Nicotine Dependence and Cost-Effectiveness of Individualized Support for Smoking Cessation: Evidence from Practice at a Worksite in Japan

作者:Nakamura Koshi*; Sakurai Masaru; Miura Katsuyuki; Morikawa Yuko; Nagasawa Shin ya; Ishizaki Masao; Kido Teruhiko; Naruse Yuchi; Suwazono Yasushi; Nakagawa Hideaki
来源:PLos One, 2013, 8(1): e55836.
DOI:10.1371/journal.pone.0055836

摘要

Given the lack of economic studies evaluating the outcomes of smoking cessation programs from the viewpoint of program sponsors, we conducted a case study to provide relevant information for worksites. The present study was carried out between 2006 and 2008 at a manufacturing factory in the Toyama Prefecture of Japan and included subjects who voluntarily entered a smoking cessation program. The program included face-to-face counselling followed by weekly contact to provide encouragement over six months using e-mail or inter-office mail. Nicotine patches were available if required. All 151 participants stopped smoking immediately. Over the 24-month study period, self-report showed 49.7% abstained continuously from smoking. The rate of 24-month consecutive abstinence was higher in participants with lower Fagerstrom Test scores for Nicotine Dependence at baseline than in those with higher scores (63.6% for 0-2 points vs. 46.5% for 3-6 points vs. 43.8% for 7-10 points; chi-square test p = 0.19). A logistic regression model showed a significant linear trend for the association between the score and abstinence status after adjustment for possible confounding factors (p = 0.03). The crude incremental cost for one individual to successfully quit smoking due to the support program was 46,379 (i.e., (sic)100 = $1.28, 0.83 pound, or (sic)1.03 at foreign exchange rates). The corresponding costs for the three categories of the Fagerstrom Test score for Nicotine Dependence were (sic)31,953, (sic)47,450 and 64,956, respectively. When a sensitivity analysis was conducted based on the 95% confidence interval of the success rate, the variance in the corresponding costs was (sic)25,514-45,034 for 0-2 points, (sic)38,344-61,824 for 3-6 points, and (sic)45,698-108,260 for 7-10 points. The degree of nicotine dependence may therefore be an important determinant of the cost-effectiveness of smoking cessation programs.

  • 出版日期2013-1-30