COST-EFFECTIVENESS OF SMOKING CESSATION MODALITIES - COMPARING APPLESWITH ORANGES

Background. Although the results of self-help and group treatments for smoking cessation are known, the cost effectiveness and participants' characteristics of these treatments remain mostly undetermined. Metho ds. Consecutive samples of 84 self-help manual requesters and 83 group participants in a Dutch community-based smoking cessation program wer e subjected to telephone interviews before treatment and after a 6-mon th follow-up. Participants' baseline characteristics were compared and contrasted with a random sample of nonparticipating smokers (N = 924) , Cost effectiveness rates were computed from the perspectives of the society, the steering group, and the participants. Results. Participan ts appeared to be more ''hardcore smokers'' than nonparticipants, Self -help manual requesters seemed easier quitters than group participants . Self-help was at least three times as cost effective as group treatm ent from the perspective of the program provider and over four times a s cost effective from the viewpoint of the participants. When taking s avings through not smoking into account, return on the social investme nt was positive. Conclusions. From a social perspective, the project s eemed cost effective, compared with medical interventions. Since both modalities attracted different groups of smokers, cost effectiveness c omparisons may incorporate the comparison of apples with oranges, and referral to either modality should be based on smokers' characteristic s and the societal value placed on health as well. (C) 1996 Academic P ress, Inc.