A COST-BENEFIT-ANALYSIS OF SMOKING CESSATION PROGRAMS DURING THE 1ST TRIMESTER OF PREGNANCY FOR THE PREVENTION OF LOW-BIRTH-WEIGHT

Background. The frequency of low birthweight decreases when women quit smoking in the first trimester of pregnancy. This analysis examines t he cost-effectiveness of smoking-cessation programs during pregnancy f or the prevention of low birthweight. Methods. Using data from the 198 8 National Health Interview Survey and estimated costs of care for low birthweight and normal birthweight infants, a decision tree was const ructed to estimate break-even costs for smoking-cessation programs, as suming a success rate of 18%. Sensitivity analyses were performed to d etermine how program effectiveness and changes in the population affec ted the break-even costs. Results. For a population similar to that wh ich participated in the 1988 National Health Interview Survey, smoking -cessation programs would be cost-effective if the program cost $80 or less. In general, to be cost-effective, a smoking-cessation program h as to decrease smoking rates by 2.15% to justify every $10 in program costs. Sensitivity analyses showed that as the baseline spontaneous qu it rate in the smoking population decreases, smoking-cessation program s of higher cost become more cost-effective. Conclusions. Smoking cess ation programs during pregnancy may be cost-effective for preventing l ow birthweight if their cost is $80 or less and they achieve success r ates of at least 18%.