Dino Geri, Horn Kimberly, Abdulkadri Abdullahi, Kalsekar Iftekhar, Branstetter Steven
Department of Community Medicine, Prevention Research Center, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA.
Prev Sci. 2008 Mar;9(1):38-46. doi: 10.1007/s11121-008-0082-0. Epub 2008 Feb 20.
Public health researchers and practitioners emphasize the need for effective, adoptable, and available youth smoking cessation interventions. Scarce resources demand that such interventions also be cost effective. This study describes a cost-effectiveness analysis (CEA) of the American Lung Association's Not On Tobacco (N-O-T) national and international teen smoking cessation program. N-O-T has been rigorously evaluated as an effective and adoptable program, and was recently found to be the most frequently-used teen smoking cessation program in the nation. N-O-T studies show intent-to-treat quit rates between 15% and 19%, among the highest reported in the literature. The current CEA resulted from a 2-year state-wide demonstration study in Florida, comparing the effectiveness of N-O-T with a 20-min brief intervention (BI). The CEA utilized a Markov transition model of decision analysis to explain stage progression of smoking cessation among participants from the age of 17 to 25 years. The Markov simulation predicted that out of a cohort of 100 N-O-T students, 10 will quit smoking and remain smoke-free at the age of 25 years and 14 will reduce smoking, resulting in 102.22 life years saved and a total of 20.11 years discounted life years (DLY) saved. Among BI youth, six will quit smoking and nine will reduce, indicating 64.31 life years saved and a total 12.65 DLY saved. The incremental DLY saved is 7.46 years. Results indicate that N-O-T is a very cost-effective option school-based smoking cessation, as cost effective as school-based primary tobacco prevention, and potentially more cost effective than adult tobacco use cessation.
公共卫生研究人员和从业者强调，需要有有效、可采用且可得的青少年戒烟干预措施。资源稀缺要求此类干预措施还需具有成本效益。本研究描述了美国肺脏协会的“不吸烟”（N-O-T）全国及国际青少年戒烟项目的成本效益分析（CEA）。N-O-T已被严格评估为一个有效且可采用的项目，并且最近被发现是该国使用最频繁的青少年戒烟项目。N-O-T研究显示意向性治疗戒烟率在15%至19%之间，是文献中报道的最高水平之一。当前的成本效益分析源自佛罗里达州一项为期两年的全州示范研究，该研究比较了N-O-T与20分钟简短干预（BI）的效果。成本效益分析利用决策分析的马尔可夫转换模型来解释17至25岁参与者戒烟的阶段进展。马尔可夫模拟预测，在100名参与N-O-T项目的学生群体中，10人将在25岁时戒烟并保持无烟状态，14人将减少吸烟，从而节省102.22个生命年，总共节省20.11个贴现生命年（DLY）。在接受简短干预的青少年中，6人将戒烟，9人将减少吸烟，这意味着节省64.31个生命年，总共节省12.65个贴现生命年。节省的增量贴现生命年为7.46年。结果表明，N-O-T是一种非常具有成本效益的基于学校的戒烟选择，与基于学校的初级烟草预防一样具有成本效益，并且可能比成人烟草使用戒烟更具成本效益。
