Department of Behavioural Science and Health, University College London, London, UK.
Health Economics Research Group (HERG), Institute of Environment, Health and Society, Brunel University London, Uxbridge, UK.
Addiction. 2018 Jun;113 Suppl 1(Suppl Suppl 1):19-31. doi: 10.1111/add.14006. Epub 2017 Sep 14.
Estimating 'return on investment' (ROI) from smoking cessation interventions requires reach and effectiveness parameters for interventions for use in economic models such as the EQUIPT ROI tool (http://roi.equipt.eu). This paper describes the derivation of these parameter estimates for England that can be adapted to create ROI models for use by other countries.
Estimates were derived for interventions in terms of their reach and effectiveness in: (1) promoting quit attempts and (2) improving the success of quit attempts (abstinence for at least 12 months). The sources were systematic reviews of efficacy supplemented by individual effectiveness evaluations and national surveys.
Quit attempt rates were estimated to be increased by the following percentages (with reach in parentheses): 20% by tax increases raising the cost of smoking 5% above the cost of living index (100%); 10% by enforced comprehensive indoor public smoking bans (100%); 3% by mass media campaigns achieving 400 gross rating points (100%); 40% by brief opportunistic physician advice (21%); and 110% by use of a licensed nicotine product to reduce cigarette consumption (12%). Quit success rates were estimated to be increased by the following ratios: 60% by single-form nicotine replacement therapy (NRT) (5%); 114% by NRT patch plus a faster-acting NRT (2%);124% by prescribed varenicline (5%); 60% by bupropion (1%); 100% by nortriptyline (0%), 10) 298% by cytisine (0%); 40% by individual face-to-face behavioural support (2%); 37% by telephone support (0.5%); 88% by group behavioural support (1%); 63% by text messaging (0.5%); and 19% by printed self-help materials (1%). There was insufficient evidence to obtain reliable, country-specific estimates for interventions such as websites, smartphone applications and e-cigarettes.
Tax increases, indoor smoking bans, brief opportunistic physician advice and use of nicotine replacement therapy (NRT) for smoking reduction can all increase population quit attempt rates. Quit success rates can be increased by provision of NRT, varenicline, bupropion, nortriptyline, cytisine and behavioural support delivered through a variety of modalities. Parameter estimates for the effectiveness and reach of these interventions can contribute to return on investment estimates in support of national or regional policy decisions.
要估算戒烟干预措施的“投资回报率”（ROI），需要使用经济模型（如 EQUIPT ROI 工具，http://roi.equipt.eu）中的干预措施的覆盖率和有效性参数。本文描述了针对英格兰的这些参数估算值的推导方法，这些估算值可以进行调整，以创建其他国家使用的 ROI 模型。
根据以下方面评估干预措施的覆盖率和有效性：（1）促进戒烟尝试，（2）提高戒烟尝试的成功率（至少 12 个月的戒断）。这些来源是对疗效进行的系统评价，辅以个体有效性评估和全国性调查。
估计以下措施可以增加戒烟尝试率（括号内为覆盖率）：将吸烟成本提高 5%，超过生活成本指数（100%）的税收增加 20%；全面强制执行室内公共吸烟禁令（100%）可增加 10%；实现 400 总评级点的大众媒体宣传（100%）可增加 3%；利用简短的机会性医生建议（21%）可增加 40%；使用经许可的尼古丁产品减少香烟消费（12%）可增加 110%。估计以下措施可以提高戒烟成功率：单一形式尼古丁替代疗法（NRT）（5%）增加 60%（5%）；NRT 贴片加更快作用的 NRT（2%）增加 114%；处方伐尼克兰（5%）增加 124%；安非他酮（1%）增加 60%；去甲替林（0%）增加 100%；西地尼布（0%）增加 298%；尼古丁贴剂增加 40%（2%）；个人面对面行为支持（2%）增加 40%；电话支持（0.5%）增加 37%；小组行为支持（1%）增加 88%；短信支持（0.5%）增加 63%；纸质自助材料（1%）增加 19%。由于缺乏证据，无法获得网站、智能手机应用程序和电子烟等干预措施的可靠、特定于国家的估算值。
税收增加、室内禁烟令、简短的机会性医生建议以及使用尼古丁替代疗法（NRT）减少吸烟都可以提高人群的戒烟尝试率。提供 NRT、伐尼克兰、安非他酮、去甲替林、西地尼布和通过各种方式提供的行为支持可以提高戒烟成功率。这些干预措施的有效性和覆盖率的参数估算值可以为支持国家或地区政策决策的投资回报率估算做出贡献。
