A smoking cessation counsellor: should every hospital have one?

The study was performed in order to ascertain the sustained smoking cessati on rate in hospital patients who received a structured programme of advice and support from a counsel and to estimate the cost-effectiveness of such a n intervention. Hospital in-patients and out-patients were referred by thei r physician/surgeon to the smoking cessation counsellor who provided advice to reinforce that of the doctor and gave support by repeated follow-up ses sions, weekly in the first month and thereafter at three, six and twelve mo nths. Of 1,155 patients referred to the counsellor, 114 (13%) failed to kee p the first appointment and 348 (30%) attended for advice on one occasion o nly. Among the latter, the self-reported sustained cessation rate at one ye ar was 5%. In the 663 patients who participated in the programme the valida ted (expired air CO) 12-month, sustained cessation rate was 21%. Allowing 7 .5% success rate among patients receiving a physician's advice only, the co st of each additional success achieved as a result of the programme is poun d 851 and the cost per life year saved is between pound 340 and pound 426. Assuming that after one year's abstinence relapse rates are relatively smal l, this represents a sound investment in the light of the cost of treating patients with smoking-related illnesses and compares favourably with Other smoking cessation strategies and health, care interventions.