Pacific Institute for Research and Evaluation, Beltsville, Maryland, School of Public Health, Curtin University, Perth, Australia.
Pacific Institute for Research and Evaluation, Beltsville, Maryland, School of Public Health, Curtin University, Perth, Australia.
Am J Prev Med. 2023 Jul;65(1):39-44. doi: 10.1016/j.amepre.2023.01.006. Epub 2023 Jan 28.
Americans of lower SES use tobacco products at disproportionately high rates and are over-represented as patients of emergency departments. Accordingly, emergency department visits are an ideal time to initiate tobacco treatment and aftercare for this vulnerable and understudied population. This research estimates the costs per quit of emergency department smoking-cessation interventions and compares them with those of other approaches.
Previously published research described the effectiveness of 2 multicomponent smoking cessation interventions, including brief negotiated interviewing, nicotine replacement therapy, quitline referral, and follow-up communication. Study 1 (collected in 2010-2012) only analyzed the combined interventions. Study 2 (collected in 2017-2019) analyzed the intervention components independently. Costs per participant and per quit were estimated separately, under distinct intervention with dedicated staff and intervention with repurposed staff assumptions. The distinction concerns whether the intervention used dedicated staff for delivery or whether time from existing staff was repurposed for intervention if available.
Data were analyzed in 2021-2022. In the first study, the cost per participant was $860 (2018 dollars), and the cost per quit was $11,814 (95% CI=$7,641, $25,423) (dedicated) and $227 per participant and $3,121 per quit (95% CI=$1,910, $7,012) (repurposed). In Study 2, the combined effect of brief negotiated interviewing, nicotine replacement therapy, and quitline cost $808 per participant and $6,100 per quit (dedicated) (95% CI=$4,043, $12,274) and $221 per participant and $1,669 per quit (95% CI=$1,052, $3,531) (repurposed).
Costs varied considerably per method used but were comparable with those of other smoking cessation interventions.
社会经济地位较低的美国人过度使用烟草制品，并且在急诊科患者中所占比例过高。因此，急诊科就诊是为这个脆弱且研究不足的人群启动烟草治疗和后续护理的理想时机。本研究估计了急诊科戒烟干预措施的每例戒烟成本，并将其与其他方法进行了比较。
先前发表的研究描述了两种多成分戒烟干预措施的有效性，包括简短协商访谈、尼古丁替代疗法、戒烟热线转介和随访沟通。研究 1（收集于 2010-2012 年）仅分析了联合干预措施。研究 2（收集于 2017-2019 年）独立分析了干预措施的组成部分。根据是否有专门人员提供干预措施，或者是否可以重新分配现有工作人员的时间来提供干预措施，分别估计了每个参与者和每个戒烟者的成本。
数据于 2021-2022 年进行分析。在第一项研究中，每个参与者的成本为 860 美元（2018 年美元），每个戒烟者的成本为 11814 美元（95%CI=7641 美元，25423 美元）（专用）和 227 美元/参与者和 3121 美元/戒烟者（95%CI=1910 美元，7012 美元）（重新分配）。在第二项研究中，简短协商访谈、尼古丁替代疗法和戒烟热线的综合效果为每个参与者 808 美元，每个戒烟者 6100 美元（专用）（95%CI=4043 美元，12274 美元）和每个参与者 221 美元和每个戒烟者 1669 美元（95%CI=1052 美元，3531 美元）（重新分配）。
使用的方法不同，成本差异很大，但与其他戒烟干预措施相当。
