Tobacco cessation program in primary care cost-effective, increased cessation rates

Key takeaways:

• The intervention reduced acute health care costs by an average of $42 per person per month.
• The cost-effectiveness of the program is a “win-win” for patients, policymakers and stakeholders, an expert said.

A tobacco cessation program was cost-effective and increased smoking cessation rates by 7.4%, a study in the American Journal of Preventive Medicine showed.

“The results of this study are particularly promising because our cessation treatment approach not only improved smoking cessation rates but also demonstrated a diminished disease burden, which resulted in the reduction of long-term health care costs associated with smoking-related illnesses,” Marlon P. Mundt, PhD, a professor in the department of family medicine and community health at the University of Wisconsin School of Medicine and Public Health, told Healio.

Mundt and colleagues assessed the costs, cost-effectiveness and savings of the Comprehensive Tobacco Intervention Program (CTIP), a smoking cessation intervention that consisted of electronic health record prompts, opt-out treatment offers and other resources.

CTIP also functioned as a method for addressing tobacco cessation treatment gaps in primary care settings, where the researchers noted only 5% of patients receive treatment.

Mundt and colleagues evaluated the program using 2017 to 2020 data from 10,683 patients in the smoking registry.

Overall, smoking cessation rates rose from 1.3% before CTIP implementation to 8.7% after implementation.

The researchers found that tobacco cessation outreach, counseling and medication costs increased from $2.64 to $6.44 per person per month, equaling a total intervention cost of $500,216 after implementation.

The incremental cost-effectiveness ratio from CTIP was:

• $628 (95% CI, $586-$695) per person who quit smoking; and
• $905 (95% CI, $822-$1,001) per quality-adjusted life year (QALY).

According to Mundt and colleagues, the cost per QALY was significantly below the threshold of $50,000 per QALY that is accepted as showing sufficient cost-effectiveness.

Additionally, acute health care costs decreased by an average of $42 (95% CI, –$59 to $145) per person per month among those in the smoking registry.

“This suggests that the limited financial resources invested in cessation treatment for all primary care patients who smoke could be offset with the reduction in health care costs over time,” Mundt noted.

He added the findings are ultimately a “win-win situation for patients, stakeholders and policymakers.”

“Investment in health-promoting interventions at the health care system level results in better patient health outcomes as well as in health care cost reductions,” he said.

Mundt concluded that a tobacco cessation intervention that includes counseling with either a clinician or a tobacco cessation outreach specialist “improves treatment reach, lowers health disparity, and increases smoking cessation rates and overall well-being while being cost-effective through acute health care offsets.”