COST-EFFECTIVENESS OF A HOSPITAL-BASED SMOKING CESSATION INTERVENTION

OBJECTIVES. This study evaluated the cost-effectiveness of a smoking c essation and relapse-prevention program for hospitalized adult smokers from the perspective of an implementing hospital. It is an economic a nalysis of a two-group, controlled clinical trial in two acute care ho spitals owned by a large group-model health maintenance organization. The intervention included a 20-minute bedside counseling session with an experienced health counselor, a 12-minute video, self-help material s, and one or two follow-up calls. METHODS. Outcome measures were incr emental cost (above usual care) per quit attributable to the intervent ion and incremental cost per discounted life-year saved attributable t o the intervention. RESULTS. Cost Of the research intervention was $15 9 per smoker, and incremental cost per incremental quit was $3,697. In cremental cost per incremental discounted life-year saved ranged betwe en $1,691 and $7,444, much less than most other routine medical proced ures. Replication scenarios suggest that, with realistic implementatio n assumptions, total intervention costs would decline significantly an d incremental cost per incremental discounted life-year saved would be reduced by more than 90%, to approximately $380. CONCLUSIONS. Providi ng brief smoking cessation advice to hospitalized smokers is relativel y inexpensive, cost-effective, and should become a part of the standar d of inpatient care.