapy - methods Cost-Benefit Analysis cost-effectiveness analysis Costs Counseling Desintoxication. Drug withdrawal extended smoking cessation Factor analysis Female Health care Humans incremental cost-effectiveness ratio Intervention Male Markov model Medical sciences Middle Aged Mortality Rates Older people Patient Acceptance of Health Care - statistics & numerical data Probability Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health Quality of Life Quality-Adjusted Life Years Secondary Prevention Smoking Smoking cessation Smoking Cessation - economics Smoking Cessation - methods Studies Tobacco smoking tobacco use cessation Tobacco Use Cessation Products - economics Tobacco Use Disorder - economics Tobacco Use Disorder - therapy Tobacco, tobacco smoking Toxicology Treatment Outcome Treatments Trials |
| title | Cost-effectiveness of extended cessation treatment for older smokers |
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