Valentelyte Gintare, Sheridan Aishling, Kavanagh Paul, Doyle Frank, Sorensen Jan
Converge: Centre for Chronic disease and Population Health Research, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Healthcare Outcome Research Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Tob Prev Cessat. 2024 Jul 12;10. doi: 10.18332/tpc/190617. eCollection 2024.
Financial incentives to stop smoking (FISS) programs have been implemented internationally to encourage people who smoke to quit smoking. However, such programs require that the financial reward structure and its resulting effects on smoking quit rates are considered. We analyzed a number of scenarios for FISS reward schedules for current smoking individuals in Ireland, with a view to identify the potential implications in terms of financial consequences and expected effects.
Using national QuitManager services data 2021-2023, we defined smoking quit rates for smokers currently using the national Health Services Executive stop smoking services in Ireland. Smoking quit rates at 4, 12 and 52 weeks were defined, and additionally defined by sex, age and education level. Using scenarios assuming different FISS reward sizes, structures and targeted population sub-groups, we estimated the number of additional quitters, budget impact, and incremental cost-effectiveness ratio.
A FISS program, if implemented for a cohort of 3500 smokers can result in a budget impact ranging €250000 - €870000. The cost-effectiveness trade-off between different payment schedules and the expected effect size suggested that FISS are cost-effective even at a moderate effect size. A FISS program implemented to approximately 20000 smokers nationally would cost between €2.0 million and €4.8 million, subject to the chosen reward schedule. Across social groups, FISS is more cost-effective for females, individuals in the youngest age group, and individuals with a medium level of education.
This analysis highlights the importance of considering different FISS schedules and potential quit effects, when designing such programs. We highlight that FISS programs should be targeted at certain social groups to achieve highest long-term smoking cessation rates. We also identified important challenges that decision-makers face when designing the reward structure of FISS programs. The acceptability or otherwise of the FISS structures may differ among stakeholders and should be explored.
国际上已实施戒烟经济激励（FISS）项目，以鼓励吸烟者戒烟。然而，此类项目需要考虑经济奖励结构及其对戒烟率的影响。我们分析了爱尔兰当前吸烟者的FISS奖励计划的多种情况，以确定在经济后果和预期效果方面的潜在影响。
利用2021 - 2023年国家戒烟管理服务数据，我们确定了目前在爱尔兰使用国家卫生服务执行局戒烟服务的吸烟者的戒烟率。定义了4周、12周和52周时的戒烟率，并按性别、年龄和教育水平进行了额外定义。通过假设不同的FISS奖励规模、结构和目标人群亚组的情况，我们估计了额外戒烟者的数量、预算影响和增量成本效益比。
如果对3500名吸烟者实施FISS项目，预算影响可能在25万欧元至87万欧元之间。不同支付计划之间的成本效益权衡以及预期效果大小表明，即使在中等效果大小下，FISS也是具有成本效益的。根据所选奖励计划，在全国约20000名吸烟者中实施FISS项目的成本在200万欧元至480万欧元之间。在不同社会群体中，FISS对女性、最年轻年龄组的个体以及中等教育水平的个体更具成本效益。
该分析强调了在设计此类项目时考虑不同FISS计划和潜在戒烟效果的重要性。我们强调FISS项目应针对特定社会群体，以实现最高的长期戒烟率。我们还确定了决策者在设计FISS项目奖励结构时面临的重要挑战。FISS结构的可接受性在利益相关者之间可能存在差异，应加以探讨。
