Danish Institute for Health Services Research, Dampfaergevej 27-29, Copenhagen Ø, Denmark.
Scand J Public Health. 2011 Dec;39(8):785-96. doi: 10.1177/1403494811421416. Epub 2011 Oct 5.
Interventions aimed at reducing the number of smokers are generally believed to be cost effective. However as the cost of the interventions should be paid up front whereas the gains in life years only appear in the future--the budgetary consequences might be a barrier to implementing such interventions.
The aim of the present paper was to assess the long-term cost effectiveness as well as the short-term (10 years) budget consequences of cessation programmes and a smoking ban in enclosed public places.
We develop a population-based Markov model capable of analyzing both interventions and assess long-term costs effectiveness as well as short-term budgetary consequences and outcome gains. The smoking cessation programme model was based on data from the Danish National Smoking Cessation Database (SCDB), while the model of the smoking ban was based on effect estimates found in the literature.
On a population level the effect of a smoking ban has the largest potential compared with the effect of smoking cessation programmes. Our results suggest that smoking cessation programmes are cost saving and generate life-years, whereas the costs per life-year gained by a smoking ban are 40,645 to 64,462 DKK (100 DKK = €13.4). These results are conservative as they do not include the healthcare cost saving related to reduced passive smoking.
Our results indicate that smoking cessation programmes and a smoking ban in enclosed public places both in the short term and the long term are cost-effective strategies compared with the status quo.
旨在减少吸烟者数量的干预措施通常被认为具有成本效益。然而，由于干预措施的成本需要提前支付，而生命年的收益仅出现在未来，因此预算后果可能成为实施此类干预措施的障碍。
本文旨在评估戒烟计划和在封闭公共场所禁烟的长期成本效益以及短期（10 年）预算后果。
我们开发了一种基于人群的马尔可夫模型，能够分析这两种干预措施，并评估长期成本效益以及短期预算后果和结果收益。戒烟计划模型基于丹麦国家戒烟数据库（SCDB）的数据，而禁烟模型则基于文献中发现的效果估计。
在人群层面上，与戒烟计划相比，禁烟的效果潜力最大。我们的结果表明，戒烟计划具有成本效益并产生生命年，而禁烟每获得一个生命年的成本为 40645 至 64462 丹麦克朗（100 丹麦克朗=13.4 欧元）。这些结果是保守的，因为它们不包括与减少被动吸烟相关的医疗保健成本节约。
我们的结果表明，与现状相比，短期和长期的戒烟计划和在封闭公共场所禁烟都是具有成本效益的策略。
