Mudde A N, de Vries H, Strecher V J
Department of Health Education and Promotion, Maastricht University, The Netherlands.
Prev Med. 1996 Nov-Dec;25(6):708-16. doi: 10.1006/pmed.1996.0110.
Although the results of self-help and group treatments for smoking cessation are known, the cost effectiveness and participants' characteristics of these treatments remain mostly undetermined.
Consecutive samples of 84 self-help manual requesters and 83 group participants in a Dutch community-based smoking cessation program were subjected to telephone interviews before treatment and after a 6-month follow-up. Participants' baseline characteristics were compared and contrasted with a random sample of nonparticipating smokers (N = 924). Cost effectiveness rates were computed from the perspectives of the society, the steering group, and the participants.
Participants appeared to be more "hardcore smokers" than nonparticipants. Self-help manual requesters seemed easier quitters than group participants. Self-help was at least three times as cost effective as group treatment from the perspective of the program provider and over four times as cost effective from the viewpoint of the participants. When taking savings through not smoking into account, return on the social investment was positive.
From a social perspective, the project seemed cost effective, compared with medical interventions. Since both modalities attracted different groups of smokers, cost effectiveness comparisons may incorporate the comparison of apples with oranges, and referral to either modality should be based on smokers' characteristics and the societal value placed on health as well.
尽管自助戒烟和团体戒烟治疗的效果已为人所知，但这些治疗的成本效益以及参与者的特征大多仍未确定。
对荷兰一项基于社区的戒烟项目中84名自助手册申请者和83名团体参与者的连续样本，在治疗前和6个月随访后进行电话访谈。将参与者的基线特征与未参与的吸烟者随机样本（N = 924）进行比较和对比。从社会、指导小组和参与者的角度计算成本效益率。
与未参与者相比，参与者似乎更多是“重度吸烟者”。自助手册申请者似乎比团体参与者更容易戒烟。从项目提供者的角度来看，自助治疗的成本效益至少是团体治疗的三倍，从参与者的角度来看则超过四倍。如果将因不吸烟而节省的费用考虑在内，社会投资的回报是积极的。
从社会角度来看，与医疗干预相比，该项目似乎具有成本效益。由于两种方式吸引的是不同群体的吸烟者，成本效益比较可能好比将苹果与橙子进行比较，而且转诊至任何一种方式都应基于吸烟者的特征以及社会对健康的重视程度。
