UK Centre for Tobacco Control Studies, School of Management, University of Stirling, Stirling, FK9 4LA, UK.
Nicotine Tob Res. 2011 Feb;13(2):135-45. doi: 10.1093/ntr/ntq222. Epub 2010 Dec 31.
An observational study examining 1-year follow-up of clients of two National Health Service smoking cessation services in Glasgow was used to inform a cost-effectiveness analysis. One service involved 7 weeks of group-based support (n = 411) and the other consisted of up to 12 weeks of one-to-one counseling with pharmacists (n = 1,374). Pharmacological aids to quitting (e.g., nicotine replacement therapy) were available to all clients.
Quit rates were calculated for each service at 52 weeks after the quit date, and these were used for an economic evaluation of both the annual and the lifetime cost-effectiveness of the pharmacy- and group-based interventions in comparison with a baseline "self-quit" scenario. The annual cost-effectiveness model established the incremental cost per 52-week quitter, while a Markov model was developed for the lifetime analysis to estimate the potential lifetime outcomes in terms of cost per quality-adjusted life years (QALY) gained, to account for the benefits quitters will receive in terms of extended life years and improvements in quality of life from smoking cessation.
The proportion of carbon monoxide-validated quitters from both services combined fell from 22.5% at 4-week follow-up to 3.6% at 52 weeks. The group service achieved a higher quit rate (6.3%) than the pharmacy service (2.8%) but was more intensive and required greater overhead costs. The lifetime analysis resulted in an incremental cost per QALY of £4,800 for the group support and £2,600 for pharmacy one-to-one counseling.
Despite disappointing 1-year quit rates, both services were considered to be highly cost-effective.
一项观察性研究对格拉斯哥的两家国民保健服务戒烟服务的客户进行了为期 1 年的随访，为成本效益分析提供了信息。一项服务涉及 7 周的基于小组的支持（n = 411），另一项服务则由多达 12 周的一对一药剂师咨询组成（n = 1374）。所有客户都可以使用戒烟的药物辅助（例如尼古丁替代疗法）。
在戒烟日期后的第 52 周计算了每项服务的戒烟率，并将这些数据用于对基于药物的和基于小组的干预措施的年度和终生成本效益进行经济评估，与基线“自我戒烟”情景进行比较。年度成本效益模型确定了每 52 周戒烟者的增量成本，而生命周期模型则用于终生分析，以根据每获得一个质量调整生命年（QALY）的成本来估计潜在的终生结果，以考虑戒烟者将从延长的生命年和生活质量的改善中获得的收益。
从两项服务中联合计算得出，经过 4 周随访，经一氧化碳验证的戒烟者比例从 22.5%下降到第 52 周的 3.6%。小组服务的戒烟率（6.3%）高于药剂师服务（2.8%），但更密集，需要更高的间接成本。终生分析导致小组支持的每 QALY 增量成本为 4800 英镑，而一对一的药剂师咨询为 2600 英镑。
尽管 1 年的戒烟率令人失望，但这两种服务都被认为具有很高的成本效益。
